bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of Covid-19 on incident reporting
Authors: Doimo A , Bianchet B , Moretti V , Mellace F , Favero B , Longobardi G , Bellomo F , Degan S , Farneti F , Cocconi R
Published: October 2021

Background

Incident reporting (IR) is a system of spontaneous and voluntary reporting of events, important for assessing safety risks and for improving safety and quality of care. Since Covid-19 pandemic led to a change on the hospital organization, related to an overload of work and an increase of pressure in the wards, this study aims to evaluate the impact of Covid-19 on IR and on safety culture.

Methods

This retrospective study analyzed the data of IR in 2019 and 2020 in the academic hospital of Udine. Number of IR, severity of the events (near miss, events with no harm and events with harm) and IR'S topic were compared. Inappropriate IR were excluded from severity analysis. The chi-square test was used for statistical significance.

Results

IR in 2020 showed a reduction of 17.7% compared to 2019 (1097 vs 1334, p < 0,05). Furthermore, we observed a reduction in near misses (276 vs 390, - 4,81%, p < 0,05) and an increase in events with harm (226 vs. 219, + 4,52%, p < 0,05). Events with no harm showed no significant increase. The analysis of topics revealed an increase in 2020 of problems concerning assessment of patient (+ 4.47%), especially swab's results delays, organizational aspects (+ 4.88%), due to staff reassignment and ward reorganization, and infection prevention and control (+ 4.65%). This increase is significantly associated with Covid-related IR (p < 0,05).

Conclusions

In 2020 were collected fewer IR than 2019 and with an higher level of severity. This change may be associated to the increased workload of the staff who had less time to report incidents. Nevertheless 2020 showed an increase in reporting Covid-19 related issues concerning delay of diagnostic test, new work condition and infection prevention and control measures. This analysis suggests that the decreased number of IRs and near miss during the first year of the pandemic could represent a reduction in safety culture. Additional data are needed.

Key messages

Covid-19 disease influenced the safety culture by reducing the number of IR and near misses reported. New Covid-related issues emerged as critical during the pandemic.
Future challenges in hospital hygiene and public health due to air-associated health hazards
Authors: Döhla M , Döhla C , Exner M
Published: October 2021

Issue

In recent decades, hospital hygiene has focused on effective control strategies against contact or waterborne transmissions. Outside operating theatres or infection wards, airborne pathogens have played a minor role so far. For public health, the airborne route of transmission also played a subordinate role. Apart from bioterrorism, the focus here is more on chemical and physical hazards. In future, air-associated health hazards will increase. Besides airborne pathogens, examples include insects, heatwaves, particulate matter as well as pollen, mould and radon.

Description of the problem

No attention has been paid to systematic risk regulation of the transmission mode air. Hospital hygiene is ‘micro-level public health' with a particularly vulnerable population. The experience of hospital hygiene measures can help to develop appropriate public health interventions. Which air hygiene measures have we taken to counter SARS-CoV-2 and how can these be more efficient in the future?

Results

In response to SARS-CoV-2, face masks were introduced. This has reduced the risk of transmission both in hospitals and in public, but has not completely prevented indirect transmission through aerosols indoors. Ventilation rules further reduced the risk of transmission, but were not applicable everywhere. Since most buildings do not have central air filtration units, the use of decentralised air filters increased, with unknown relevance.

Lessons

Breathing air cannot be substituted. Therefore, air hygiene is a primary prevention and needs to become more structured to be effective against future air-associated health hazards. Future construction projects for hospitals and public buildings must be adapted to prevention of air-associated health hazards. Hazard and risk analyses, technical, organisational and personal control measures, their monitoring and an incident management should be combined into an ‘Air Safety Plan' as part of a hygiene plan for hospitals and the public.

Key messages

Breathing air is increasingly polluted by natural or anthropogenic chemical, biological and physical influences and thus becomes a carrier of health hazards, especially for vulnerable groups. Since air cannot be replaced, primary preventive air hygiene based on “Air Safety Plans” will be important in the future as an efficient measure against air-associated hazards such as SARS-CoV-2.
COVID-19, Stress and Behavioral Aspects Among Students of the University of Georgia
Authors: Lobjanidze M , Jikia T , Antia Kh , Lobjanidze T
Published: October 2021

Background

Pandemics, state of emergency, restrictions and new regulations, new ways of thinking, teaching, learning, working and communicating. Transforming social environment, Covid-19 pandemics has greatly affected lifestyle of all people around the globe. In this matter, students are not an exception. The aim of the study was to describe self-reported stress and behaviors of students at the University of Georgia during Covid-19 pandemics.

Methods

In frame of online survey design, self-administrative semi-structured Questionnaires (Geo/Eng) were disseminated via UG's intranet. Target population was BA, MA and One-Cycle Program students with active status (6545). Questionnaires were available during two weeks.

Results

In result, 446 (CL = 95%; CI = 5) students participated in online survey. Students reported physiological, emotional, and cognitive symptoms they never noticed before moving to online learning due to Covid-19 pandemics. Both, local and foreign students reported headaches (30%) and Feeling of being depressed (25%). Fatigue (25%) and irritation (28%) was marked by local students, nearly 20% of foreign students marked hardness of dealing with the life problems. Changing of sleep and physical activity patterns were highlighted by both local and international students. In average, 55% students evaluated their sleep as deteriorated or very deteriorated. 60% of students could recall only 3 days or less when they walked for at least 10 minutes without break. 35% noticed increase or significant increase of body weight. Nearly 30% of students evaluated their stress level as 8; 9; or 10 at ten-point scale (0=no stress; 10=high stress level).

Conclusions

Study hasn't shown significant differences between local and international students. Negative changes were reported in physical and emotional level, physical activity and sleep patterns. Study results underlined importance of Further research and strengthening of supportive services for students during pandemics.

Key messages

Creating/strengthening of supportive services for students during pandemics. Integrate physical activity training into online lectures.
Antivaccination attitudes and intention to take COVID-19 vaccine in Croatian adult population
Authors: Miskulin M , Gavranic K , Domacinovic T , Pavlovic N , Vukoja I , Miskulin I
Published: October 2021

Background

COVID-19 vaccine is an effective choice to stop the pandemic. To improve COVID-19 vaccination coverage the better understanding of factors influencing individual intention of vaccination is needed. Antivaccination attitudes (AAs) are important predictors of vaccination behaviour. The aim of this study was to investigate the intention to take COVID-19 vaccine in Croatian adult population and to evaluate factors that influence such intention with emphasis on AAs.

Methods

This cross-sectional questionnaire study was conducted during the June 2020 to December 2020 in convenient sample of adults from Split-Dalmatia County at the primary health care setting. Vaccination Attitudes Examination scale (VAX) was used to assess AAs.

Results

The study sample consisted of 632 subjects (52.7% males and 47.3% females). The median age of all subjects was 38.0 (interquartile range (IQR) 29.0 - 48.0) years. The overall prevalence of intention to take COVID-19 vaccine was 46.8%. Males and subjects living with the partner more frequently expressed intention to take COVID-19 vaccine (P = 0.001 and P = 0.015 respectively). The study revealed fair negative correlation between AAs and intention to take COVID-19 vaccine (rho=-0.453; P < 0.001). Subjects who did not intend to take COVID-19 vaccine demonstrated larger mistrust of vaccine benefits, more worries over unforeseen future effects, more concerns about commercial profit and larger preference for natural immunity (P < 0.0001, P < 0.0001, P < 0.0001, P < 0.0001, respectively).

Conclusions

The study showed fairly low proportion of subjects who intended to take COVID-19 vaccine. The study revealed that gender, marital status, and AAs are good predictors of intention to take COVID-19 vaccine in study population. The good predictors of intention to take COVID-19 vaccine in Croatian adult population should be considered during COVID-19 vaccination popularization strategies development.

Key messages

The structured communication campaigns on COVID-19 and COVID-19 vaccines should be developed and directed specifically to all target groups for vaccination. Understanding the factors that could improve the acceptance of COVID-19 vaccination is crucial to design effective vaccination program.
Adherence to the Mediterranean Diet during COVID-19 national lockdowns: a systematic review
Authors: Della Valle PG , Mosconi G , Nucci D , Gianfagna F , Iacoviello L , Bonaccio M , Odone A
Published: October 2021

Background

The Mediterranean Diet (MD) is one of the healthy eating plans recommended to promote health and prevent chronic diseases. During the COVID-19 pandemic, many countries adopted restrictive measures to mitigate infection spread, which might have influenced people's lifestyle and dietary habits. We conducted a systematic review to evaluate the impact of stay-at home orders' implementation on adherence to MD.

Methods

Studies were identified searching Medline, Embase, and Web Of Science, the search strategy was developed using a combination of free text and mesh terms referring to COVID-19 pandemic, lockdown, and MD. Studies published until March 31st, 2021 were included. We only considered studies reporting original data from quantitative analysis and assessing modifications of adherence to the MD through validated dietary scores or any change in consumption of food categories that are typically ascribed to the MD. Data extraction, pooling and quality appraisal of the included studies, were conducted applying PRISMA guidelines.

Results

42 studies were retrieved. After duplicates removal, and in-blind two-step screening, 10 studies met our a priori defined inclusion criteria and were included in the review. 71.4% of the studies reporting a rate of change in adherence, measured through validated questionnaire both before and during lockdown, reported an increase, while 28.6% reported no significative changes. All included studies reporting the percentage of participants having a high adherence to the MD, based on their results on MEDAS questionnaire, before and during the lockdown, found an increase in this percentage.

Conclusions

Adherence to the MD could have raised in people undergoing lockdowns due to COVID-19.

Key messages

The impact of restrictive measures on determinants of health must be monitored. Despite the literature suggests adherence to MD has declined in the last years, this trend may have reversed or, at least, slowed during the initial phases of the current pandemic.
Corona-specific health literacy: a longitudinal study in the German-speaking part of Switzerland
Authors: Guggiari E , De Gani SM , Berger F , Jaks R
Published: October 2021

Background

The COVID-19 pandemic is accompanied by an infodemic, i.e. a flood of conflicting infor-mation through numerous channels and mis-/disinformation. To cope with these challenges and to make sound health-decisions, people need skills that enable them to access, under-stand, appraise, and use health-related information, i.e. adequate health literacy (HL). Thus, the present study investigates how people in the German-speaking part of Switzerland handle with Corona-specific information, what their difficulties are and what potential improvement measures could be.

Methods

Three representative samples of 1'000 individuals each were interviewed online in early sum-mer, autumn and winter 2020 using a modified version of the HLS-EU-Q16 questionnaire. Da-ta were analyzed using descriptive methods and an index for Corona-specific HL was built.

Results

In early summer, 55% of the German-speaking Swiss population reported adequate Corona-specific HL, with a tendency to increase with the duration of the pandemic (autumn: 62%; winter: 63%). Nonetheless, a great proportion reported difficulties, especially with assessing the trustworthiness of information from the media. With the progress of the pandemic, partici-pants felt less informed and the proportion of (very) poorly informed increased from 8% in early summer to 16% in winter 2020.

Conclusions

Participants often found it difficult to assess the trustworthiness of information on COVID-19 and to derive consequences for their own behavior. Hence, it is important that all relevant stakeholders such as health organizations, authorities and media support the population with tools to facilitate the use of health information and to empower them to take responsibility for their own health as well as for their community.

Key messages

People need adequate HL to handle the amount and complexity of COVID-19-related information. Relevant stakeholders need to take over responsibility to empower the population and to enhance their HL.
The implementation of health promotion on health professionals practice and public policy managers
Authors: Casamitjà MT , Ventura N , Mantas S , Sunyer J , Mallolas J , Bou A , Parreño R , Turró O
Published: October 2021

Background

Reorientation in interventions aimed at implementing Health Promotion (HP) on health professionals and public policy managers is a key issue on the political agenda. It is crucial to know which factors influence the process of implementing HP between both fields. The aim of this study was to identify barriers, facilitators and proposals for the implementation of HP and to know which were the differences and similarities between health professionals and public policy managers.

Methods

A qualitative study was carried out to determine which were the barriers, facilitators and recommendations for the implementation of HP programmes. Between March 2017 -December 2018 six focus groups, purposively selected, were formed (32 women & 20 men). The study was completed with three semi-structured interviews to public policy managers of our area between January 2020-February 2020. Theorical saturation was reached and validity of the study was ensured by triangulation.

Results

Globally, health professionals and public policy managers identified shortage of global actions, lack of coordination between different health agents and the complexity of social determinants in the implementation of HP as the main barriers. Common facilitators were belief in the effectiveness of social prescription and the tasks related to HP and the existence of new professionals oriented towards the individual and their assets in health. Greater intersectoral relationship with a vision of health in all policies, redistribution of public resources and increase in social prescription were the most valued proposals.

Conclusions

Prioritize HP strategies in the agenda of all professionals. Health in all policies from all health agents and from interdisciplinary work. Identify and deepen in the study of these factors to develop new proposals for the implementation of HP.

Key messages

Greater intersectoral relationship is needed. Prioritize HP strategies in the agenda of all professionals.
Public health lessons from the soda taxes enacted in France in 2012 and modified in 2018
Authors: Le Bodo Y , Etilé F , Julia C , Friant-Perrot M , Breton E , Lecocq S , Boizot-Szantai C , Bergeran C , Jabot F
Published: October 2021

Background

In 2016, the WHO officially recommended sugar-sweetened beverage (SSB) taxation as a strategy to reduce consumption, stimulate product reformulation and generate revenues for health-related programmes. This recommendation was based on a number of studies and experiments amongst them the 2012 French SSB tax that was redesigned in 2018. In this presentation, we summarize the lessons learnt from the soda taxes in France and offer insights on their potential public health benefits.

Methods

Our rationale is structured according to the interdisciplinary perspective of the Soda-Tax research consortium (2019-2023), addressing: (1) the soda tax policy change process; (2) the impact on price and purchases; (3) the consumer receptiveness to the tax and; (4) its legal framework and potential application to other foods/nutrients.

Results

Our overview of evidence highlights that the process leading to the enactment of the 2012 tax was initially based on a public health justification that was later set aside in favour of budgetary concerns. The tax, whose rate was flat and low and whose scope was extended to artificially-sweetened drinks containing no added sugar, generated modest effects on SSB consumption. Yet, it was ground breaking and offered an opportunity to appreciate its equity, to document its acceptance through a population-based survey and its legal viability. Six years later, the new tax comes closer to international recommendations: it is framed within the scope of public health action, focuses on SSBs and its rate is indexed to the quantity of added sugar in the drink.

Conclusions

The Soda-Tax project will study the degree of policy learning that may have contributed to the evolution of the 2018 tax, as well as the conditions of its implementation, administratively more complex than the previous one. It will also explore the social acceptability of this new tax and the extent to which it results in higher SSB prices, lower consumption and changes in the market.

Key messages

The design of the 2012 French soda tax was not optimal for public health, but it set a precedent. The 2018 soda tax, closer to international recommendations, deserves further investigation.
Tackling bad air and promoting prevention and care for chronic lung diseases in sub-Saharan Africa
Authors: Ku GMV , Da Silveira VC , Kegels G , Develtere P , Nemery B , Doussou JP , Bossyns P , Gyselinck K
Published: October 2021

Chronic respiratory diseases (CRD) are de facto neglected diseases in Sub-Saharan Africa (SSA) although prevalences are significantly rising and more women and young people are affected. Disabilities from CRD lead to decreased productivity and steep increases in direct and indirect costs for individuals, families, and society. The wide implications are recognized but serious challenges to effective action remain. We conducted scoping reviews of literature and policy documents on CRD and interviewed key informants to identify specific determinants and current health system responses in SSA to formulate targeted and feasible strategies that could inspire future interventions to address the issue. In SSA, air quality is poor and worsening (100% exposed to PM2.5 levels exceeding WHO guideline value), affecting development of and damaging lungs. Poor air quality is driven by socio-demographic phenomena with accelerated rural-to-urban migration and mobility needs; industrial and agricultural pollution; fossil fuel driven transport; inadequate waste management; electric power generation. A large component is indoor air pollution from inefficient burning technologies of unclean fuels and tobacco smoke, combined with insufficient ventilation. Health systems responses to CRDs are poor/non-existent. Medications are rarely available, CRD knowledge is low among healthcare professionals and the population, prevention activities are lacking. Holistic approaches to tackle outdoor & indoor air pollution and labour regulations for decent work can be part of the solutions. “Basic CRD care packages” can be introduced and decision-support to healthcare professionals offered. Engagement of stakeholders (communities; civil society, e.g., women's organisations, professional associations) can be commenced. Sporadic/scattered projects/programs can be stimulated towards synergistic actions. An assessment tool determining contextual applicability of strategies can help tailor appropriate responses.

Key messages

Chronic respiratory diseases (CRD) are on the rise in sub-Saharan Africa, commonly caused by outdoor air pollution (bronchial asthma) & use of biomass fuels (chronic obstructive pulmonary disease). Contextualized multisectoral actions are needed to tackle bad air and its causes (rapid urbanization; industrial, agricultural pollution; unclean fuels, etc) and address CRDs and risk factors.
Inequalities in incidence and prevalence from arthropathy in Lithuania by age and gender
Authors: Knystautas S , Andriuškevičiūtė D , Meščeriakova-Veliulienė O
Published: October 2021

Background

Arthropathy is a collective term for any disease of the joints. Osteoarthritis is the most common type of arthritis. It is characterized by joint pain and functional impairment which results in a negative impact on quality of life. The aim of the study is to analyze inequalities in prevalence and incidence from arthropathy by gender and age groups and their changes in Lithuania in 2001-2019.

Methods

The data (aged 0+) on incidence and prevalence from arthropathy (ICD-10 codes M00-M25) in 2001-2019 was obtained from Hygiene Institute. Joinpoint regression analysis was used to assess trends of rates during 2001-2019.

Results

In 2001-2019 incidence rates of arthropathy changes were similar in females (by 6.5% per year, P < 0.001) and males (by 6.6% per year, P < 0.001). However, prevalence was higher in males (by 5.6% per year, P < 0.001) than in females (by 4.1% per year, P < 0.001). Incidence of arthropathy increased on average by 6.6% per year (P < 0.001) in the age group 18-44 years. Besides, incidence rates increased: by 6.1% per year (P < 0.001) among adults aged 45-64 years and by 6.2% per year (P < 0.001) among adults ≥65 years. According to statistical data in 2001-2019 prevalence rates increased the most among adults aged 18-44 years (on average by 5.9% per year, P < 0.001). Prevalence increased: in the age group 45-64 years by 4.0% per year (P < 0.001); ≥65 years by 2.3% per year (P < 0.001).

Conclusions

In 2001-2019 incidence rates of arthropathy among females and males were similar and prevalence rates were higher in males compared to females. Moreover, the highest incidence and prevalence rates were in age group 18-44 years.

Key messages

In 2001-2019 the prevalence of arthropathy was higher in males than females in Lithuania. In all age groups prevalence and incidence increased (notably among adults aged 18-44 years).
Follow-up of the diabetic patient: experience of a district of the city of Casablanca
Authors: Tsoumbou-Bakana G , Kissi D , Hassoune S , Nani S
Published: October 2021

Introduction

Diabetes is a chronic disease with a significant socioeconomic impact, especially in developing countries. In Morocco, the prevalence of diabetes is estimated at 12.4% and there are nearly 12,000 deaths/year related to this disease and its complications.

Objectives

To describe the epidemiological, therapeutic and follow-up profile of diabetic patients.

Patients and Methods

This was a cross-sectional epidemiological study conducted from 20 to 22 March 2018, in the Mers Sultan-Fida district of the city of Casablanca, in the context of mass consultation of diabetic patients. The collected data were obtained through data collection and the obtained results were analyzed by SPSS v.16 software.

Results

A total of 228 patients were included in this study, the median age was 62 years [13-88], the median age of diabetes was 10 years [0.25-36]. The most frequent circumstance of discovery was the appearance of functional signs (31.6%). Regarding family history, 43.9% had a history of diabetes and 49.1% a history of hypertension. The median blood pressure was 150/80 mmhg, the median body mass index was 33.54 [21.16-42.72]; the mean HbA1c level was 8 +/- 1.81 g/l [5-15]. In the follow-up of these patients, 14.5% admitted to regular check-ups. Regarding treatment, 52.6% were on oral antidiabetic drugs and 22.8% on insulin therapy, 37.3% declared to take their treatment regularly.

Conclusions

It seems important to continue to raise awareness among diabetic patients in these three districts about the importance of diabetes control and regular monitoring of this condition in order to prevent or delay the occurrence of possible complications.

Key messages

Diabetes is a major public health issue in Morocco. Patient education on the importance of diabetes management is systematic.
The challenge of monitoring climate changes and its consequences in North Macedonia
Authors: Petrovski K , Kjosevska E , Memeti S , Petrovski M
Published: October 2021

Background

The aim of the paper is to assess how well prepared are the public and the public institutions for developing a digital climate change monitoring system.

Methods

A descriptive-analytical method and cross-sectional study were applied. Literature from the UNDP, Green Climate Fund (GCF), European Commission and the WHO was used. An on-line survey with 101 participants was conducted to evaluate the level of public interest on tackling climate change, and establishing an inter-institutional integrated system (IIIS) for monitoring climate change.

Results

The Government has appointed a National Body for Cooperation with the GCF in order to strengthen the capacity of the state for strategic engagement. Decreasing rainfall, cold and heat waves imply that the country is vulnerable to natural disasters, such as droughts, floods and forest fires. Furthermore, the survey shows that 81,2% of the respondents think that climate changes have a negative impact on their health, whereas 70,3% consider that the public is not sufficiently informed about climate changes and the state of the ecosystem. 58,4% are not familiar with any steps being taken against climate change. Only 5% know about the development of an IIIS for monitoring climate change. 38,6% say they would participate in the work of the IIIS.

Conclusions

The IIIS should be developed with the aim to connect key institutions that would create a strong hub aimed at researching and preventing diseases caused by climate changes. Including the public in the IIIS could help pinpoint local problems. If the establishment of an IIIS yields good results, it could grow into an international monitoring system. Implementing the General Data Protection Regulation and using proper safeguards would be crucial in protecting the gathered and exchanged data. This research will help develop the IIIS to be the first of its kind in the country, with the potential to prevent climate change related diseases, as well as disasters.

Key messages

The mutual effort of the society as a whole, including the government, NGO’s, the public and private sectors is the only way we can battle the growing threat of climate change. Creating a digital, centralized integrated international and inter-institutional digital tools is the best weapon for monitoring the climate change and its consequences.
Public health strategies to combat opioid epidemic in the United States: A systematic review
Authors: Balidemaj F
Published: October 2021

Background

The opioid epidemic in the United States is a national public health crisis. Driven by an increase in availability of pharmaceutical opioids and by an increase in their consumption, specifically, for pain treatment, more so in the past twenty years, it has led to an economic cost of prescription opioid abuse, overdose, and dependence in the United States estimated to be 78.5 billion USD. The purpose of this systematic review was to identify and evaluate public health strategies that contribute towards combatting the opioid crisis.

Methods

Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist, a search was conducted of the PubMed database for articles in English language that analyzed the most effective ways to regulate health markets to decrease the opioid crisis in the United States.

Results

The initial search yielded 2397 titles, of which 15 full-text articles were ultimately selected for inclusion in this systematic review. The review identified four categories in overcoming this epidemic nationwide, including required improvement in patient utilization of and access to safe and effective treatment options for opioid abuse and overdose, addressing the stigma correlated with opioid use, considering appropriate use of abuse deterrent formulations (ADF) along with patient education, and improving prescribing practices via utilization of drug monitoring programs, CDC opioid prescribing guidelines and provider continuing education.

Conclusions

Attempts to combat the opioid epidemic have been made, and the state and federal governments have only recently started to understand the magnitude of the seriousness of this public health crisis. While the methods with promising improvement of the situation have been identified, implementing them has shown to be a challenge. Continued application is needed, while considering possible new steps that could help reinforce their utilization further.

Key messages

Attempts to combat the opioid epidemic have been made, and the state and federal governments have only recently started to understand the magnitude of the seriousness of this public health crisis. The methods with promising improvement of the opioid crisis situation have been identified, however utilizing and implementing the existing public health strategies has shown to be a challenge.
Health of older people in places and work-related outcomes: are all health indicators equal?
Authors: Murray ET , Shelton N , Norman P , Head J
Published: October 2021

Background

Health has been posited as an explanation for why older people who live in more disadvantaged areas have worse work-related outcomes. The policy implication being that if a higher proportion of older persons in a place had better health, those labour markets would be better for everyone. No literature exists on this topic.

Methods

Data was used from 428,646 members of the Office for National Statistics Longitudinal Study (LS) who were 16-74y at the 2011 census and had information on employment status, economic activity and occupational socioeconomic classification. Generalised Structural Equation Modelling was used to examine whether each of the three work-related outcomes were equally related to nine 2011 local authority district (LAD)-level older adult health indicators.

Results

In age-adjusted analysis, all nine LAD-level health indicators (modelled in terciles) were associated with all three work outcomes. However, strengths of association varied both across and within each outcome. For example, the strongest associations were for being ‘sick or disabled' versus ‘In employment'. If an LS member lived in the ‘unhealthiest' versus ‘healthiest' third of LADs, associations varied between a high of 2.74 higher odds (95% CI: 2.53,2.95) for long-term illness and a low of 2.10 higher odds (1.89,2.32) for disease-free life expectancy at age 50y. The weakest associations were for part-time versus full-time employment: ranging from life expectancy at birth at 1.29 (1.21,1.38) to healthy-life expectancy at age 50y: 1.18 (1.10,1.27). Adjustment for individual health reduced, but did not eliminate, associations. Sensitivity analysis showed robustness to area health indicators being assessed for sub-groups of older people (ages 50-64 & 65-74), genders and a reduced sample of older persons (50-74y) only.

Conclusions

Health of older people in places is associated with work outcomes of people in those places; both the older people themselves and the wider community.

Key messages

At a place level, health and work outcomes are linked. Strengths of association between place-level health and work outcomes will depend on the health measure used.
Space-time analysis of pulmonary tuberculosis hospitalizations in mainland Portugal (2002-2016)
Authors: Almeida Santos J , Nunes C
Published: October 2021

Background

Tuberculosis (TB) imposes a great pressure on healthcare resources, particularly in terms of hospital-based treatment and extended hospitalization. Understanding the space-time clustering of pulmonary TB (PTB) hospitalizations leads to a richer knowledge to assist decision makers in Public Health to develop strategic interventions to reduce these hospitalizations. Our objective was to identify space-time clusters of PTB hospitalizations at municipality level in mainland Portugal.

Methods

Ecologic study using data from nationwide hospitalization database of Portugal. All patients with a diagnosis of PTB (primary or secondary) and reference to place of residence were included in the study (n = 22760). Space-time analysis was used to define clusters with high rates of hospitalizations at the municipality level between 2002 and 2016.

Results

Overall hospitalization rate was 17.7/105population/year, with hospitalization rates decreasing by 64.9% during this period (2002:29.4/105; 2016:9.6/105). Space-time analysis of the overall period identified five different clusters, with the clusters in Lisboa and Porto metropolitan areas presenting the highest hospitalization rates (51.5/105 and 43.6/105population, respectively). In a more recent period (2011-2016), were identified four clusters with Lisboa metropolitan area and a northeast rural region presenting the highest hospitalization rates (27.6/105 and 46.2/105population, respectively).

Conclusions

PTB hospitalization rates in continental Portugal presented a constant decrease between 2002 and 2016. We identified a cluster of PTB hospitalizations in a rural region of northeast mainland Portugal, an area where the incidence of TB is below 20/105population. A closer look is needed to understand the reasons behind this high number of hospitalizations. Our results show that space-time analysis can be a resource to monitor the dynamic of the disease and identify possible areas needing Public Health intervention.

Key messages

Pulmonary tuberculosis hospitalizations are decreasing in mainland Portugal, with the two major urban areas (Lisboa and Porto) presenting the clusters with highest hospitalization rates. A cluster of hospitalizations for pulmonary tuberculosis was identified in a rural region in the northeast of mainland Portugal, an area with a low incidence of tuberculosis.
Illegal drug sales in the mirror of the dark web marketplace
Authors: Vlassov V , Meilahs P , Soshnikov S , Idrisov B
Published: October 2021

Background

Studies of the epidemiology of substance use are problematic by the disorder's nature and the illegal character of the substances' turnover. For safety, the illegal substances' markets had moved to the Internet, to the less transparent darknet part. The objective of this study was to get estimates for the Russian drug market using data collected at dark net market ‘Hydra', get the amounts of drugs offered, the relative frequency of offers, and the regional distribution of the market activities. We analyze the relationship between estimates of the illegal drug market with traditional indicators of drug use disorders on the next stage.

Methods

We use two types of data: 1) Deep Web Black Market data; 2) Official Russian statistical indicators related to drug use. We use Python program via VPN service to extract data. R software was employed for statistical analysis to build the maps of drug offerings and sales by the regions of Russia. Er use the descriptive statistics and correlation analysis to compare the estimates with the state statistics.

Results

Using the estimates of sales for the drug classes in grams by region (per 100000 population), we mapped the data and found that there is a correlation with the registered drug users and drug-related deaths. There is no Hydra sales of opiates in some regions indicating that older supply channels are still active. Total drug sales and offers championed by cannabis, opiates/opioids, cocaine, amphetamines and the other drugs in smaller amounts. There is a significant correlation between the supply of opiates in regions of Russia and the official incidence of fatal drug poisoning (r = 0.41; p = 0.003), and the number of HIV positive injected drug users (r = 0.47; p = 0.002).

Key messages

Analysis of the deep internet sales of drugs helps assess the situation with the illegal drug supply in the regions of Russia. Data on deep internet sales of drugs should not substitute the other sources of data.
The economic burden of coronary artery disease: A systematic review
Authors: Lanza-León P , Sánchez-Ruiz L , Cantarero-Prieto D , Blázquez-Fernández C , Moreno-Mencía P , Pérez-Hernández F , de la Torre JM , Cayón-de las Cuevas J
Published: October 2021

Background

Although mortality has decreased in recent decades and patient survival rates have increased, cardiovascular disease remains one of the leading causes of mortality and morbidity in developed countries these days. The purpose of this study is to analyze the available literature that describes the economic burden of coronary artery disease and to compare costs. The study is framed in the Horizon 2020 project “A patient-centered early risk prediction, prevention, and intervention platform to support the continuum of care in coronary artery disease (CAD) using eHealth and artificial intelligence - TIMELY”.

Methods

A systematic literature review has been carried out using various databases such as PubMed, Web of Science, Cochrane Library and Scopus. Precisely, a 5-year retrospective horizon has been considered until the present (April 2021). In all databases, terms related to “Coronary artery disease” and “Cost*” were combined.

Results

113 publications were primary located. After examining the titles based on the eligibility criteria, 16 articles were selected. Of these, 5 articles were excluded because they did not meet the inclusion criteria. Therefore, a final set of 11 selected studies were considered in this review. The costs included in the review correspond, mainly, to direct healthcare costs. Our results affirm that the highest costs are derived from the possible adverse effects (€41,450, approx.).

Conclusions

The figures presented in this literature review will provide a good framework to quantify these costs for both economic experts and researchers and political decision-makers, both nationally and internationally.

Key messages

The costs included in the review correspond, mainly, to direct healthcare costs. The highest costs are derived from the possible adverse effects.
Study of rs10177833 polymorphism in SLC4A5 gene and salt sensitivity in Bulgarian population
Authors: Georgieva Tz , Kuzova E , Arsova St , DImbareva D , Georgieva R , Duleva V
Published: October 2021

High sodium intake is associated with increased blood pressure and and increased risk of cardiovascular disease (CVD). Among the countries of the European Union, Bulgaria ranks first in mortality from CVD. Genetically determined salt sensitivity is present in 50% of the hypertensive and 26% of the normotensive population, posing a major public health problem. The present study was conducted within the National Program for Prevention of Chronic Non-Communicable Diseases 2014 - 2020 to assess the sodium intake of the population in Bulgaria. 36 normotensive participants are included in the study. DNA from each volunteers was isolated and genotyped for rs10177833 (A>C) in SLC4A5 gene by TaqMan SNP genotyping assay. To determine the 24-hour urinary excretion of sodium in the subjects, a random sample was taken from each participant. Sodium concentration was determined by atomic absorption spectrometry. A WHO protocol has been used to recalculate sodium excretion (Protocol for Sodium Determination in 24-hour Urine Samples). Eighteen of total of 35 participants had wild AA genotype (51.43%), thirteen were heterozygotes (37.14%) and four were carriers of two polymorphic C alleles (11.43%). The frequency of A allele of rs10177833 (A>C) in SLC4A5 gene was 70%, whereas polymorphic C allele was only 30%. The correlation analysis showed negative statistical significant relationship between rs10177833 in SLC4A5 gene and sodium concentration (in milligrams) in 24 - hours urine (r = -0.365, p = 0.031). Also the holders of CC genotype had significant lower values of Na compared to these with wild AA genotype (p = 0.01) and compared to heterozygotes (p = 0.019). In conclusion, we found a clear relationship between the polymorphic variant rs10177833 in SLC4A5 gene and the concentration of sodium in urine in Bulgarian normotensives. The tendency of association was found between the studied polymorphic variant and blood pressure values, which should be studied in a large number of participants

Key messages

Increasing the population's awareness of health risks with increased salt consumption. Regular monitoring of salt consumption.
Fast WGS source attribution of Listeria monocytogenes outbreak in a sheep flock in Abruzzo region
Authors: De Angelis M , Sulli N , Salucci S , Torresi M , Centorotola G , Ciarrocchi A , Marfoglia C , Pisegna ON , Pomilio F , Cornacchia A
Published: October 2021

Background

Listeriosis is a life-threatening disease in human as well as animals, cows and sheep are the most sensible to the disease. Correlation to feed is well documented (silage). Some clonal complexes (CCs) are more virulent than others and frequently involved in animal and human listeriosis. Whole genome sequencing (WGS) and in silico CCs identification and core genome multilocus sequence typing (cgMLST) determination are the best way to characterize isolates and confirm connection between clinical strains and source of contamination. This work aimed to demonstrate the advantages of using WGS to find the source of Listeria monocytogenes (Lm), causing an outbreak in an ovine farm in Abruzzo region.

Methods

Lm was detected according to ISO 11290-1:2017. Serogroup was determined by multiplex PCR. WGS data were obtained using Illumina platform. Sequences were used to assess CCs and cgMLST according to BIGSdb Pasteur platform. Two brain samples and 1 lymph node from 2 sheep, one sample of silage (15 analytical portion), and 1 sample of hay were tested.

Results

Lm was detected in all animal specimens and in 2 analytical portions of feed (silage) tested. Out of 35 colonies detected 28 were identified as Lm (27 serogoup IVb and 1 sample of silage serogroup IIa). Five colonies were selected for WGS (one from each animal brain, one from the lymph node and one from each positive analytical portion of silage), among them only one colony from the silage showed the same CC of the strains isolated from sheep (CC1). cgMLST revealed no allelic distances between these strains.

Conclusions

CC1 is the main virulent clone among Lm isolates often involved in human and animal outbreak. Feed may be a vehicle for Lm and could be the outbreak source. Cases ceased after removing the silage. Use of WGS is a definitive help in source attribution when feed is available and the sampling is done in a correct manner.

Key messages

Silage can be cause of listeriosis in livestock. WGS can improve source attribution of outbreaks detecting the relatedness of the strains and improving the epidemiological investigation in case of outbreak.
Sickness absence and disability pension within different employment status in multiple sclerosis
Authors: Machado A , Murley C , Hillert J , Alexanderson K , Friberg E
Published: October 2021

Introduction

Limitations associated with Multiple Sclerosis (MS) can restrain work capacity and productivity, reducing the possibility to remain in work. Whilst access to sickness compensation might be an option, transitions to other types of employment, such as self-employment, might be considered. We aim to investigate the association of Sickness Absence (SA) and Disability Pension (DP) with employment status among people with multiple sclerosis (PwMS) before and after MS diagnosis compared with people without MS.

Methods

A prospective longitudinal study was conducted using Swedish register data of 2,779 MS patients diagnosed with MS in 2008-2012 in working ages (20-59 years) and 13,863 population-based matched references. Levels of SA and DP one year before and four years after MS diagnosis were analyzed. Risk of annual SA and DP levels of more than 180 days were compared among the MS patients and references and, their different types of employment, by means of Cox proportional hazard models and adjusted for socio-demographic variables and SA and DP before MS diagnosis.

Results

In general, people with MS had higher levels of SA and DP before and shortly after MS diagnosis compared to references. PwMS showed a significantly higher probability of reaching over 180 days of SA (Hazard Ratio [HR]=4.89, 95% Confidence interval [CI]=4.43-5.40) and over 180 days of DP (HR = 6.31, 95% CI = 5.46-7.30)) than the references, regardless of type of employment. Moreover, when compared to employed references, self-employed PwMS had similar likelihood to reach over 180 days of SA than employed PwMS, (HR = 4.27, 95% CI = 3.81-4.77) and (HR = 3.83, 95% CI = 2.73-5.38), respectively. In contrast, self-employed references showed less probability (HR = 0.49, 95% CI = 0.31-0.78) to reach over 180 days of SA compared to the employed references.

Conclusions

In contrast to references, employed and self-employed PwMS had similar probabilities of reaching over 180 days of SA.

Key messages

This study emphasizes that in Sweden also self-employed have access to sickness compensation, independently of employment status condition. Access to sickness compensation is utilized by PwMS.