bluuebunny/crossref_metadata_2025 huggingface dataset:
Gambling disorder and its associated factors in university students
Authors: Sert S , Aydilek O H , Arslangiray O , Onsuz M F , Metintas S
Published: October 2024

Background

Gambling disorder (GD) is defined as persistent and uncontrollable gambling behaviour that has negative effects on an individual’s life. This can lead to financial problems, poor academic performance, and health problems. GD has been associated with psychological disorders like depression, anxiety, and attention-deficit hyperactivity disorder (ADHD). We aimed to examine the gambling disorder and its associated factors in university students.

Methods

We conducted a cross-sectional study among students at a university in Eskisehir (Türkiye) in 2024. A stratified random sample design was used. Five faculties were randomly selected. A total of 1,201 students were included according to the stratum weight of the faculties. A questionnaire including sociodemographic characteristics, South Oaks Gambling Screen (SOGS), and Adult ADHD Self-Report Scale (ASRS) was applied. Data were analysed through descriptive statistical analyses and multivariate logistic regression models.

Results

The mean age was 21.5±2.8 years, and 46.8% were male. While 48.7% of the students stated that they had gambled at least once, 2.2% had a gambling disorder. The three most common types of gambling played by students were stock market (28.2%), bet on sports (22.0%), and scratch cards (18.2%). In multivariate analysis, being male (Odds ratio-OR:6.5, 95%CI:1.4-29.8), having lost years during education (OR:2.7, 1.1-6.8), having relatives with gambling problems (OR:8.0, 1.8-36.2), investing greater amounts of money in gambling (OR:3.7, 1.0-13.0), and having a high probability of ADHD (OR:4.3, 1.4-12.8) were found to be predictors for GD.

Conclusions

Although about half of the students had engaged in gambling activities, only a small proportion showed signs of GD. We can conclude that being male, having lost years in education, having relatives with gambling problems, investing larger amounts of money in gambling, and having a higher probability of ADHD are predictors of GD among students.

Key messages

• Implementing educational campaigns at universities to raise awareness of the potential risks and consequences associated with GD could be beneficial.

• It may be helpful if mental health services at the university were equipped to consider mental health conditions such as ADHD, that contribute to GD.
Luxury depiction in posts of the most popular Lithuanian influencers on Instagram and Facebook
Authors: Basijokas R , Austys D
Published: October 2024

Background

Studies show that depiction of high living standards in social media is related to mental health problems. Influencers in social networks are those who might publish such content and reach high numbers of people. We aimed to assess the prevalence of luxury depiction in posts published by Lithuanian influencers on Facebook and Instagram.

Materials and methods

All publicly available posts created by 21 most popular Lithuanian influencers on Facebook and Instagram in 2022 were included. The content analysis of the posts was performed and information about luxury and other lifestyle factors was registered. Distribution of the posts depicting luxury was compared according to social networks where they were published and characteristics of the influencers: gender, age, number of followers, and the target audience.

Results

A total number of 6425 posts were analysed. Every fifth (18.2%) post depicted luxury. Posts depicting luxury were published on Facebook and Instagram with a similar frequency (p = 0.066). Among these posts, luxury brands were presented in 7.5%, luxury hotels and restaurants - in 7.1%, luxurious trips - in 63.0%, luxurious cars - in 27.6%, luxurious activities - in 0.8%, and jewellery - in 0.5%. Overall, men, older influencers, influencers with higher number of followers more frequently posted content depicting luxury (respectively, 29.0% vs. 10.6%, 20.2% vs. 14.5%, 20.3% vs. 15.4%, p-value less than 0.001). Luxury was more frequently depicted in posts targeted to male audience than targeted to female or unisex audiences (respectively, 46.6% vs. 10.5% vs. 20.7%, p-value less than 0.001).

Conclusions

Every fifth post of Lithuanian influencers depicts luxury. Luxurious trips are depicted most frequently. Male and older influencers, and those with more followers more frequently depict luxury-related content. Luxury is most frequently depicted in posts targeted to male audience.

Key messages

• Every fifth post of Lithuanian influencers depicts luxury – this might be considered as an important risk factor for public mental health.

• Higher prevalence of luxury depiction targeted to male audience should be taken into account when implementing public health interventions.
Stigma towards people with mental conditions in healthcare workers: an Italian cross-sectional study
Authors: Cerino E , Lo Moro G , Mimmo R , Giacobbe A , Scaioli G , Bert F , Siliquini R
Published: October 2024

Background

Stigma towards people with mental disorders (MD) in healthcare workers (HCWs) can negatively influence the quality of care provided and hinder patients from accessing healthcare.

The aim of this study was to analyze stigma and its determinants among physicians and nurses in Italy, as a basis for future strategies to reduce its extent.

Methods

A cross-sectional study was conducted from April to September 2023. A sample of 1053 physicians and nurses working in Italy answered an online 52-item questionnaire. Variables explored demographic data, work context, burnout symptoms, and personal or family history of MD. The Opening Minds Scale for Health Care Providers (OMS-HC) was used to assess the level of stigma (score from 20 to 100, higher scores represent higher levels). Descriptive analysis and multivariable linear regression were performed.

Results

Females were 69.5% and median age was 48 years (IQR=37-58). Physicians were 60.5%. A total of 20% of the sample worked in psychiatric settings. Burnout symptoms were reported by 23.5%. Results showed a median OMS-HC score of 49 (IQR=43-54). Positive associations with stigmatizing attitudes were found for being a nurse (p = 0.020) and being in burnout (p = 0.017), while working in a psychiatric setting (p < 0.001) and having personal or family history of MD (p < 0.001) had negative associations.

Conclusions

This research unveiled a notable amount of stigma among Italian HCWs towards individuals with MD. Since people with MD experience higher rates of disability and mortality, it has to be a public health priority to develop targeted strategies to reduce stigma in HCWs, as it discourages patients from accessing healthcare. Future interventions should be tailored for different professionals and dealing with HCWs burnout.

Key messages

• Future interventions should consider that healthcare workers in burnout and nurses tend to have more stigma toward patients with mental conditions.

• Healthcare professionals working in psychiatric settings and having personal or family history of mental disorders showed lower stigma.
Factors affecting ageism and depression levels in individuals aged 65 and over living in society
Authors: Erol S , Nevin Sisman F , Aydoğmuş A , Cengiz S
Published: October 2024

Background

The aging process is perceived negatively by some people. This perception prevents/reduces the happiness that can be gained from the aging process. As a result, depressive symptoms may occur. Therefore, this study aimed to examine the factors affecting ageism and depression levels in individuals aged 65 and over living in society.

Methods

The sample of the research, which was conducted with a cross-sectional, descriptive design, consisted of 287 individuals aged 65 and over living in a neighborhood on the Anatolian side of Istanbul. Data were collected with socio-demographic form, Ageism Questionnaire and Yesavage Geriatric Depression Scale-15. T test, variance analysis and chi-square test were used to analyze the data. Ethical permissions were obtained.

Results

Moderate depression was found in 27.5% of individuals with a mean age of 70.80±5.42. Individuals scored below the average (18.48±8.14) on the ageism survey. Ageism scores were higher for men, those aged 85 and over, those with poor economic conditions, those with chronic diseases, those hospitalized in the last year, those with severe and moderate depression, and those who needed help with daily tasks (p < 0.05). A statistically significant difference was found between age groups, chronic disease, continuous medication use, hospitalization in the last year, working status, need for help with daily tasks, economic status and depression levels (p < 0.05). Ageism scores of those with severe and moderate depression were found to be high (F = 3.43;p=0.017).

Conclusions

Variables that are effective in ageism and depression are being aged 85 and over, having a poor economic situation, having a chronic disease, needing help with daily tasks, and receiving inpatient treatment in the last year. The results of this study show that more efforts and resources are needed within the scope of political and social services to reduce ageism in society and the level of depression in older individuals.

Key messages

• As the level of depression in elderly individuals increases, ageism increases.

• Advanced age, economic status, chronic disease, hospitalization and dependence on daily tasks affect depression and ageism.
Examining the link between age of alcohol initiation, adolescent alcohol use and adult substance use
Authors: Brennan M M , Doyle A , Mongan D , Millar S R , Galvin B , Nixon E , Smyth B , Zgaga L , Ivers J H , McCarthy N
Published: October 2024

Background

Understanding the relationship between adolescent alcohol use and adult substance use is important for prevention programmes. Existing evidence presents divergent findings and potential mechanisms are debated.

Methods

We estimated associations between the age of alcohol initiation and alcohol use at age 17 and substance use at age 20 in a nationally representative cohort (n = 4554). Weighted logistic regression models were fitted using Generalised Estimating Equations in multiply imputed and complete case data.

Results

Our analysis identified that 27% of participants reported first alcohol use at ≤ 14 years old, with 37% engaging in risky alcohol use by age 17. At age 20, 14% reported hazardous alcohol use, while 38% used tobacco, 24% cannabis, and 28% other drugs. The age at which alcohol was initiated and risky alcohol use at 17 years old were both strongly associated with alcohol, tobacco, cannabis and other illicit drug use at 20 years old. Sequential change in effect estimates coupled with non-overlapping confidence intervals suggest a dose-response relationship between age of alcohol initiation and tobacco and other drug use at age 20.

Conclusions

First use of alcohol at 14 or younger was common. Earlier alcohol initiation and risky alcohol use are each associated with substantially elevated risk for substance use at 20 years old even after accounting for common liability factors. Acknowledgement: Growing Up in Ireland (GUI) is funded by the Department of Children, Equality, Disability, Integration and Youth (DCEDIY). It is managed by DCEDIY in association with the Central Statistics Office (CSO). Results in this report are based on analyses of data from Research Microdata Files provided by the CSO. Neither the CSO nor DCEDIY take any responsibility for the views expressed or the outputs generated from these analyses.

Key messages

• Delaying alcohol initiation and preventing risky alcohol use during adolescence may reduce levels of substance use in young adults.

• Self-reported early use of alcohol remains common.
Public health prevention programmes for mental illness in school-age children and adolescents
Authors: Serazzi F , Barbic F , Stranges S
Published: October 2024

Background

Psychiatrists, psychotherapists and other mental health professionals have long stated the importance of adequate social groups and early intervention for the prevention of severe mental diseases. With psychiatric illness incidence increasing most in the adolescent and young adult populations, we propose the use of school-age directed public mental health initiatives to combat remaining social stigma and promote mental wellbeing, as well as educate children and adolescents in how to recognise symptoms and ask for help.

Methods

We conducted a systematic review on PubMed as well as government and NGO websites to identify public health initiatives in the prevention and early identification of mental illness among young individuals.

Results

Preliminary results show that, while certain countries have delineated guidelines on how to support students’ mental health, very few have implemented nation-wide, or even region-wide programmes that directly target prevention and education. A particular note should be made regarding substance abuse and addiction, one of the few illnesses for which many countries have already enacted in-school programmes, that however often overlook the medical aspect of such diseases. Of further note are certain local programmes aimed at offering quality and accessible care to adolescents struggling with mental diseases.

Conclusions

With psychiatric diseases projected to become one of the greatest contributors to the global burden of disease by 2030, and the importance of early intervention in preventing severe psychiatric illness, we advocated for European public health initiatives implemented in schools, which could be crucial in curbing the spread of mental illness.

Key messages

• Adolescent and young adults are those most affected by the rising prevalence of mental illness. Consequently, we advocate for in-school programmes to aid in early identification and intervention.

• Early identification of mental diseases is crucial in the prevention of severe psychiatric illness, but little has been done so far in terms of public health interventions to tackle such problems.
Beyond Numbers: Investigating the Impact of COVID-19 on Suicide Rates in Austria
Authors: Roesler D
Published: October 2024

During the COVID-19 pandemic, individuals’ mental health faced substantial challenges. This study aims to provide a comprehensive examination of the pandemic’s impact on suicide rates in Austria, with a particular focus on variations by gender, region, and age. The study employs a regression discontinuity in time design and an interrupted time series analysis, utilising monthly death records from January 2015 to December 2021. To account for seasonal variations and potential underreporting of suicides, harmonic Fourier terms are incorporated into the analysis, and both suicides with intended self-harm and self-harm with undetermined intent are included. While existing research offers valuable insights into the impact of the pandemic on suicidal behaviour, it does not yet allow for specific conclusions to be drawn for Austria. In contrast to the methods typically employed in previous research on other countries, this approach enables a comprehensive examination of the temporal effects surrounding the implementation and lifting of pandemic-related measures. The study reveals a significant negative trend in Austria’s suicide rates before the start of the pandemic and more suicides than expected after its onset. In particular, the number of suicides among men aged 64-85 and women in the age groups 0-19, 20-34, and 65-84 was significantly higher than expected. Conversely, the data indicated a positive impact among women aged 35-64. This study contributes to understanding the impact of the pandemic on suicide rates in Austria. It demonstrates that, even within the same country, the impact can differ by gender, age, and region, thereby supporting the need for subgroup analysis. It also highlights that potential underreporting of suicides may result in an underestimation of the impact of the pandemic on suicides in previously conducted studies. Understanding these nuances is crucial for suicide prevention and informing policy decisions to improve health system resilience.

Key messages

• The study found higher than expected suicide rates in Austria during the COVID-19 pandemic, especially among men aged 64-85 and women aged 0-19, 20-34, and 65-84.

• The underreporting of suicides may result in an underestimation of the impact of COVID-19 on suicides in previously conducted studies.
Factors influencing delay in cancer diagnosis: a qualitative study in Chile, Colombia and Ecuador
Authors: Vargas I , Vázquez M L , Eguiguren P , Mogollón-Pérez A S , Torres A L , Peralta A , Rubio-Valera M , Aznar-Lou I , Jervelund S S , Dias S
Published: October 2024

Background

Although the greatest delays in cancer diagnosis in Latin America occur in the provider interval, little is known about related factors. This study, part of EquityCancer-LA, aims to analyse the factors influencing access to cancer diagnosis from key stakeholders’ perspective in healthcare networks of Chile, Colombia, and Ecuador.

Methods

A qualitative, descriptive-interpretative study was conducted in two networks per country in 2023, using semi-structured individual interviews (n = 114) with a criterion sample of primary care (PC) (n = 40) and secondary/tertiary hospitals (n = 44) health/administrative professionals, managers, and policy makers (n = 30). Thematic analysis was performed, segmented by country.

Results

The analysis revealed interacting factors that cause cumulative delays, with differences between countries. In all, participants identified networks structural characteristics (deficits in diagnostic resources; geographical accessibility), organizational factors (long waiting times, especially after referral), and limited knowledge of PC doctors, which all lead to delayed referral. In Chile and Colombia, barriers related to care rationing/prioritization policies hampered access to tests, and in Chile, increased delays for non-prioritized conditions. Barriers related to the health system organization also emerged: in Chile, problems related to private services subcontracting and the voucher system for using them; in Colombia, the management of care by insurers (authorizations; fragmented and short-term contracting of providers); and in Ecuador, health system underfunding. The barriers mostly affected the elderly, those with low socioeconomic status, limited social support networks, and rural areas residents.

Conclusions

The results reveal significant barriers in access to timely cancer diagnosis, which can and should be addressed with specific cancer diagnosis policies and general measures that strengthen public healthcare systems and networks.

Key messages

• Key health system factors influencing provider delays in cancer diagnosis are identified.

• Evidence is provided for the design of policies to improve timely cancer diagnosis in studied countries.
Social inequalities in the prevalence and treatment of depressive symptoms in Czechia
Authors: Kuklová M , Lustigová M
Published: October 2024

Background

Depressive symptoms are associated with achieved socioeconomic status (SES) in men and women. The aim of the analysis is to verify this association between severity of depressive symptoms and socioeconomic status in the Czech context. Another aim is to examine the use of psychiatric and psychological treatment among men and women.

Methods

The data come from the 2019 European Health Interview Survey (EHIS). The Patient Health Questionnaire (PHQ-8) was used to measure the symptoms and severity of depressive symptoms among respondents. Participants were aged 20 and above and resided in households. Binary logistic regression was used to test the relationship for using of treatment and depressive symptoms.

Results

The weighted prevalence of mild depressive symptoms is determined to be 10.5% (8.0 % in men; 12.8% in women), with severe depressive symptoms recorded at 3.1% (2.6% in men; 3.7% in women) within the Czech population. The psychiatric or psychological treatment is utilized by 3.8% (2.8% in men; 4.7% in women) of the Czech population. Respondents with severe depressive symptoms (37.4%) use care the most, followed by those with mild symptoms (11.9%), and the least by those with none (1.6%). Individuals with tertiary education utilize treatment the most among respondents with moderate and severe depressive symptoms. Respondents differ in the utilization of treatment; however, after stratifying the model only for respondents with mild or severe depressive symptoms, these respondents do not differ in the utilization of treatment.

Conclusions

SES level is reflected differently in the prevalence and severity of depressive symptoms for men and women. But no difference was found in the use of psychiatric or psychological care in men and women. A treatment gap was found for depressive symptoms in the Czech population.

Key messages

• The results confirmed the relationship between the utilization of care and depressive symptoms.

• It was revealed that respondents did not differ in the utilization of care after the stratification.
Digital strategies of public youth mental health services to raise awareness of their existence
Authors: Hernández Encuentra E , Casañas Sánechez R , Boixadós Anglès M , Merino Rubio L
Published: October 2024

Background

Data from a survey of the first part of the eHealthLit4teen Project show that adolescents in the city of Barcelona (12-16 years old) are not aware of the public youth mental health services (YMHS) available in the city. Considering the intensive use that young people make of digital platforms, YMHS might leverage these channels to raise young people’s awareness of available resources, which would impact on the help-seeking behaviours. The aim of this work is to analyse the social media strategies for the dissemination of public YMHS and emotional well-being services (promoted by the city council and the regional government) in Barcelona.

Methods

Identification of public YMHS and emotional wellbeing services, and interview on the use of social networks for dissemination with those responsible for the services and communication (March-April 2024). Analysis of the use of persuasive design and behavioural design techniques by the social media profiles of these services and, by way of contrast, the influencers who publish mental health content identified by the adolescents in the previous survey of the Project (March 2023).

Results

Public YMHS mainly rely on outreach through face-to-face visits to high schools. This format makes it easier for reluctant young people to access formal support, but more difficult for them to seek support because of stigma. In general, public YMHS do not show a clear strategy to disseminate their service on social media, and the information provided confusion between the characteristics of the services offered. Likewise, there is no widespread use of behavioural design or persuasive design techniques in the publications of health services on social media, nor in those of influencers.

Conclusions

Public YMHS do not make efficient use of the digital platforms that young people use intensively to raise awareness of their existence and increase usage.

Key messages

• There is no clear digital strategy for communicating public youth mental health services (YMHS), although they recognise that digital platforms can be a good means of dissemination.

• YMHS need to be accessible on digital platforms to young people’s adults of reference (especially for younger teens), as they are the ones who seek out online the existence of this type of services.
Examining Lifestyle Risk Factor Clusters and Mental Health in Adults
Authors: Gunay E , Torun P , Duzcan S , Kizilyel E , Okan H
Published: October 2024

Background

Lifestyle risk factors often cluster, impacting both physical and mental health. Studies reveal bidirectional relationships between lifestyle factors and health. The aim of this study is to examine the relationship between mental health problems, self-reported depression, and lifestyle risk factors in a sample of the adult population in Turkey.

Methods

2022 Turkey Health Survey (THS) data were used. The sample group was made using cross-sectional data of approximately 22742 individuals in the adult population over 15 years of age. Two-stage clustering method was used to determine vital risk factor clusters. Regression analysis was used to determine the relationship between vital risk factor clusters and self-reported depression and mental health problems.

Results

Lifestyle risk factors were grouped into 4 clusters. It was observed that unhealthy diet, inadequate physical activity, and smoking, which are modifiable lifestyle risk factors, were together in the clusters. It was also observed that self-reported depression and mental problems were more associated with clusters with more than one lifestyle risk factor. In addition, women, married individuals, and individuals over 65 years of age were more associated with mental problems.

Conclusions

As a result of the findings, there was an association between people with mental problems and lifestyle risk factors such as smoking, unhealthy diet, and insufficient physical activity. These findings may help to plan and implement more effective health policies and individual interventions targeting groups with multiple lifestyle risk factors in the future.

Key messages

• The target group was determined to improve community mental health and to make necessary interventions.

• Since inadequate physical activity, which is one of the vital risk factors, and unhealthy nutrition and smoking tend to cluster together, it was determined that these problems should be prioritised
Operationalizing Macro-Level Structural Sexual Minority Stigma: A Scoping Review of the Literature
Authors: van der Star A , Garetti O
Published: October 2024

Background

Structural stigma, including discriminatory laws, inequitable policies, and negative attitudes, has been conceptualized as the general societal climate and institutional conditions that shape sexual minorities’ lives, mental, and physical health. While multidimensional indices have been used globally, U.S.-based studies have largely relied on single indicators (e.g., a law or policy; presence of resources). This scoping review aimed to identify structural sexual minority stigma indicators relevant to the U.S. context, to inform comprehensive, multidimensional future operationalizations.

Methods

Systematic database searches in PubMed, PsycINFO, and JSTOR, and snowball techniques resulted in 70 articles. After duplicate deletion and abstract review, 25 unique indices were long-listed relevant to structural sexual minority stigma at country or state level (i.e., macro level). School (district) and county (i.e., exo level) indicators were excluded.

Results

From the long-listed indices, a total of 112 legal and policy indicators were narrowed down to relevant 33 macro-level indicators and grouped across seven domains: criminal justice, hate crime protections, non-discrimination, religious refusal, relationship recognition, parenting, and youth laws and policies. Two different quantifications of population attitudes were identified that aggregated social and policy opinions across states regarding sexual minority adoption, hate crimes, health benefits, labor and housing, public speaking or teaching, marriage, sodomy, and civil unions.

Discussion

While a large variety of legal and attitudinal indicators was identified, few U.S.-based studies used multidimensional operationalizations (e.g., law, policy, opinion) needed to reduce risk of confounding bias through population-attitudes-to-law/policy backdoor pathways. To further advance the science on structural sexual minority stigma and health globally, future studies may benefit from multidimensional approaches.

Key messages

• With many legal and attitudinal indicators identified, few studies used multidimensional operationalizations (e.g., law, policy, opinion) needed to reduce risk of confounding bias.

• To further advance the science on structural sexual minority stigma and health globally, future studies may benefit from multidimensional approaches.
Gender-specific impact of COVID-19 in the UAE: Analyzing gender disparities in health and well-being
Authors: Saddik B , Shukla A , Zeidan R
Published: October 2024

Background

Understanding gender disparities in health impacts during pandemics is crucial. While early observations of the COVID-19 pandemic suggested higher severity and mortality rates among males, subsequent studies hinted at a disproportionate impact on females’ health and well-being. This study aimed to explore gender-specific differences related to COVID-19 in the United Arab Emirates (UAE).

Methods

Data from four independent surveys were analyzed to assess gender differences in knowledge about available vaccines, vaccine hesitancy, COVID-19 severity, admission to the Intensive Care Unit (ICU), anxiety among healthcare workers (HCWs), and psychological health of healthcare workers and the general population. Gender gaps were calculated as the absolute difference between males and females. Chi-square tests and logistic regression were performed to test the association between gender, age, and selected outcome variables.

Results

Males had a significantly higher risk of moderate to severe COVID-19 symptoms (71%) compared to females (63%). The gender gap in symptom severity was smallest among those aged 55+ and highest among adults aged 35-54. Post-discharge, 22% more females reported multiple conditions than males. Among HCWs, females showed lower knowledge (19% gap) and higher vaccine hesitancy (20% gap), with larger gaps among older age groups. Females also experienced more anxiety and psychological stress, especially in the 35-54 age group. Logistic regression confirmed higher odds for females in reporting vaccine hesitancy, long COVID-19 symptoms, and anxiety, even after adjusting for demographic factors.

Conclusions

This study highlights unequal health outcomes and burdens experienced by women and men during the COVID-19 pandemic in the UAE. The distinct challenges faced by women, including higher mental health burdens and persistent post-recovery symptoms, suggest systemic gender disparities that require targeted attention in healthcare policies and practices.

Key messages

• Gender disparities in COVID-19 were evident in the UAE with males experiencing severe COVID-19 symptoms, while females experienced post-recovery symptons, vaccine hesitancy, and stress.

• Urgent action is required to address gender disparities in COVID-19 impacts, emphasizing mental health support and post-recovery care in policy formulation.
Intention to use HIV pre-exposure prophylaxis (PrEP) in health sciences students
Authors: Vicente Molina F , Ramos Tenorio M P , Sosa Gonzalez Y R , Hernandez Rico M , Villegas-Dominguez J E , Hernandez Rico M , Sosa Gonzalez Y R
Published: October 2024

Introduction

HIV is a public health issue, and as such, there are currently programs for the use of pre-exposure prophylaxis for HIV (PrEP) in various public institutions, with family physicians being one of the pillars to provide information and raise awareness among individuals at risk for HIV who wish to use these strategies.

Objectives

To determine the factors associated with the intention to use PrEP among university students in the healthcare field in the Veracruz-Boca del Río region.

Methods

A cross-sectional, prospective, and analytical study was conducted from August 2023 to March 2024, including students from healthcare-related majors at universities in the Veracruz region. An instrument was used to assess the level of knowledge about PrEP (Cronbach’s alpha of 0.8), with scores ranging from 0 to 10. Students were invited to participate in this research at different faculties of health sciences.

Results

508 subjects participated, with 299 (58.9%) females and 386 (76.0%) heterosexual; 65.9% had never heard the term ‘PrEP,’ and 12% learned it from social media. The intention to use PrEP was positive in 81.5% of subjects in case of becoming a high-risk person for acquiring HIV. The level of knowledge about PrEP showed a score of 2.2 (SD ± 2.6), with 3.7% having high knowledge, 10.2% having a passing grade, and 55.9% scoring above the median (1.4) of the group’s scores. No association was identified between gender identity, sexual orientation, academic characteristics, and sources of information with the intention to use PrEP (p > 0.05). Knowledge level above the median of 6 points showed an odds ratio of 2.95 (95% CI 1.03-8.3) for the intention to use PrEP (p < 0.05).

Conclusions

The level of knowledge increases the probability of the intention to use PrEP in young people, making it essential for the primary care physician to carry out this training and awareness activity within their daily interactions with young patients.

Key messages

• It is essential to generate education programs on Prep for the population, as this will favor informed decision making on the use of these medicines in case they are required.

• It is necessary to provide people with general information about Prep, since despite the existence of active programs for its distribution, most people have never heard anything about this drug scheme.
Injury risk in foreign workers: a proposal for a prevention plan in South Tuscany
Authors: Guerreschi E M , Francini C , Giomarelli A , Nante N
Published: October 2024

Background

There are nearly 2.3 million foreign workers in Italy, many of whom hold low-skilled and heavy jobs that expose them to greater safety risks. The aim of the study is to analyze data on the accident phenomenon by using information flows from the national work accident insurance institute, in order to ensure a safe and inclusive work environment.

Methods

The total number of foreign workers’ accidents in the South Tuscany during the five-year period 2017-2021 was quantified. General injury trend was assessed, breaking down the events by province (Siena, Arezzo, Grosseto), year of occurrence and severity. We analyzed the events by nationality of the injured ones and by severity of compartment.

Results

A total of 38,254 occupational accidents were recorded, of which 6,172 (16.13%) occurred to foreign workers. Compared to the incidence of foreigners residing in the reference territory, the accident figure is 16.13% out of the 10.5% resident population. The majority involve people from Eastern Europe (60.8%). The most representative nationalities are: Romania (1,477 events), Albania (1,022), Morocco (404), Macedonia (341), Kosovo (264), Tunisia (190) and India (170). Romanian workers are the population most affected by occupational injuries in Southeast Tuscany with 1,477 events. Agriculture is the predominant sector with 17.7% of total injuries.

Conclusions

Information flows on foreign workers’ accidents is the starting point for specific design of prevention plans (supervision, assistance, research, information and training, awareness raising) aimed at reducing specific accident risk factors. Language and cultural differences represent an element of possible conditioning of risk perception, which must be considered in an effective design of safety training courses for foreigners.

Key messages

• The study of accident information flows of foreign workers provides the basis for specific design of prevention plans in order to reduce accident risk factors.

• Language and cultural differences must be considered in an effective design of safety training courses for foreigners.
School-based outdoor education and teacher well-being: the LärMiljö (Learning Environment) - study
Authors: Simonsen N , Wackström N , Ray J
Published: October 2024

Background

School-based outdoor education (OE) is a teaching method aiming to promote pupils’ learning and wellbeing. OE with its action-oriented and cooperative learning approach can inspire teachers to develop their teaching and may also have a positive impact on their work wellbeing. According to self-determination theory, satisfaction or frustration of employees’ basic psychological needs - need for autonomy, competence and relatedness - are important facilitators or impediments of work wellbeing. We explored possible associations between OE use and teachers’ 1) satisfaction/frustration of basic needs at work and b) work engagement.

Methods

The study, part of the LärMiljö-study, used data collected in 2022 through electronic surveys among teachers in Swedish-language primary schools in Finland; N = 134 teachers from 44 schools. Main measures were the 24-item Basic Psychological Need Satisfaction and Need Frustration at Work Scale and 9-item Utrecht Work Engagement Scale. Data was analysed with Mann-Whitney U-tests and Spearman correlation.

Results

The vast majority was female, classroom teachers and had a master’s degree. Preliminary findings show that 69% practiced OE (sporadically or regularly) and 31% did not; both groups were similar in terms of teaching experience, age and gender. Teachers using OE had higher autonomy and competence need satisfaction, and lower relatedness need frustration than teachers not using OE (p < 0.05). There was no difference in overall work engagement (p = 0.07), but OE teachers had higher dedication to work (p < 0.05). Satisfaction of basic needs at work was positively, and frustration of needs negatively, associated with work engagement (p < 0.001).

Conclusions

Practicing OE appears to have positive associations with teachers’ dedication to work and satisfaction of need for autonomy and competence, and a negative association with relatedness frustration. More research is needed to confirm and examine the direction of these associations.

Key messages

• Outdoor education (OE) may besides pupils’ learning and wellbeing also promote teachers’ work wellbeing. Work wellbeing among teachers was studied within the framework of self-determination theory.

• Practicing OE seems to be positively associated with teachers’ dedication to work, a sub-dimension of work engagement, and satisfaction of the basic needs for autonomy and competence at work.
Phenotypes of Italian workers with disability: a cluster analysis on workers with multiple sclerosis
Authors: Ponzio M , Grange E , Di Antonio F , Persechino B , Manacorda T , Inglese M , Durando P , Battaglia M A , Brichetto G , Podda J
Published: October 2024

Background

While job maintaining/reintegrating are clearly complex issues in multiple sclerosis (MS), where many aspects (physical, psychological, relational and personal resources) can play a key role, they offer scope for potential interventions. This study aimed to identify and describe phenotypes of workers with MS considering specific work-related domains such as work-related difficulties, anxiety and depressive symptoms, and coping strategies.

Methods

A cross-sectional online survey on MS workers was conducted in Italy. Hierarchical cluster analysis was performed by the Ward method followed by k-means cluster analysis.

Results

A total of 209 workers with MS were included in the analysis. We identified four phenotypes: phenotype 1 had low work difficulties, low depressive symptoms and mild anxiety, with a moderate tendency to use problem focus and positive attitude and a mild one to use social support as coping strategies (n = 82, 39.2%); phenotype 2 had low-to-mild work difficulties, mild anxiety and low depressive symptoms, with a high tendency to use positive attitude and religion, moderate problem focus and social support, and mild denial (n = 38, 18.7%); phenotype 3 had low-to-mild work difficulties, moderate anxiety and depressive symptoms, with a mild tendency to use problem focus, positive attitude, religion, social support, denial as coping strategies (n = 50, 23.9%); phenotype 4 had mild-to-moderate work difficulties, moderate anxiety and depressive symptoms, with a moderate tendency to use problem focus, positive attitude, and mild social support and denial as coping strategies (n = 39, 18.7%)

Conclusions

This explorative analysis aimed to find distinct workers with MS profiles in a working-age population based on work-related domains such as work-related difficulties, coping strategies, and psychological aspects. This could lead to a better tailoring of the vocational rehabilitation interventions for workers with MS.

Key messages

• This approach, in which different domains related to work are considered, could help to identify a taxonomy that recognizes distinct and predominant MS worker phenotypes.

• Identification of subgroup MS workers, could result in better tailoring of the vocational rehabilitative interventions for people with MS.
Unveiling social disparities in later life: Income’s Impact on mortality among the elderly in Italy
Authors: Frova L , Coppola L , Grande E , Pappagallo M , Siciliani I
Published: October 2024

Background

Income is an important predictor of adult mortality, as a proxy of living conditions, capability and access to health services. Previous studies show that mortality decreases by increasing income. In Italy, studies at a national level are missing. This study aims to investigate inequalities in mortality by income in Italy.

Methods

The analysis is based on the integration of the National Population Register (comprising the resident population as of Dec 31, 2018, and deaths in 2019) and the Income Statistical Register (representing perceived income during 2018). This integration enabled the availability of information on age, sex, residence, education, income, and vital status at the individual level for 13 million people aged 65 or above. Individuals were categorized according to their individual disposable income quintiles both before and after disability benefits. Inequalities by income are assessed by mortality rate ratios (MRR) estimated using negative binomial regression models controlling for demographic and socioeconomic features. The study is carried out within the Next Gen EU-funded project “Age-It Ageing well in an ageing society” (PE0000015), NRRF, M4.C2, Intervention 1.3.

Results

Considering income net of disability benefits, lower income levels are associated with higher mortality rates compared to the highest income level, for both sexes. Inequalities are more marked for men. The highest excess was observed for individuals with the lowest income (male MRR=1.65, 95%CI: 1.6-1.71; female MRR=1.43, 95%CI: 1.38-1.48). The excess decreases with increasing income.

Conclusions

The observed relationships between income and mortality are crucial for targeting policies to reduce health inequalities and promote the well-being of the elderly, the goal of which should be to improve access to social and health care and develop supportive policies for the most disadvantaged people. Further research will be devoted to the use of household income for individuals.

Key messages

• For the elderly, lower income levels are associated with higher mortality, with wider disparities in men.

• The choice of definition of income is essential for an accurate assessment of the association between income and mortality.
Understanding smoking cessation process in Tunisia from 2020 to 2023: description of quit attempts
Authors: Bebses K , Ayedi Y , Fitouri S , Skhiri A , Ben Aissa M , Fourati A , Nsiri Z , Hamdi R , Harizi C , Fakhfakh R
Published: October 2024

Background

Many smokers attempt multiple cessation methods before seeking specialist intervention. This study aims to describe these prior cessation attempts and identify relapse factors to enhance support for these individuals.

Methods

Data from 440 patients consulting the Department of Epidemiology Statistics at Abderrahman Mami Hospital from 2020 to 2023 were analyzed. It included information on previous quit attempts, methods used, longest duration of abstinence, number of attempts, reaction to cessation, and reasons for relapse. Statistical description was conducted using IBM SPSS 25.

Results

Among participants, More than half of the smokers had previously attempted to quit smoking 63,4%, with an average of 2 attempts ± 1,7 (0-10 attempts) per patient. The majority of patients (86.8%) quit smoking without using substitution methods. Among those who resorted to substitution, nicotine replacement therapy was the most frequently used method (n = 30; 6.8%). The longest duration of abstinence averaged 8 years. The main reaction to smoking cessation among patients was an improvement in their health (9,1%). The most common reasons for relapse were psychosocial problems (5.5%), followed by relapses during social events (4.3%), and withdrawal symptoms (3%).

Conclusions

This study emphasizes the importance of considering each patient’s journey during their smoking cessation process. Analyzing these factors will enable better management of the cessation program with the patient, as well as a deeper understanding of their feedback regarding our program, ensuring long-term cessation success.

Key messages

• Failed spontaneous quit attempts prior to NRT initiation are prevalent among smoking patients.

• Understanding failed spontaneous cessation attempts can guide the development of more effective strategies.
InfoQ: Certifying credible providers of digital health information
Authors: Schmidt-Kähler S , Münch I , de Gani S M , Flaschberger E , Nitsch M , Schaefer C
Published: October 2024

Background

Access to accurate health information is crucial. Despite the abundance of information online, sorting through it can be overwhelming, especially with the spread of misinformation. This poses a threat to public health and challenges health literacy. Efforts to combat misinformation are struggling due to the rapid growth of available information. We need complementary strategies, such as promoting trustworthy information sources. An initiative by Bertelsmann Stiftung, aims to counter misinformation by promoting health information from credible sources.

Methods

In 2021, the U.S. National Academy of Medicine outlined principles for identifying credible health information sources, endorsed globally by the WHO and embraced by the social media industry. However, these principles lack operationalization, leaving indicators for credibility undefined. To address this gap, Bertelsmann Stiftung, in collaboration with German experts, conducted workshops in 2023 to draft evaluation criteria. Their ongoing work, alongside initiatives by the Careum Foundation and Gesundheit Österreich GmbH will be presented.

Results

The criteria focus on structure (e.g., the expertise of providers) and process (e.g., methods for identifying relevant evidence) rather than outcome (i.e., the quality of each piece of information), and are based on the domains science-basis, transparency and legitimacy. Mandatory and complementary criteria allow a two-step approach to identify health information providers of good quality (meeting all mandatory criteria) and excellent quality (meeting all criteria).

Conclusions

These criteria build the basis of the establishment of an international certification system and represent a crucial measure to combat misinformation and promote population health literacy. Various international partners and social platforms have already reached a strong consensus on the relevance of the project goals and expressed their willingness to deepen their efforts in this regard.