bluuebunny/crossref_metadata_2025 huggingface dataset:
Does Climate Change Matter to Us? Knowledge, Attitudes, and Environmental Behavior
Authors: Dopelt K , Davidovitch N , Loren O , Gapich G
Published: October 2020

Background

Climate change is one of the greatest global threats to humanity in the 21st century, and it is directly or indirectly caused by human activity. In view of the effects of climate change, it is important to examine the level of knowledge, attitudes, and behavior of the public. A better understanding of these variables should improve the current debate on the impact of human behavior on environment and health.

Methods

In a cross-sectional study using an online questionnaire, 704 students were asked about their knowledge, attitudes, and behavior related to climate change. The data were analyzed using correlations, independent t-tests, one-way ANOVA, and linear regression models.

Results

We found that students have a medium level of knowledge about the impact of climate change and that their attitudes are moderately pro-environmental, yet they are not strict about pro-environmental behavior. Students with higher levels of environmental knowledge demonstrated more pro-environmental attitudes and behavior, and attitudes mediate the relationship between level of knowledge and behavior. Women demonstrated more pro-environmental behavior than did men, and computer science and management students have the highest levels of knowledge, while health sciences students hold the most positive attitudes and more pro-environmental behavior.

Conclusions

Our results highlight the importance of raising awareness of the effects of climate change and increasing knowledge about how climate change can be mitigated. To this end, an introductory course on environmental science should be integrated into various academic study programs. Further research is needed in order to understand the factors associated with pro-environmental behavior and how to promote it.

Key messages

Environmental behavior is a function of knowledge, skills, and values. Nevertheless, gaps might exist between social and environmental values that a person aspires to believe in and his/her behavior. Preferring the present over the future is a classic sustainability problem, as intentional sustainable behavior necessitates long-term thinking and gives precedence to future benefits.
Gentrification, mobility patterns and health in Lisbon: a time series’ analysis from 2008 to 2018
Authors: Sá R , Soares dos Santos E , Gabriel T , Moreira A , Giraldo P
Published: October 2020

Background

Mobility patterns have a great impact on health. The use of cars is known to be related with increasing air pollution, noise and accidents, and less active transportation, leading to cardiovascular, oncological or respiratory diseases, among others. Gentrification is a process through which the rising value of a geographical area displaces low-income inhabitants, mostly due to rising rents, mortgages and property taxes. This change has the potential for relocating long-time residents and businesses. The aim of this study was to quantify the effect of gentrification in the car influx in the city of Lisbon.

Methods

A time series' analysis was performed using public ecological data, from 2008 to 2018, of habitation costs per square meter (as a proxy of gentrification) and the number of cars that entered Lisbon through accessing highways. The model was adjusted for confounding factors such as Lisbon's gross income and fuel prices.

Results

We verified the effect of seasonality in the car influx, with peaks before and after summer - july and october - and a downward trend until 2013 that then inflected and started an upward trend from 2014 to 2018. Habitation costs were positively correlated with car influx into the city (R2=0.773; p < 0.001). In the model, 1€/m2 of increment in housing prices corresponded to 200 more cars that entered the city.

Conclusions

In Lisbon, gentrification was associated with the increasing number of cars entering the city. These findings may have implications in future policies that regulate housing and mobility. Further research is needed to fully understand the causal pathways of this phenomenon.

Key messages

Mobility patterns have a great influence on health, and gentrification may influence them. The increase of 1€ per square meter in housing prices lead to an increase of the influx of cars of 200.
Urban diabetes in the metropolitan area of Rome: development of the action plan
Authors: Nicolucci A , Baroni M , Crialesi R , da Empoli S , Dotta F , Frontoni S , Morviducci L , Tanese A , Vaccaro K , Lenzi A
Published: October 2020

Issue

The world is rapidly urbanizing, causing alarming health problems to their citizens. The Cities Changing Diabetes program aims to address the social factors and cultural determinants that can increase type 2 diabetes vulnerability among people living in cities. Rome joined the program in 2017, and a series of initiatives was launched with the aim of mapping the problem, sharing the learnings, and designing interventions.

Description of the Problem

The first phase of the project documented that a wide variation exists in the prevalence of diabetes among the districts of Rome, associated with social and cultural determinants. A linear correlation exists between the prevalence of diabetes in the districts, unemployment rate and use of private transportation rate, while an inverse correlation is present with aging index, school education level, and slow mobility rate. These findings were the base for the development of an action plan to be implemented in the next three years. A structured, multi-stakeholder approach was adopted to prioritize the areas of intervention. Politicians, healthcare policy makers, healthcare providers, epidemiologists, social scientists, and patient association representatives were involved.

Results

The following actions have been identified: To potentiate healthcare resources to meet the increasing needs associated with urban development and improve accessibility;To create and strengthen support networks in the territory, to meet the needs of elderly, fragile people, often living alone;To support sustainable mobility and improve the usability of shared and public transport networks;To increase information available to the most vulnerable subjects;To create a uniform network of specialist care through innovative solutions and increase the access to specialist care in suburban, underserved areas;To support the development of information and telemedicine systems, to promote integrated care.

Key messages

The aim of the initiative is triggering a virtuous circle in which prevention, access to care/innovation and sustainability of healthy lifestyles are the result of integrated actions in the territory. The experience of Rome can inspire other metropolitan areas in implementing effective strategies to reduce the burden of diabetes.
Validity of air pollution annoyance to assess long-term exposure to air pollution in Belgium
Authors: Pelgrims I , Bastiaens H , Devleesschauwer B , Keune H , Nawrot T , Remmen R , Saenen N , Guyot M , De Clercq E M
Published: October 2020

Background

In environmental epidemiology, air pollution exposure is often estimated at the population level. To avoid the risk of exposure misclassification, one possibility is to interpolate air pollution measures at the residence through Geographical Information Systems. However, this might imply cumbersome administrative procedures. Data on air pollution annoyance from surveys can be an alternative to assess individual exposure to air pollution. This study investigates the association between air pollution annoyance and individual air pollution exposure.

Methods

Analyses were carried out based on a linkage of data from the Belgian Health Interview Survey (HIS 2008 and 2013; >15 years; n = 9347) and annual means of air pollution concentration at the residence. Self-reported air pollution annoyance was assessed through a five-point Likert scale. Statistical analyses included Spearman correlation coefficient, analysis of variance and multivariable ordinal logistic regressions (OLR).

Results

A significant exposure-response relationship was observed between long-term air pollution exposure and self-reported air pollution annoyance. However, Spearman coefficients were low (0.18-0.24), meaning a high heterogeneity of annoyance levels for a given exposure. In multivariable OLR, the odds of being annoyed by air pollution was 2.10 (95% CI: 1.86-2.67) times higher for each Interquartile range (IQR) increase in NO2 concentration (PM2.5: 1.77 [95% CI: 1.53-2.07], PM10: 1.61 [95% CI: 1.33-1.67], black carbon: 1.45 [95% CI: 1.27-1.67]). Air pollution annoyance depended largely on individual factors especially health status.

Conclusions

Air pollution exposure has a significant influence on self-reported air pollution annoyance. However, many other factors were found to influence annoyance, independently of the exposure. We found a limited validity of self-reported air pollution annoyance to assess individual long-term exposure to air pollution.

Key messages

Significant exposure-response relationship between individual long-term air pollution exposure and self-reported air pollution annoyance. Limited validity of self-reported air pollution annoyance for assessing individual long term exposure to air pollution.
Working in psychiatry: staff perception of the Brazzaville hospital and university centre
Authors: Mbou Essie D
Published: October 2020

Background

In Congo-Brazzaville, there is a lake of mental healthcare providers and facilities specialized in psychiatric care: only two psychiatrists and one psychiatric department around the country. Poor appreciation of their role and work environment can negatively impact the esteem of psychiatric staff and lead to stigma and discrimination towards patients.

Aims

The study aimed to assess the perception of the staff of the only psychiatric service in Congo.

Material and Methods

We conducted a cross-sectional descriptive, prospective survey; conducted among the psychiatric staff of the Brazzaville University Hospital in September 2019. An anonymous individual questionnaire was administered to collect: (i) socio-professional data, (ii) perceptions (assignment, role, workload and working conditions) and (iv) identify the main problems of the service. Averages and frequencies were calculated on Epi info 7.2.2.6.

Results

Thirty out of 42 staff had responded (71.4%), 16 were male and at their first psychiatric assignment (28/30), with an average age of 44,7±7 and seniority of 8,4 ±8,3 years. Among them: one psychiatrist, two psychologists, and 19 nurses. Their assignment in psychiatry was well perceived in 93.3% (27/30), as well as their role (the importance of psychiatric care and psychiatry). Working conditions were perceived as poor: precarious hygiene (93.3%), cohabitation with dangerous patients (82.1%), heavy workload due to lack of staff (100%). Of their professional future, 23.3% (7/30) were considering leaving.

Conclusions

Almost all psychiatric staff had a good perception of their role and psychiatry, but not of the working conditions. Local measures to improve working conditions must be carried out to improve the attractiveness of psychiatry and the quality of care.

Key messages

Staff perceived heavy workload due to lack of staff and poor working conditions. Lake of workforce will be deeply acute in psychiatry.
Actual challenges of mental health in Indonesia: Urgency, UHS, humanity, and government commitment
Authors: Rahvy A , Habsy A , Ridlo I
Published: October 2020

Mental health has become one of the biggest challenges in the world. But in most of developing countries, including Indonesia, mental health issue has not been prioritized, compared to infectious diseases. This paper will describe the implementation of mental health policy in Indonesia and its challenges, as other developing countries may also learn about ways to deal with it.

Mental health policies and regulations implementation in Indonesia are still followed by wide gap, related to its coverage and humanity problems. This paper is a literature review which examines implementation of Mental Health Law and its alignment with UHC and humanity in Indonesia since policies applied. Researches about mental health policy and economic impact of it in other countries are included, and evidences as reasons policy should be evaluated are provided. This research is aimed to explain reasons and ways government can strengthen mental health policy.

Results showed Mental Health Law (2014) implementation in Indonesia had not been effective enough. Riskesdas, a national health survey conducted by Ministry of Health, found 14% of families who did confinement, with 31.5% did it in the last 3 months. WHO data in 2017 showed psychiatrist rate 0.31, mental health nurses rate 2.52, and social workers rate 0.17 (all per 100.000 population) confirming the lack of mental health resources in Indonesia. DALYs reached 2,463.29 per 100.000 population and suicide mortality rate 3.4 with no strategy related to suicide prevention found.

Mental health is an important part of the complete state of health. Government should integrate mental health services into community-based services as a way to ensure universal coverage of mental health services. This will work as bottom-up empowerment, and it will solve problems of resources and stigma that obstruct the success of mental health program in Indonesia. This also supports family as caretaker of patients and reduce the possibility of relapse.

Key messages

Mental health can not be considered only as a peripheral issue in Indonesia, as it may also affect other aspects of society such as social and economy. Government should reform policy and regulation of mental health in order to achieve the complete state of health.
Mortality and causes of death: 6 years of monitoring treated drug users
Authors: Jandl M , Hocevar Grom A , Drev A
Published: October 2020

Background

This study aims to analyse mortality among deceased cohort members from 2009-2015 in Slovenia in terms of causes of death. Cohort follows illicit drug users who were registered for the first time or repeatedly in Centres for illicit drug usage prevention and treatment.

Methods

5157 subjects entered in a retrospective cohort study who were observed for 29.146 years. Data on deceased drug users from 2009 to 2012 were cross-linked with data from the General Mortality Register for the period 2009-2015.

Results

During 2009-2015 total of 153 deaths were recorded, mean age at death was 39.5 years. In almost three quarters violent death was the prevalent cause; among somatic causes alcoholic liver cirrhosis was the most frequent cause of death, followed by malignancies. Violent deaths occurred due to unintentional poisoning in 37%, followed by deaths from unidentified causes (11%), suicides (17%) and road accidents (2%). One half of suicides were committed by hanging.

Conclusions

Public health policies in the field of addiction should be more intensely focused on education on alcohol damage due to drinking, screening for patients with overdose risk and in establishing specific programs and strategies for reducing the risk of suicide in this population.

Key messages

Drug users should receive education on alcohol damage due to drinking. Drug users are in the risk of suicide.
Protection of the rights of people in situations of violence
Authors: Garbin A , Yasuda N , Leslão J
Published: October 2020

The Municipal Health Department of the city of Diadema, São Paulo, Brazil, has the Health Promotion and Violence Prevention Center focused on prevention, reception and protection of the rights of people in situations of violence. Articulation of the epidemiological, health and health surveillance actions of the worker with the psychosocial care network (in the field of mental health). What is the role of the Health Surveillance in the network of attention and protection for people in situations of violence? What is the health status of the places that shelter people in mental distress? How to intervene in situations of psychological violence at work? Violence is an important public health problem, considering the impact it has on the lives of people, families and communities. Violence is a complex, multifactorial phenomenon that can leave deep marks. From the users-guide were produced new arrangements in the production of care involving the surveillance teams, in intra and intersectoral interlocution, analyzing the situations, unfolding in the construction of other work processes and qualified interventions.

In Diadema, the three health surveillance departments (Epidemiology, Reference Center in Occupational Health and the Health Surveillance department) developed strategies aimed at the qualification of comprehensive attention to people and integrating the Network of Psychosocial Care (RAPSI).

The users in violence were treated with priority by the health services and the intervention was immediate. We observed that health services are more sensitive to dealing with cases of violence. The intervention requires the establishment of a network of attention and care for people in situations of violence. The interventions contributed to the prevention of violence and the promotion of health and the exchange of comprehensive care practices for people living in situations of violence and population segments at risk.

Key messages

The articulation of a network of protection for people in situations of violence exposes institutional violence and social vulnerabilities in order to intervene in the determinants. The compulsory notification of situations of interpersonal and self-harm inflicted violence is the basis for the action of care, prevention of violence and promotion of health.
Burnout and its associated factors among Tunisian healthcare students
Authors: Tlili M A , Aouicha W , Testouri A , Hamoudi M , Lamine H , Taghouti E , Mtiraoui A , Chelbi S , Ben Rejeb M , Mallouli M
Published: October 2020

Background

Burnout is a major issue among healthcare students and a public health issue in general. Indeed, the consequences of student burnout are as complex such as mental distress factors with smoking and alcohol consumption and unhealthy lifestyle. The aim of this study is to determine the prevalence of burnout among health sciences students and its associated factors.

Methods

This is a cross sectional descriptive study conducted among 368 students of the Higher School of Health Sciences and Techniques of Sousse (Tunisia) from March to April 2018. The study instrument is the French validated version of the Maslach Burnout Inventory-Student Survey (MBI-SS). This instrument measures academic burnout through 3 dimensions (emotional exhaustion, cynicism and academic efficacy). Data entered and analyzed using the Statistical Package for the Social Sciences (SPSS 20.0).

Results

The prevalence of burnout was 64.4%. The presence of a diagnosed health problem, a diagnosed mental disorder or sleep problems found to be associated with all the aspects of burnout. Students who live alone are significantly the most emotionally exhausted (p = 0.010), and have the highest levels of cynicism (p = 0.033). Students who had a low socio-economic level are significantly more cynical than those who had a medium or high socio-economic level (m = 3.45, m = 2.81, m = 2.25; p = 0.032 respectively). Furthermore, students who perform leisure activities and practice physical activities had a significantly lower levels of emotional exhaustion (p = 0.007, p = 0.008 respectively). Also, studying with new pedagogical approaches decreased significantly the levels of the different burnout dimensions.

Conclusions

Burnout is prevalent among Tunisian health sciences students, which can have severe consequences such as anxiety and sleep disorders. Hence why preventive strategies should be applied to encounter this problem and avoid its consequent risks.

Key messages

Students and teachers must be aware of the phenomenon of burnout and its consequences as an important public health issue. Future interventions to minimize the prevalence of burnout and its negative effects should be conducted by focusing on its associated factors.
Burnout syndrome among health care workers in the tertiary psychiatric facility in Serbia
Authors: Terzic-Supic Z , Trajkovic G , Camagic K , Todorovic J , Djordjevic V , Stasevic-Karlicic I
Published: October 2020

Background

Recent studies reported there is a high prevalence of burnout syndrome in healthcare workers and particularly among mental health professionals. The aim of this study was to examine the burnout syndrome in the tertiary level psychiatric hospital and potential factors associated with it.

Methods

This study was conducted as a cross sectional study, during September 2017 in Clinic for psychiatric disorders “Dr Laza Lazarevic” Belgrade, Serbia. The study included 159 health care professionals. Instrument used consisted of section on socio-demographic characteristics, linguistically adapted Serbian versions of Maslach Burnout Inventory - General Survey (MBI-GS) with three subscales (emotional exhaustion-EE, depersonalization- DP, low personal accomplishment-PA) and Beck's Depression Inventory (BDI).

Results

The mean age of the participants was 42.46±10.2 years (the youngest participant was 20 years old, and the oldest was 65 years old). In the overall sample, almost 70% of respondents were educated nurse-technicians. The physicians had the highest values on the EE and DP scale and the lowest values on PA scale: physicians- EE scale: 24.86 ± 15.27, DP scale: 4.29 ± 5.77, PA scale: 37.19 ± 9.77 vs. nurses: EE scale: 17.70 ± 13.58, DP scale: 4.07 ± 6.15, PA scale: 32.56 ± 16.62 vs. health associates: EE scale: 15.54 ± 5.85, DP scale: 3.18 ± 3.43, PA scale: 37.00 ± 6.53. The score on EE-subscale was associated with the years of age (ß=0.310, p = 0.037) and score on Beck's depression inventory (ß=0.828, p < 0.001). The score on DP scale was associated with the score on Beck depression inventory (ß=0.339, p < 0.001). The score on PA scale was associated with the score on Beck depression inventory (ß=0.363, p < 0.001).

Conclusions

Physicians are the category of employees in psychiatry with the highest severity of burnout syndrome at work, and the degree of development of this syndrome depends on age and degree of depression.

Key messages

Physicians are the most vulnerable to the burnout syndrome among health care workers at psychiatry. All three domains of burnout are associated with the scores on Beck depression inventory.
Dialogical research to open up new narrative patterns among young women living with severe anxiety
Authors: Cantarero Arevalo L , Fejfer Olsen S
Published: October 2020

Background

16,889 new cases of severe anxiety (SA) were diagnosed in Denmark in 2019. Incidence rate is highest among 16 to 24 year-old women, a population group with 64% risk of being diagnosed with SA. Experiences of stigma and shame are common among this group, affecting negatively their quality of life and opportunity to recover. The aim is 1) to gain insight into the digital narratives young women with SA share through social networking websites, and 2) to open up the possibility to develop new narrative patterns using dialogical research as a method rooted in Bakhtin (1895-1975) and further developed by Frank (2005).

Methods

Netnography of four large Facebook groups focused on anxiety was used to gain insight into the patients' narratives and to build guiding themes for the off-line dialogical interviews (DI). Biographical narrative patterns were analyzed in light of a narrative-constructivist approach. Participants were invited to sign an informed consent prior to the DI and received ample information about the project aims and their rights.

Results

8 young women diagnosed with SA participated in the off-line DI. They had experienced stress, loss, betrayal or violation against them prior to the trigger of SA. All had constructed a narrative that explained why they were suffering from SA. Patient experiences were dominated by the struggle to control intrusive thoughts and to live in a threatening world. Some felt stigmatized and tried to hide their condition from colleagues, friends and family. They had different preferences regarding healthcare needs and were active in their search for alternative ways to cope with SA.

Conclusions

Participants perceived DI as beneficial. It thus has the potential to not only explore the patient's perspective in depth, but also serve as therapy during the process of inquiry.

Key messages

Dialogical research has the potential to not only explore the patient’s perspective in depth, but also serve as therapy during the process of inquiry. Young women suffering with severe anxiety experience shame and stigma, which worsen their condiction and hinder their opportunity to recover.
Socioeconomic Inequalities in Mental Health in Mongolia
Authors: Dorjdagva J , Batbaatar E , Dorjsuren B , Kauhanen J
Published: October 2020

Background

Promotion of mental health and well-being is recently recognized as a health priority at the global level. In Mongolia, mental health issues have been on the rise. However, less is known on socioeconomic inequality in mental health in the country. The aim of this study is to examine socioeconomic inequality in mental health in the adult population in Mongolia.

Methods

This study analyzed the data of 30,567 adults from the Household Socio-Economic Survey, collected in 2012 by the National Statistical Office of Mongolia. Self-reported mental health was used as a health outcome variable. Socioeconomic status was measured by household income. We employed the Wagstaff's concentration index to assess the degree of socioeconomic inequality in mental health.

Results

The results show that the prevalence of self-reported mental health was 1.17% among the respondents. The adults living in urban areas suffer significantly more with mental illness compared to the adults living in rural settlements. The Wagstaff's concentration index for mental health was significantly negative (-0.243), indicating that mental health problems were concentrated among the lower-income groups. The decomposition results show that education, economic activity status and marital status were the main contributors to socioeconomic inequalities in mental health after removing age-sex related contributions.

Conclusions

Socioeconomic inequality in mental health exists in the adult population in Mongolia, which was mainly explained by the education level, employment and marital status. Prospective policies are needed to reduce socioeconomic inequality in mental health in the country.

Key messages

Socioeconomic inequality in mental health exists in Mongolia. It calls for further policy actions.
The emotional impact of medical error on Portuguese medical residents - An exploratory study
Authors: Mota D , Moreira de Sousa A , Ribeiro L
Published: October 2020

Background

The consequences of the medical error on patients are unquestionable. However, the emotional impact on the health professional that made the error is usually devastating and usually neglected. The present study aimed to study the perception and experiences in a sample of medical residents regarding the emotional impact of the medical error in a clinician.

Methods

A cross-sectional and exploratory study analyzed a sample of 264 Portuguese residents. A survey with multiple-choice questions was created, taking into account the available scientific literature on this topic. The survey was then shared online within the mailing lists and social groups of Portuguese medical residents. The responses were collected between 14th-29th February 2020. Descriptive and logistic regression analyses were carried out using R 3.6.1 and Rstudio 1.2.5033.

Results

48,1% of the residents mentioned that at a certain point in their careers, they made a medical error. 98,4% of them had indirect contact (e.g., discussions with colleagues) with scenarios where a medical error could or was made. The residents that made a medical error had mainly feelings of guilt (85,8%), anxiety (73,2%), and frustration (64.6%). 93,7% of the clinicians that made a medical error reported more caution and the implementation of preventive measures in their future practice. 16,5% of them thought about leaving the medical profession. The odds for a medical error are 2,44 higher (95% CI 1,49-4,02) in the later phase of medical residency.

Conclusions

Although international literature describes the impact of medical error on the clinician, there is no published research on this theme in Portugal. The results allowed us to explore the emotional impact of these events and underline the unmet need for psychological support for the health professional. This exploratory study may serve as support for other research studies on this matter with a more robust methodology and a bigger sample size.

Key messages

Medical error is frequent and has an emotional impact on medical residents. Need for further research in Portugal and the creation of programs for psychological support.
Impact of retirement on depression, a systematic review
Authors: Gianfredi V , Patti A , Amerio A , Fracella B , Gaetti G , Vigezzi G P , Odone A
Published: October 2020

Aim

Due to the improving of life conditions, life expectancy is steadily increasing, especially in developed countries. In this perspective, Governments have to face important challenges as guaranteeing the welfare state, providing pensions and long-term healthcare for an increasing number of people. To maintain the sustainability of the pension system, many developed countries are rising the proportion of elderly persons in paid employment by both extending working life through a higher official retirement age and preventing premature exit from paid employment. However, postponing the exit from work exposes workers to potential stressors for a longer period. Stress is one of the risk factors for depression, that represent one of the leading causes of burden of disease. Our aim is to retrieve evidence in order to understand the association between retirement and risk of depression.

Methods

This is a systematic literature review, conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. In January 2020, the following databases PubMed/Medline, Embase, Psycoinfo, and Cochrane were used to perform the search, using a combination of three components of keywords: depression, aging and retirement.

Results

A total of 2,203 studies were retrieved of which 782 were excluded because duplicates. Screening of 1,421 retrieved studies is in progress and data will be showed in tables and summarized in narrative form. Results are preliminary.

Conclusions

The present research intends to bridge the lack of knowledge on the association between retirement and depression, to tackle these methodological limitations of the evidence, and to contribute to the advancement of scientific knowledge on the link between work life extension and mental health. Poor mental health is a major source of disability. Improving mental health of workers remains a critical goal if future populations need to reach older age in good health and continue to work.

Key messages

Work life has been extended but low information are available regarding its impact on depression. Depression is a leading cause of burden of disease and studies aimed to reduce its incidence are extremely needed.
Factors associated with the violence and victimization in dating between high school students
Authors: Villegas Vázquez E A , Leyva Chipol J C , Valencia Almeida S I , Márquez Celedonio F G , Villegas Domínguez J E
Published: October 2020

Introduction

According to data from the World Health Organization (WHO), 3 out of 10 adolescents report that they suffer violence in dating. In the Mexican case, 76% of adolescents between 15 and 17 years have suffered 17% sexual and 15% physical psychological violence. In 2019, Veracruz registered in the first place of feminicide in Mexico with a rate of 3.44 per 100 thousand women

Methods

A cross-sectional, prospective, observational and analytical study was carried out from December to February 2020. Middle-high school students from the Veracruz-Boca del Río region were included, who had a dating relationship and were excluded those who did not accept to participate. The CADRI test was applied to quantify “violence committed and victimization in dating”.

Results

741 students were included. There was a prevalence of violence committed of 86.2% and victimization of 89.2%. Being a woman, having active sex life, relationships over 12 months, living in a rural area, having a history of physical, psychological and sexual violence in previous relationships, daily life and in your family were the main factors associated with the violence committed, highlighting physical violence in previous relationships (OR 7.36 95% CI 1.8-31.6) (p < 0.05). With regard to victimization, the associated factors were being a woman, having a relationship greater than 12 months, having suffered physical, psychological and sexual violence in the family, daily life and previous relationships, the main one being psychological violence (OR 7.1 IC95 % 2.5-19.8) in previous relationships, as well as sexual violence in everyday life (OR 6.0 IC95% 1.4-25.1) (p < 0.05.)

Conclusions

The violence generated and victimization share associated factors, the most important being women, having a history of physical, psychological and sexual violence in the family, daily life and previous relationships.

Key messages

Women suffer more aggressions at different stages of their lives, which may increase the risk to tolerate aggressions or be more aggressive or suffer mental health problems. We must study if the violence generated by women is a response to a previous aggression.
Burden of mental health disability in Kerala: A secondary time trend analysis from 2002 to 2018
Authors: Joseph J , Sankar H , Nambiar D
Published: October 2020

The fourth target of Sustainable Development Goal (SDG) 3 advocates for the promotion of mental health and wellbeing. The Indian state of Kerala is recognized for its gains in health and development but has substantial burden of mental health ailments. Historical analysis is vital to understand the pattern of mental health morbidity. The current study focusses on comparable estimates available from three largescale population-based surveys in India to explore trends in prevalence of mental health disorders over the years and map resources and infrastructure available for mental health care in Kerala.

We undertook a secondary analysis of national demographic surveys from 2002 to 2018 which reported information on mental health and availability of health infrastructure and human resources. Data were collated and descriptive analyses were conducted. We compared the national and state level estimates over the years to study the trend in the prevalence of mental health disability.

The prevalence of mental retardation and intellectual disability in Kerala increased from 194 per hundred thousand persons in 2002 to 300 per hundred thousand persons in 2018, two times higher to the national average. The prevalence of mental illness increased from 272 per hundred thousand people to 400 per hundred thousand people in sixteen years. The prevalence was higher among males (statistical significance was not indicated) in mental illness and mental retardation. 2018 data showed that the public sector had 0.01 hospitals and 5.53 beds per hundred thousand persons available for mental health treatment.

Results showed a substantial increase in mental health illness over the 16-year study period that has affected males and females, as well as all social classes of the state. The current health infrastructure and human resources in the public sector of the state are inadequate to meet the current burden of the problem and to ensure universal access to care for its population.

Key messages

The trend in prevalence of mental health disorders in the state is increasing across the years. There is a mismatch between the extend of the problem and resources available in public sector.
Cardiovascular health metrics and prevalence of cardiovascular disease in the Republic of Moldova
Authors: Raevschi E M , Martin B C
Published: October 2020

Background

Achieving and maintaining cardiovascular health of individuals has a significant impact on reducing cardiovascular disease (CVD) and mortality at the population level.

Methods

We performed a cross-sectional community survey of 2,612 adult respondents in the Republic of Moldova. The American Heart Association cardiovascular health metrics score was used in total and by its two components: (1) health factors (blood pressure, total cholesterol, glucose, body mass index); (2) health behaviors (nonsmoking, physical activity, healthy diet score). The prevalence of CVD was identified as the main outcome measure.

Results

The prevalence of CVD was lower in study participants having all 7 cardiovascular health metrics (14.7%; 95% CI, 2.8% to 26.6%) compared to those with 0 to 1 cardiovascular health metrics (78.2%; 95% CI, 67.3% to 89.1%). Among participants who met all health factor metrics, the prevalence of CVD was lower (15.1%; 95% CI, 5.5% to 24.7%) compared to those with 0 to 1 health factor metrics (72.5 %; 95% CI, 69.9% to 75.0%). Study respondents who engaged in all health behaviors and those who engaged in 0 to 1 health behaviors had a similarly high prevalence of CVD (60.1%; 95% CI, 57.4% to 62.8% and 60.4%; 95% CI, 55.3% to 65.4%, respectively).

Conclusions

Lower prevalence of CVD was related to a greater total score of cardiovascular health metrics and with health factor components. While those diagnosed CVD appear willing to improve their behaviors, the population at risk is not likely to engage in health behaviors to prevent the onset of CVD.

Key messages

Increasing individual’s responsibility in addressing their own health implies improvement of community health. Strategies for health promotion should focus more on an individual’s motivation to assume personal responsibility for behaviors affecting their health.
Social inequalities in multimorbidity among European population
Authors: Alvarez-Galvez J , Suarez-Lledo V , Almenara-Barrios J , O'Ferral-Gonzalez C , Lagares-Franco C , Gonzalez-Caballero J L
Published: October 2020

Background

Life expectancy has increased dramatically in all regions of the world over the last years. The average life expectancy in Western Europe was 79 years for males and 84 years for females in 2018. Consequently, the number of people suffering (or at risk of) long-term conditions, such as diabetes, heart disease, musculoskeletal disorders, mental health conditions, or cancer is also rising rapidly. Multimorbidity can be defined as the presence of two or more chronic medical conditions in an individual and is one of the main challenges facing governments and healthcare systems around the world. This health condition is associated with a lower quality of life, increased disability, functional decline, higher healthcare utilisation and fragmentation of care, complex treatment, and higher mortality. This study is aimed to identify the underlying determinants of social inequalities in multimorbidity.

Methods

We used latent class analysis to identify multimorbidity subgroups with interdependent disease patterns using the European Social Survey. The statistical model was based on 13 chronic diseases: heart problem, high blood pressure, breathing problems, allergies, back or neck pain, muscular or joint pain in hand or arm, muscular pain in foot or leg, stomach or digestion related, skin condition, severe headaches, diabetes, cancer, and obesity.

Results

Specific multimorbidity classes with singular disease patterns were identified among different socioeconomic groups the in the latent class analysis. The study showed that some disease combinations were more prevalent between different socioeconomic groups and countries. In particular, musculoskeletal diseases and cardiovascular diseases were found to be the most prevalent multimorbidity classes in Europe.

Conclusions

These findings suggests that tailored public health strategies are needed to address social inequalities in multimorbidity.

Key messages

Multimorbidity patterns present a different distribution depending on socioeconomic characteristics of population. Tailored public health strategies are needed to address social inequalities in multimorbidity.
Economic impact of cervical cancer premature mortality in Brazil 2001-2030: a human capital approach
Authors: De M , Cancela Camargo , Borges L , de Souza Lopes , Leite Martins L F , Correa Schilithz A , Bezerra de Souza D L , Hanly P , Barchuk A , Soerjomataram I , Sharp L , Pearce A
Published: October 2020

Background

Cervical cancer is a preventable disease, vaccination and screening for precursor lesions are effective primary prevention measures. Some developed countries aim to eradicate it in the near future. In Brazil, there is still a need for progress in cervical cancer control. Using the human capital approach, we estimate how much cervical cancer-related premature mortality indirectly impacts the economy through productivity loss. Given the diversity of sociodemographic profiles in Brazil, we estimated lost productivity due to cervical cancer by regions, providing evidence for local decision-makers.

Methods

Data of all cancers deaths among working-age women (15-64 years) occurring between 2001 and 2015 were extracted from the National Mortality System, by region and age-group. Data on life expectancy, workforce participation, unemployment and wages were obtained from the Brazilian National Institute of Geographics and Statistics. NordPred package by software R was used to calculate predictions to 2030. Loss of productivity was calculated as the value of time between death and potential retirement age, adjusted for unemployment and participation rates.

Results

Nationally, 76,617 premature cervical deaths occurred between 2001 and 2015, and 90,437 deaths are predicted for 2016-2030, corresponding to an observed cost of US$2,260,623 (thousands) and a predicted cost of US$4,939,561 (thousands). The impact of cervical-cancer related productivity varied by region. In the affluent South and Southeast regions, 14% and 11.5% of the loss related to cancer premature mortality will be due to cervical cancer (2016-2030) while in the North and Northeast, it will be responsible for 26.8% and 17.5% of the loss, respectively.

Conclusions

If the situation in Brazil remains the same, the economic impact of cervical cancer deaths among working-age women will remain critical. It is urgent to reinforce primary prevention measures, especially in the North and Northeast regions.

Key messages

The number of cervical cancer deaths among working-age women in Brazil is predicted to increase until 2030. It is urgent to reinforce cervical cancer primary prevention measures, especially in the North and Northeast regions.
Manual on the creation of quality indicators for population based cancer screening programs in Italy
Authors: Rivolta S , Ponti A , Deandrea S , Campari C , Zorzi M , Zappa M ,   on the behalf of the ICSIWG
Published: October 2020

Issue

In many countries the organized screening programs have been in the frontline in developing and implementing the evaluation of the quality of screening and of the entire process of care following a positive test. Over the years, the three Italian Screening Groups (GIS) have separately published indicators and standards concerning the programs for breast, cervical and colorectal cancers they were responsible for, thus hampering coherence, homogeneity. In addition, at local level, an increasing number of indicators have been observed with difficult to monitor all of them.

Description of the Problem

The Screening Indicators Manual, prepared by a multidisciplinary working group, represents the guidance agreed upon by the Italian Screening Network (ONS) and the three GIS on how to develop, implement, communicate and maintain a set of quality indicators for the evaluation of cancer screening programs.

Results

The Manual indicates that the three GIS must first constitute, with ONS, the common steering committee made of six-nine experts. The involvement of the public and the management of the conflicts of interests are foreseen. The conceptual framework distinguishes indicators of context, coverage and process. It is based on six dimensions: efficacy, efficiency, security, appropriateness, person centeredness, equity. There are four macro-processes: invitation; test, further assessment and diagnosis; treatment and follow-up; evaluation. The methods include: a survey of the existent indicators, their selection with the Delphi method, the evaluation of the completeness of the resulting indicators set, its integration, when needed, by means of a public call, and finally a new Delphi round. Appropriate standards, empirical or evidence based, are then identified. Last, indicators are assigned to core or library list based on priority.

Lessons

Select, define and measure an indicator is a way to understand what we are aiming at even more than provide the measure of how we do it.

Key messages

The creation of the Manual allows to build a coherent evaluation framework for the three screening programs. The Manual promotes the adoption of rigorous methods and make feasible the monitoring activity according to its purpose, level of observation and detail of information needed.
Estimating life expectancy among older multimorbid adults to personalize preventive care
Authors: Gastens V , Del Giovane C , Anker D , Syrogiannouli L , Schwab N , Rodondi N , Chiolero A
Published: October 2020

Background

Providing high value care and avoiding care overuse is a challenge among older multimorbid adults. There is evidence on benefits and harms of cancer screening and cardiovascular diseases (CVD) preventive treatment up to the age of 75. However, this evidence is not directly applicable to older multimorbid patients. Because each cancer and CVD preventive care has a specific lagtime to benefit, many guidelines recommend tailoring preventive care according to the estimated life expectancy (LE). However, there is no tool to estimate LE among multimorbid patients. Our objectives are therefore to develop new mortality risk prognostic indices and to derive a new LE estimator, what will help clinicians tailoring preventive care in older multimorbid adults.

Methods and Results

We conduct a prospective cohort study by extending the follow-up of 822 patients in Bern, Switzerland, included in the OPtimising thERapy to prevent Avoidable hospital admissions in Mulitmorbid older people (OPERAM) study over 3 years. Detailed information about cancer screening and CVD preventive treatment will be collected. We will identify variables independently associated with mortality and weight the variables to create 1 year and 3 year mortality prognostic indices. We will transform the 3 year prognostic index into a LE estimator. Preliminary results will be presented at the congress.

Conclusions

We will develop the first life expectancy estimator specifically for older multimorbid adults. This tool will help clinicians to tailor cardiovascular and cancer preventive care in older multimorbid adults.

Key messages

Because of the lagtime to benefit, personalizing preventive care by estimated life expectancy is recommended. We will provide the first life expectancy estimator for older multimorbid adults.