bluuebunny/crossref_metadata_2025 huggingface dataset:
Carbapenemase-producing Enterobacteriaceae (CPE) patient notification exercise
Authors: Murphy L , Tysall L , Wellington L , Guthrie L , Inverarity D , Willocks L , Czarniak E , McCallum A , Gillies T
Published: November 2019

Issue

CPE has become endemic in many European countries. Scotland has few locally acquired cases at present and interventions are aimed at minimising transmission of CPE into acute hospital settings.

Description of the problem

NHS Lothian held an incident management team (IMT) following the transmission of CPE in an inpatient setting. Initial management of the incident included informing and screening all inpatient contacts, enhanced infection control precautions and staff education. The IMT considered whether to inform and screen patient contacts who had been discharged. A literature review was carried out and teams in the UK who had considered patient notification exercises for CPE were contacted. This highlighted variation in approach.

The IMT assessed whether a patient notification exercise was required and considered: The need to reduce the risk of CPE transmission in acute hospitals by screening and isolating community contacts on readmission to hospital.The ethics of raising patient anxiety around CPE transmission with limited options for effective treatment.Risk stratification to identify contacts at highest risk.Information Governance: electronic tagging of case notes if patients have not been informed.

Results

The IMT agreed that a patient notification was appropriate. Contacts were risk assessed to determine those at greatest risk of CPE transmission. After speaking to GPs, 33 patients were sent letters. No screening of community contacts was advised unless they were re-admitted to an acute hospital or resided in a care facility. No further CPE reports have been linked to the situation.

Lessons

The IMT worked through the issues systematically to protect the public’s health without infringing their rights. The IMT advised that the Scottish CPE toolkit should be revised to support future Incidents including how to analyse transmission pathways, undertake patient notification exercises and meet public health ethics standards.

Key messages

There needs to be clear guidance on how to manage contacts of patients with CPE once discharged from hospital. Team work between Public health and Infection control is essential in manageing incidents of CPE in hospitals.
An objective structured clinical examination to assess the communication skills of students
Authors: Bekbergenova Z , Derbissalina G , Umbetzhanova A , Alibekova G , Mauletbayeva G , Akhmetova D , Zhunussova D , Koikov V
Published: November 2019

Background

Communicative competence is one of the important components of professional competence that needs to be developed in the process of training future doctors.

Methods

At the end of the study of the “General Practice” module, students of the 5th year of the specialty General Medicine must pass a two-stage exam consisting of comprehensive testing and acceptance of practical skills of an objective structured clinical exam (OSKE) with the participation of volunteers. Students, who passed the exam, anonymously filled out the questionnaire on the evaluation of the organization of the OSKE with volunteers and their communication skills.

Results

The analysis of the questionnaires showed that 4% of the students noted the unfriendliness of the volunteers, 27% wrote that it was difficult to engage with the volunteers in the collection of the anamnesis, 2% of the students, unfortunately, had never before encountered a similar situation. 12% of students who passed the exam wished to improve the communication skills of the volunteers themselves, for example, they advised to speak louder, not to ask unnecessary and unnecessary questions, to get more real in the role of the patient. Only 10% of examinees decided that OSKE did not develop their communication skills; 24% noted individual stations, which caused them some difficulties. However, the students themselves acknowledged their poor preparedness, including during communication with standardized patients.

Conclusions

The analysis of the questionnaires showed that the students themselves are self-critical of their communication skills and recognize the need for their continuous improvement.

Key messages

The student’s communicative competence can be assessed by conducting an objective structured clinical examination. Conducting an objective structured clinical examination with volunteers can improve the communicative competence of students.
Formative dialogue research - an appropriate strategy in community public health projects?
Authors: Ausland L H , Stang I
Published: November 2019

Background

Lately, there has been a call for knowledge-based community public health strategies and for evaluating local public health interventions. In addition to contributing to the public health knowledge base, it is underlined that the evaluations should be formative for ongoing local processes. The community professionals often lack evaluation competency, and a university course (10 ECTS) about process- and self-evaluation has been developed and facilitated for local public health workers. Vestfold County Council and University of South-Eastern Norway have collaborated to develop the course. The course has a particular focus on Formative Dialogue Research (FDR). FDR strategies may emphasize both project impact and processes, and local competences. The FDR approaches also contributes to the public health knowledge base (Rønningen 2010).

Objective

To examine and discuss whether FDR in combinations with an evaluation course, may be an appropriate strategy to meet the new expectations for community public health evaluations.

Results

Preliminary results indicate that FDR in combination with a evaluation course, may be an appropriate and desirable approach in community public health projects. The local public health professionals welcome the course. The focus has until now been on the development of the course and the cooperation and dialogues between the university and the county. Questionnaire and interview data collected in September 2019 will exemplify and nuance these preliminary results.

Conclusions

So far, the developing process indicate that FDR in combination with a course in self- and process evaluation, support FDR as an appropriate evaluation approach in community public health projects and processes.

Key messages

The local public health workers often lack competences in project evaluation. FDR in combination with a comprehensive course in process and self-evaluation seem appropriate evaluation approaches in community public health projects.
The role of Emotional Intelligence in health care professionals burnout
Authors: Arnone R , Cascio M I , Parenti I
Published: November 2019

The purpose of this study is to explore the relationship between Emotional Intelligence (EI) and burnout in health care professionals. More specifically, this survey has the purpose of demonstrating the role of EI as a protective factor against the risk of burnout. Health professionals (doctors, nurses, and other caregivers) composed the sample. Health care professionals were invited to complete the following tests: Self Report Emotional Intelligence Test (Schutte et al., 1998; it. ad. Craparo, et al.[35]); Link Burnout Questionnaire,LBQ; Other variables, such as gender, lenght of service (years of professional experience) and organizational department. Major results of this survey underline the relationship between EI and burnout. More specifically, there is a negative and significant correlation between burnout and Emotional Intelligence. Moreover, burnout varies depending on length of service: burnout increases between 5 and 10 years of experience and decreases over 10 years. Indeed, burnout is differently expressed amongst healthcare professionals: more specifically, Psycho-physical exhaustion, Detriment of the relationships and Burnout (total score) impact physician (doctors) more than other investigated health professionals.

These findings seem to suggest the opportunity to improve Emotional Intelligence abilities through specific training programs, useful to promote the ability to cope with stress and to enrich the relationships in the workplace.

Key messages

Burnout is more diffuse among health professionals working in emergency departments. Emotional intelligence has the role to cope with burnout.
The depression phenotype in a European population-based study
Authors: Cuschieri S , Mamo J
Published: November 2019

Introduction

Depression is a growing public health concern and associated with a number of co-morbidities including diabetes mellitus. The aim was to estimate the prevalence of depression at a population level across different glycaemic statuses while establishing phenotypic characteristics of this sub-population.

Methods

A national representative cross-sectional study was conducted in Malta (2014-6). Participants were categorized into different sub-populations according to their glycaemic status. Depression prevalence rates and bio-socio-economic characteristics for each sub-population were established. Multiple regression analyses performed to identify links between glycaemic status and depression.

Results

Depression was prevalent in 17.15% of our study population (CI 95%: 16.01 - 18.36) with a female predominance. The normoglycaemic sub-population had the highest depression rates. Persons with known diabetes had a higher probability of having a history of depression (OR:2.36 CI 95%:1.12 - 4.96), as well as with being of female gender, having lower educational status, smoking tobacco and having established cardiovascular disease.

Conclusions

Depression was highly prevalent among the normoglycaemic population. Primary care physicians should implement a depression screening tool as part of their routine health check-ups, with special attention to those with cardiovascular co-morbidities and low socioeconomic status.

Key messages

Depression prevalent mostly in the normoglycemic population. Screening for depression should be part of routine health check-ups.
Depressive symptoms and suicidal ideation among medical students: a cross-sectional survey in Turin
Authors: Lo Moro G , Bert F , Olivero E , Rossello P , Corradi A , Barello S , Leombruni P , Gualano M R , Siliquini R
Published: November 2019

Background

A high prevalence of mental illnesseshave been detected in medical students (MS) during college. The aim of this study was to evaluate depressive symptoms (DS) and suicidal ideation (SI) in MS and estimate factors that can influence these conditions.

Methods

In November 2018 a cross-sectional survey was conducted at the School of Medicine of Turin, Italy. The questionnaire consisted of a 30-item sociodemographic part and 3 psychometric tests, including the Beck Depression Inventory II (BDI-II). Overall, 506 surveys were collected. Multivariable logistic regressions were performed mainly. The significance level was p ≤ 0.05.

Results

Females were 65% and median age was 22 (IQR 19-24). Median BDI-II score was 9 (IQR 4-15). Presence of DS (BDI-II score>13) and of SI was found in 29% and 15% of the sample, respectively. Preliminary results showed that females (OR 2.03, CI: 1.16-3.56), non-heterosexuals (OR 2.69, CI: 1.49-4-84), participants negative about their college choice (OR 4.79, CI: 2.78-8.26) had a higher risk to report DS. MS who consider unsatisfying their friendships with classmates had a higher likelihood of reporting DS and SI (OR 3.10, CI: 1.16-8.30; OR 2.91, CI: 1.10-7.68, respectively). While the opposite was for those with good economic condition (OR 0.39, CI: 0.16-0.91; OR 0.21, CI: 0.09-0.52, respectively) and those practicing sports more than 90 min/week (OR 0.60, CI: 0.37-0.99; OR 0.47, CI: 0.25-0.89, respectively). Choosing Medicine for profit was related to a higher risk of reporting SI (OR 3.36, CI: 1.43-7.92), having a good family bond to a lower risk instead (OR 0.42, CI: 0.20-0.84).

Conclusions

Since depression is the leading cause of disability worldwide, it has to be a public health priority in Europe. It is essential to consider MS as at risk and set up interventions to improve factors surrounding them and help them to face difficulties in personal and academic life, without forgetting that they will be the future health professionals.

Key messages

Females, non-heterosexuals, students negative about Medical School choice and students unsatisfied with their friendships with classmates had a higher risk of reporting depressive symptoms. Students unsatisfied with their friendships with classmates and students who chose Medical School for profit had a higher risk of reporting suicidal ideation.
Mapping of early intervention programs for psychosis in France in 2018
Authors: Courouve L , Duburcq A , Gozlan G , Meunier-Cussac S , Lecardeur L , Krebs M O
Published: November 2019

Early intervention programs (EIP) have been developed in many countries (United States, Europe, Canada) and are now widely considered effective in the treatment of early psychosis. In France, current national policies in the field of mental health promote the development of early intervention but France has not yet met national standards of care for EIP. A recent report from the London School of Economics (2016) even mentioned the delay of France in this area, referring to only one EIP in the country. A preliminary investigation conducted in 2017 showed a strong dynamic with many ongoing projects which led us to renew this investigation in 2018.

This was a two-phase study. First, an inventory was achieved through a bottom-up approach and many contacts across the country which may either provide this kind of care or know of such initiatives: psychiatrists, healthcare facilities or Health Regional Agencies. Then, an online declarative survey was administered covering structure of attachment, dedicated team, funding, targeted population, activity in 2017, difficulties and prospects. Between May and October 2018, 69 EIP were identified in France: 35 were operational and 34 were being established or beginners. The 35 identified operational programs were located throughout the country with a few disparities. Half of the programs had been existing for 2 years (17/35). All programs operated with multidisciplinary teams, including at least one psychiatrist and with a mean of 5.9 dedicated full-time equivalents workers. Half of the programs offered case management (48.6%). Most programs were not as a specific setting and had mixed activities, including chronic patients with schizophrenia and most programs offered an integration of ambulatory follow-up in the living environment for some patients (77.1%).

A real dynamic has been launched in France. This study will help to improve visibility of programs and to harmonize and ensure a high level of care.

Key messages

This study shows that a real dynamic has been launched in France. This study shows a need for teams to harmonize and standardize practices of care.
Building Resilience in Adolescents and Youths - The Maltese Scene
Authors: Cachia J M
Published: November 2019

The Office of the Commissioner for Mental Health in Malta was established in 2011 to promote and protect rights of persons with mental disorders and their carers. This advocacy role includes monitoring of involuntary care, regular reporting on quality of care and care environments, in-depth analysis and recommendations on emerging issues such as mental health literacy, multidisciplinary care plans, drug addiction services and stigma and regular networking across ministries, agencies, departments, and NGOs, breaking silos and building bridges.

Data for 2018 shows that acutely ill young people (10-29 year olds) were 30% of acute involuntary admissions. Males and foreign nationals from medium and least developed countries were more frequently represented. Substance abuse, mood disorders and psychotic disorders were the more common diagnostic groups. Building resilience and providing opportunities for early intervention are key elements of better mental health and well-being in the younger generation.

Six examples of good practice in adolescent and youth mental health from Malta will be presented: Youth.inc by AÄ¡enzija Å»gÄ§aÅ¼agÄ§; Kellimni.com by SOS Malta; Youth Mental Health First Aid by Richmond Foundation; Research and Professional Education by ACAMH (Malta); Student Support Services at MCAST MALTA; Project Enlight! by Enlight Foundation. Two of these initiatives were recognised as best practices at European level in a peer learning exercise conducted by the Dutch Youth Institute.

The recommendations are: more focused approaches towards young people with acute mental disorders with special attention to their specific needs; the identification of young people in trouble; work programmes that build resilience, life-skills and employment prospects; the intensified use of refined electronic and social media tools for promotion, prevention and early intervention; and active support and encouragement of peer group development and self-help initiatives.

Key messages

Networking stakeholders to break silos and build bridges. Resilience and early intervention for better mental health and well-being.
Psychotropic drug purchases among Finnish disability pension applicants with mental disorders
Authors: Perhoniemi R , Blomgren J , Laaksonen M , Tuulio-Henriksson A
Published: November 2019

Purpose

Trajectories of psychotropic drug purchases around disability pension process have only been studies among awarded applicants. The aim was to follow and compare psychotropic drug purchases between awarded and rejected applicants before and after the application ruling, and to analyse whether such differences are affected by diagnostic group and sociodemographic background.

Methods

A representative 70% sample of Finnish adults applying disability pension due to mental or behavioral disorder in 2009-2011 (N = 18,087) were followed for four eight years in three-month periods. Registers of purchased psychotropic drugs measured in defined daily doses (DDDs), gender, age, occupational class, unemployment history, and diagnostic group were used. The DDD levels and trends were analysed using growth curve models.

Results

The average purchased DDDs of psychotropic drugs increased before the application ruling and decreased gradually thereafter among both awarded and rejected applicants. Before the application ruling the DDD level was higher for the rejected applicants. However, the increase in DDDs was steeper for awarded applicants. The inversed U-curve of purchase amount was most prominent awarded applicants in diagnostic groups of bipolar disorders, depression, anxiety disorders and schizophrenia. The results partly varied between sociodemographic groups.

Conclusions

The early high level of psychotropic drug purchases of rejected disability pension applicants signals long running ill-health, calling for earlier measures to uphold their functional ability. Respectively, for awarded applicants, the steep DDD increase before the ruling may reflect accurate identification of worsening condition but also access to precise treatment.

Key messages

Rejected disability pension applicants with mental disorders suffer from long-running mental ill-health, calling for earlier measures to uphold their mental health and prevent the pension process. Awarded disability pension applicants with mental disorders may have access to more precise treatment, but their worsening condition appear to be accurately identified by Finnish system.
Assessment of Cognitive Reserve: a pilot study for Bulgarian Population
Authors: Yaneva A , Massaldjieva R , Mateva N , Bakova D
Published: November 2019

Background

The Cognitive Reserve (CR) is a concept used to represent the individual differences in processing cognitive tasks, allowing to cope with the pathology of the brain. CR describes the individual brain potential as a result of various activities during the lifespan. The study of this construct could open one more “door” on the path to the prevention of diseases associated with cognitive dysfunctions in human aging. The objective of this pilot study was to assess the CR as a part of a project aimed to evaluate the effectiveness of various options for stimulating active aging.

Methods

The Cognitive Reserve Index Questionnaire (CRIq) was translated into Bulgarian and was administered to 114 healthy participants (84,2% female and 15,8% male), aged 23 to 84 years (M = 52,40 SD = 16.81), divided into three age groups (up to 44, 45- 69 and over 70 years old). An individual CRI-level was calculated based on the subscores for education, working activity and leisure time. Non-parametric tests (Chi-square, Mann-Whitney U-test, and Kruskal-Wallis test) were used for statistical analysis.

Findings

The CRI-level depends significantly on age (χ2=31.834, (df = 6), p < 0.001) but does not depend on gender (p = 0.257). Significant difference was found in three age groups for the total CRI-score (p < 0.001), CRI-Education (p < 0.001) and CRI-WorkingActivity (p < 0.001) except for CRI-LeisureTime score (p = 0.547). The total CRI-score significantly correlate with CRI-Education (r = 0.863), CRI-WorkingActivity (r = 0.809) and CRI-LeaisureTime (r = 0.414).

Key messages

The CRIq is an easy to administer instrument that could help the assessment of the cognitive reserve in Bulgarian population. The cognitive reserve depends on human behavior through the life span and this fact gives new opportunities for prevention of diseases associated with cognitive dysfunctions in human aging.
Psychosocial distress and cardiovascular disease
Authors: Natt och Dag Y , Mehlig K , Rosengren A , Lissner L , Rosvall M
Published: November 2019

Background

The contemporary increase in psychological distress observed in many countries is, by itself, a public health issue of great concern.

Methods

This prospective study aims to investigate the impact of psychological distress on incident cardiovascular disease, in different age groups and also with respect to sex, among participants in the Gothenburg-based InterGene Study cohort. This cohort comprises a total of 3614 men and women, aged 25-75 years. Included in the present study were individuals who were free of previous CVD diagnoses and who fully completed all baseline examinations. Inclusions took place during 2001-2004. Psychological distress at baseline was assessed by self-rating depression and anxiety scales. A wide range of physiological and behavioral parameters were also assessed, which allowed for relevant adjustments. The outcome was incident CVD, and with a 12 year follow-up. Cox-regression analyses were performed.

Results

The results showed an increased risk of incident CVD with higher scores on each of the scales. The majority of the findings persisted after adjustments for relevant confounders. It was most common for young women to score high on the anxiety and depression scales.

Conclusions

The associations between psychological distress and later life cardiovascular disease calls for enhanced public health measures aiming at ameliorating psychological health, not least in younger age groups.

Key messages

There was an increased risk of incident CVD with higher scores on psychosocial distress scales. The majority of the findings persisted after adjustments for relevant confounders.
Evaluation of Social Media Use Disorder in Medical Faculty Students
Authors: Aygar H , Unsal A , Arslantas D , Isıktekin Atalay B , Cam C , Kılınc A , Akbulut Zencirci S , Durak Aras B
Published: November 2019

Background

Recently, social media usage disorder has become a behavioral addiction with the internet which has entered our daily life rapidly. One of the important factors considered to be associated with social media use disorder is thought to be loneliness. The aim of the study was to evaluate the social media use disorder in medical school students.

Methods

This study is a cross-sectional study conducted on the students who were studying in Eskisehir Osmangazi University Faculty of Medicine between January 2 and February 28, 2019. The study group consisted of 422 internet user students. The level of social media usage was assessed by Social Media Disorder Scale (SMD-scale). The level of loneliness was evaluated with the short-form of the UCLA Loneliness Scale (ULS-8). Mann Whitney U, Kruskal Wallis, Spearman correlation analysis were used.

Results

Of the participants 226 (53.6%) was male. The age of the study group ranged from 17 to 29 years and the mean (SD) was 19.78 (1.33) years. The scores obtained from SMD-scale ranged from 0 to 63, with a mean of 12.18±10.35 (median = 9.0). All students had at least one social media account. In the study, no difference was found between the scores obtained from gender, age group, father’s education status, family income status and family type. While the scores of the students whose mothers have a university education level are lower; those who spent more than 2 hours a day on social media had a higher score. There was a weak positive correlation between the scores obtained from SMD-scale and ULS-8 (p < 0.001, r = 0.215). There was a weak negative correlation between the scores obtained from the SMD-scale and the academic grade point average (p = 0.012, r = -0.123).

Conclusions

It is concluded that the correct use of social media can be increased by informing about this issue. Increasing platforms such as student clubs in which individuals could socialize in real life may be useful in reducing this disorder.

Key messages

Public health studies could help prevent social media use disorder transform into more serious health problem in future. Further studies are needed to determine the effects of social media use disorders on mental and physical health.
Socioeconomic differences in the adolescent mental health time trend: what do we refer to?
Authors: Kim Y , Evans B E , Bergh D , Hagquist C
Published: November 2019

Background

The long-term increase in adolescent internalizing mental health problems in many countries has raised the question of potential socioeconomic status (SES) differences in this trend. Inconsistencies in how SES and mental health are operationalized hamper this question to be addressed. We examined variation in the adolescent mental health trend across different SES groups using different ways of operationalizing SES and mental health.

Methods

We used six waves (1993-2013) of Swedish data from the Health Behaviour of School-aged Children (HBSC) study, an international repeated cross-sectional study. We used three proxy indicators of SES: an objective measure and two subjective measures (adolescents’ perceptions of their own and their family’s economic situation). The mental health indicator was psychosomatic symptoms. For each SES indicator, we analyzed the mental health trend using two standards of dividing SES subgroups (absolute vs. relative standard) and mental health (mean vs. top 90% cut-off score).

Results

The long-term trend of adolescent mental health varied by the SES indicator used. The objective SES measure did not differentiate mental health across different SES groups and the subjective measure of adolescents’ own economic situation did so in terms of the level but not the trend. The subjective measure of the family’s economic situation revealed SES gaps in mental health in terms of both the level and the trend.

Conclusions

Adolescents’ perceptions of their family’s economic situation has a greater discriminant value than the other SES measures to identify SES gaps in mental health in Sweden. Thus, the trend in adolescent mental health across different SES groups varies depending on how SES and mental health are operationalized. We call for efforts in other countries to report trends with varying measures of SES and mental health. This will help identify vulnerable groups in each country and facilitate well-informed international comparisons.

Key messages

This study shows that the long-term trend in adolescent mental health according to one’s SES may meaningfully differ depending on how SES and mental health are operationalized. This study calls for future studies in other countries for a more precise identification of vulnerable groups and for a facilitation of well-informed international comparison.
Healthcare use prior to suicide in the Stockholm County population 2011-2016
Authors: Narusyte J , Kosidou K , Dalman C
Published: November 2019

Background

Suicide is a major public health problem. A detailed description of healthcare use prior to suicide can serve to improve prevention strategies. The aim of the study was to describe the patterns of primary, specialized outpatient, and inpatient healthcare use from two weeks and up to one year prior to suicide in Stockholm County.

Methods

The study population included all 15 year or older suicide victims who died in Stockholm County 2011-2016 (n = 1950) identified through National Cause of Death Registry. Data on number of visits and contacts with healthcare among suicide victims were obtained from VAL healthcare use registry in Stockholm County. Healthcare use was depicted from one year to up to two weeks prior to suicide death.

Results

Preliminary results showed that there were 65% and 57% of women and men, respectively, who had at least one contact with healthcare during the last two weeks before suicide death. Measured one year prior to suicide, there were 93% of women and 85% of men who had at least one contact with healthcare. Among those who had at least one contact with healthcare two weeks prior to suicide, there were 16% of women and 12% of men who were hospitalized, 55% of women and 47% of men who had a contact with specialized outpatient care, and 32% of women and 27% of men who had a contact with primary healthcare. The proportion of those who did not have any contact with healthcare during the six months prior to suicide decreased gradually with increasing age among men (23% at ages of 15-24 years old and 7% at ages of 65 and older). There were on average 7% of women in all age groups who did not have any contact with healthcare during the six months prior to suicide.

Conclusions

The majority of the suicide victims had a contact with healthcare during the last year prior to suicide death. The findings suggest that suicide prevention efforts may target improved tools for clinically-based risk assessment.

Key messages

The majority of the suicide victims had at least one contact with healthcare during the last year prior to suicide death. Those who did not have any contact with healthcare during six months prior to suicide were more likely to be young men.
Use of antidepressant medication in Côte d’Ivoire (2017-2018)
Authors: Kouame J , Oga S S , Koffi K , Attia-Konan R , Tiade M L , Yapi Y P , Kouadio L
Published: November 2019

Background

Like industrialized countries, people in developing world are increasingly exposed to mental disorders. Antidepressant drugs play a major role in the treatment of these disorders. The objective of this study was to describe the use of these drugs in Côte d’Ivoire based on data from a mutual health insurance company.

Methods

This is a retrospective analysis of the health care consumption data from the mutual insurance company for civil servants and agents of the State of Côte d’Ivoire (MUGEFCI). The sample consisted of members and beneficiaries aged twenty (20) years and over who had taken at least one antidepressant drug reimbursed by the mutual insurance company between January 1, 2017 and December 31, 2018. Consumption was described for each drug and expressed in defined daily doses (DDD)/1000 inhabitants/day.

Results

The sample consisted of 5712 people aged 20 to 88 years with an average age of 50.61±12.02 years. There was a male predominance with a sex ratio of 1.10. The number of prevalent users was 3135 in 2017 and 2607 in 2018. The number of incident users in 2018 was 2013. 10871 ’boxes’ of antidepressant drugs were consumed during the study period (52.11% in 2017 and 47.89% in 2018). Amitriptyline (52.71 DDD/1000 inhabitants/day in 2017), fluoxetine (8.60 DDD/1000 inhabitants/day in 2017) and paroxetine (3.32 DDD/1000 inhabitants/day in 2017) were the most used drugs. Their consumption increased by 11.82%, 3.71% and 41.03% respectively in 2018. Venlafaxine (0.37 DDD/1000 inhabitants/day in 2017) was among the least used molecules. Its consumption fell by 52.53% in 2018.

Conclusions

The overall trend was an increase in antidepressant use, with a significant proportion of new users.

Key messages

Depression is a public health problem that is still relevant in developing countries. Depression mainly affects young adults and can influence their productivity.
Large sociodemographic differences in response rates and methods in a population survey in Sweden
Authors: Molarius A , Persson C , Lindström J , Lindén-Boström M
Published: November 2019

Background

Declining response rates in population surveys may decrease the representativeness and introduce bias in survey results. This study investigated sociodemographic differences in response rates and methods in a population survey in Sweden.

Methods

The study is based on a large population survey conducted in five counties in Mid-Sweden in 2017. Three age-specific questionnaires for persons 18-29, 30-69 and 70 years or older were designed to study living conditions, life style factors and health. The sample was random and stratified by gender, age group and municipality, and comprised 78 000 persons 18 years or older. Up to two reminders were sent, the last reminder consisted of a short version of the questionnaire. The survey could be answered using a written questionnaire or on-line. The web-questionnaire was available in Swedish and English.

Results

The overall response rate was 44% with the lowest participation rate in ages 18-29 years (26%) and highest in ages 70-84 years (70%). Women, persons with high educational level, and persons born in Sweden were more prone to respond than others. Those aged 18-29 years were overrepresented in the sample and the participation rate would have been 46% if the sample had been unstratified by age. The majority of the respondents answered the written questionnaire, even though it was more common that younger people responded via the web compared to older people. In total, 8% of the respondents replied to the short form and this was most common (17%) among those born outside the Nordic countries.

Conclusions

In line with previous research, the results indicate large sociodemographic differences in response rates. The response methods also vary between sociodemographic groups, and knowledge about these differences may be helpful when designing future population surveys.

Key messages

The response rate was higher among older people, women, persons with high educational level, and persons born in Sweden than among other groups. Persons born outside the Nordic countries were most prone to respond to the short form and younger people replied more often to the web-questionnaire than older people.
Comparison of the difference between income quintiles with the slope index of inequality
Authors: Khang Y H , Lim D , Bahk J , Kim I , Kang H Y , Chang Y , Jung-Choi K
Published: November 2019

Background

The difference between income quintiles in health is relatively well accepted by the general public as a measure of health inequality. However, the slope index of inequality (SII) in health reflects the patterns of all social groups, including the middle 60%, and it could therefore be considered more academically desirable. If these two measures are closely correlated, the widespread use of the difference between income quintiles in health would be better supported. This study was conducted to compare differences between income quintiles in life expectancy (LE) and healthy life expectancy (HLE) with the SII.

Methods

Data on LE and HLE by income quintile from all 252 subnational districts of Korea were obtained using the National Health Information Database of the National Health Insurance Service and the Korea Community Health Survey. The SII was estimated with linear regression analysis, and Pearson correlation coefficients between differences between income quintiles and the SII were computed.

Results

The correlation coefficients between differences between income quintiles and the SII were generally high: 0.97 (95% CI: 0.96-0.98) for LE in men and women combined and 0.96 (95% CI: 0.94-0.97) for HLE in men and women combined. In most districts, the SII was greater than the difference between income quintiles.

Conclusions

Differences between income quintiles were closely correlated with the SII. The widespread use of differences between income quintiles in health as a measure of health inequality may be preferable for communicating results of health inequality measurements to the public.

Key messages

Differences in life expectancy and health life expectancy between income quintiles were closely correlated with the slope index of inequality in life expectancy and healthy life expectancy. The widespread use of differences between income quintiles in health as a measure of health inequality may be preferable for communicating results of health inequality measurements to the public.
Does diet quality mediate socioeconomic differences in metabolic syndrome in the French West Indies?
Authors: Colombet Z , Perignon M , Salanave B , Landais E , Martin-Prével Y , Allès B , Drogue S , Amiot-Carlin M-J , Méjean C
Published: November 2019

Background

Obesity and metabolic diseases represent a major health burden in the Caribbean, particularly since a large part of the population is disadvantaged. However, socioeconomic inequalities in chronic diseases are poorly explored in this region, and the contribution of diet to explain these inequalities has not yet been studied. We investigated the association between socioeconomic position and the prevalence of metabolic syndrome (MetS), and explored whether this association was mediated by diet quality in the French West Indies.

Methods

This cross-sectional analysis included 1,144 adults (≥16 y) from a multistage sampling survey, representative of the Guadeloupean and Martinican population. The prevalence of MetS was assessed using the Joint Interim Statement. Dietary intakes were estimated using 24hours dietary recalls, and diet quality was assessed through the Diet Quality Index-International (DQI-I). Associations between socioeconomic indicators (education, employment, social assistance benefits) and prevalence of MetS, and the potential mediating effect of diet quality in this association were assessed using multivariable logistic regression models adjusted for sociodemographic factors.

Results

MetS prevalence adjusted for age and sex was 21% and 30% among Guadeloupean and Martinican, respectively. Compared to those with a high education level, low- and middle-educated subjects were more likely to be at risk of MetS (OR = 1.9; 95%CI = [1.0-3.6] and OR = 2.7; 95%CI = [1.4-5.1], respectively), as were recipients of social assistance benefits compared to non-recipients (OR = 2.2; 95%CI = [1.1-4.2]). The DQI-I explained 11% of the overall variation in MetS due to education.

Conclusions

Socioeconomic inequalities in MetS prevalence were found in a Caribbean population but diet quality contributed only to socioeconomic inequalities due to education. Future public health measures need to target specifically populations with limited financial resources and low education.

Key messages

Our work identified subgroups with higher risk of MetS, which is needed when implementing public health measures, particularly in this Caribbean population with of high poverty rates. Diet quality contributed only to socioeconomic inequalities due to education underlining that education may impact health through the ability to generate overall dietary behavior, long-term beneficial.
Determinants of self-rated general health among men and women 70 years or older in Sweden 2017
Authors: Persson C , Molarius A , Lindström J
Published: November 2019

Background

Goal 3 of the 2030 Agenda for Sustainable Development states that ensuring healthy lives and promoting the well-being at all ages is essential. But health and well-being still vary between different groups. The aim of this study was to find factors associated with self-rated health that can explain the differences among people 70 years or older in Sweden.

Methods

The study is based on a cross-sectional population survey conducted in five counties in Mid-Sweden in 2017. An age-specific questionnaire for persons 70 years or older was used. The response rate was 65% and the study population included 9 482 persons who answered all questions used in the study. Multivariate binomial logistic regression with outcome good or very good self-rated general health was used for the analysis.

Results

The overall prevalence of good or very good self-rated health was 54%. The factors with the strongest positive associations with good/very good self-rated health were: good appetite (OR: 4.48; 95% CI: 3.41-5.88) and physical activity (2.07; 1.87-2.2 9). The strongest negative associations were found for: need for help in everyday life (0.37; 0.24-0.57), troubled by loneliness once a week or more often (0.40; 0.34-0.47), obesity (0.55; 0.48-0.63), troubled by loneliness some times a month (0.59; 0.50-0.71), sedentary 10 hours/day or more (0.61; 0.52-0.72), and being patronized (0.65; 0.55-0.76). Other statistically significant positive factors were e.g. to have someone to confide in, participation in activities with others, trust in people in general, feeling safe in residential neighbourhood and access to personal support. Included in the analysis, but not statistically significant, were sex, country of birth and care of relatives.

Conclusions

Good self-rated health is more common among persons 70 years or older who have good appetite, are physically active and have good social relations.

Key messages

To promote good self-rated health in persons 70 years or older it is essential to enhance possibilities for social interaction and social support. Also promoting healthy lifestyle in form of physical activity and healthy eating habits is important.
Alcohol use among 15–16-year-old adolescents in Estonia, 2003–2015
Authors: Pärna K , Kudre D , Vorobjov S
Published: November 2019

Background

Alcohol is one of the most common psychoactive substances used by adolescents. The aim of the study was to describe the prevalence of alcohol use in 2003-2015 and to analyse association of alcohol use with family- and school-related factors, other risk behaviors, and perceived alcohol availability.

Methods

This study was based on data of 15-16-year-old adolescents (n = 9559) from the cross-sectional studies of European School Survey Project on Alcohol and Other Drugs conducted in Estonia in 2003-2015. Prevalence of past 30-day alcohol use was calculated for each study year. Chi-square test for trend was used to assess statistically significant changes of alcohol use over the study period. Logistic regression analysis was used to analyse association between alcohol use and study year, family- and school-related factors, risk behaviors, and perceived alcohol availability. Fully adjusted odds ratios with 95% confidence intervals were calculated.

Results

In 2003-2015, alcohol use decreased significantly among adolescents in Estonia (p < 0.001). In 2015, the prevalence of alcohol use was 36.1% (95% CI 33.4 − 38.8) among boys and 39.1% (95% CI 36.3 − 41.8) among girls. Fully adjusted logistic regression models showed that alcohol use among boys and girls was statistically significantly associated with study year, lower parental awareness where the child spends Saturday evenings, skipping the lessons, smoking, cannabis use and easy access to alcohol. Alcohol use was associated with lower socioeconomic status of the family and with unusual family structure among girls only. Compared to the first study year, alcohol use was lower in the last study year (OR = 0.52, 95% CI 0.43 − 0.64 among boys, OR = 0.46, 95% CI 0.38 − 0.56 among girls).

Conclusions

In order to continue reduction of alcohol use among adolescents, the health promotion interventions should take into account the factors related to alcohol use in Estonia.

Key messages

Alcohol use decreased among adolescents in Estonia in 2003–2015. Alcohol use was associated with study year, family- and school-related factors, other risk behaviors and perceived alcohol availability.
Implementation of a national epidemiological surveillance of prison suicide in France
Authors: Chan Chee C
Published: November 2019

Context

Worldwide, suicide is a leading cause of death in prison. In France, suicide of prisoners accounts for more than 100 deaths per year representing about half of the total deaths in prison. Moreover, suicide rates in French prisons are seven times higher than in the community and are among the highest in Europe. Reducing prison suicide is a public health priority inscribed in a joint action plan of both the Ministries of health and of justice. In order to prevent this tragic loss of life, prison services and health services must collaborate for the monitoring and understanding of the risk factors involved. The aims of an epidemiologic surveillance of prison suicide are to gather information about the medical factors and factors related to prison environment, analyze them and eventually produce recommendations for prevention.

Methods

After months of consultation between Santé publique France, different administrations and professionals working in prison, a common methodology was set up. As from January 2017, whenever a suicide or suspected death occurs in prison, the Direction of the Prison Administration (DAP) informs Santé publique France, who in turn sends to the medical practitioner in charge of the prison health services a questionnaire including the history before detention: morbidity, addiction, attempted suicide, and during detention: contact with prison health services, diagnosis and final contact prior to death. Each year, the DAP sends to Santé publique France the sociodemographic, administrative, judiciary and prison environmental data of the persons.

Results

In 2017, data were collected for 106 suicides from 71 prisons: 95% males, 49% remand, 44% murder or sexual assault, median incarceration time 96 days. Questionnaires were returned from prison practitioners for 100 cases (94%): regular contact 83%, prior suicide attempt 23%.

Conclusions

Feasibility of a prison suicide surveillance is only possible with the implication of both prison and health services.

Key messages

Reducing death by suicide in prison is a public health priority. Feasibility of a prison suicide surveillance is only possible with the implication of both prison and health services.