bluuebunny/crossref_metadata_2025 huggingface dataset:
Role of surfaces and sinks in the control of multiresistant bacteria in Intensive Care Unit
Authors: Marin Caba E , Guerrero Fernandez de Alba I , Soler Iborte E , Rivera Izquierdo M , Valero Ubierna C
Published: October 2022

Background

Control of multiresistant bacteria (MRB) outbreaks in the Intensive Care Unit (ICU) is a challenge of Public Health. There is strong evidence that surfaces, and sinks are reservoirs of MRB. In 2020, because of isolation of Klebsiella type IMP, OXA-48 and VIM in moist reservoirs in ICU of Clinico San Cecilio Hospital and another carbapenemase-producing Enterobacteriaceae (CPE) outbreak, it arises our aim, which is to highlight the relevance of periodic control of humid reservoirs and surfaces in ICU to prevent MRB transmission.

Methods

Retrospective, descriptive study from March to June 2021. Due to a rise of cases of a CPE outbreak in our ICU in Granada, samples of surfaces and taps of different boxes were taken, after discharging patients and their corresponding terminal cleaning, whether they were CPE-colonised patient or not.

Results

Samples of 20 boxes were taken (N = 325). CPE OXA-48 was isolated in 7,38% of the samples which correspond to 40% of the boxes, most of them Enterobacter cloacae. 25% of the positive samples isolated two types of resistance, OXA-48, and VIM. 79,2% of the positive samples were found in March. The rest of them in April and May, after establishing control measures in surfaces. CPE was isolated in blood pressure monitor, pulse oximeter, electrocardiogram and stethoscope from 6 boxes. 3 CPE humid reservoirs were found in the tap and drain sinks of 2 boxes, one of them with CPE colonised patient.

Conclusions

We have observed the existence of carbapenem-resistant plasmids in surfaces and the persistence of humid reservoirs in our ICU, despite of establishing control measures of an outbreak. In conjunction with classical monitoring measures such as observation and training of hand hygiene, we recommend the use of disposable materials, systematic disinfection of reservoirs, appropriate use of gloves, chlorination of sinks and the goal of an ICU without water should be fundamental elements in the prevention of MRB transmission.

Key messages

• Multifactorial approach for the control of multiresistant bacteria outbreaks in the Intensive Care Unit.

• Intensive Care Unit without water to avoid humid reservoirs of multiresistant bacterias.
The vision of Dutch paediatric care until the year 2030: prevention and collaboration as key ingredients
Authors: Jansen D , Illy K
Published: October 2022

There are many societal developments in The Netherlands that have or will have an impact on Dutch paediatric care. These developments both reveal potential risks in paediatric care and require future improvement of paediatric practices to achieve the best possible outcomes for Dutch children. To realise this, the Dutch Paediatric Society decided in their renewed vision to have a closer focus on prevention and on building partnership with public health, by implementing a building block ‘Interprofessional Collaboration between Paediatricians and Other Health Care Providers’. This building block formulates the wish of the Dutch Paediatric Society to work together in networks with other domains of care, such as public health. Preferably, it will be a flexible network in which the disciplines involved align the needs of the specific child. In order to develop and participate in such a network, pediatricians and public health professionals actively have to invest in connecting, establishing, and further developing professional networks (including patient societies). A first precondition for the development and successful functioning of such a network is the implementation and use of a joint electronic medical record in which all diagnostics, treatment plans and positive health aspects of the child are collected, and which is accessible to all professionals involved. A patient record which guarantees a barrier-free exchange of medical and non-medical information between paediatricians and public health professionals within the framework of the current privacy legislation. A second precondition regards an improvement of the paediatric training curriculum in which the paediatrician of the future will gain knowledge of positive health and integrative medicine. The future paediatrician must be trained to function in networks and to make connections. In this presentation we present an update of the implementation of this building block: what is already realised and how.
Ethnic differences in COVID-19 deaths across various waves of Coronavirus pandemic in Netherlands
Authors: Chilunga FP , Stoeldraier L , Agyemang C , Stronks K , Harmsen H , Kunst AE
Published: October 2022

Background

It is not known how ethnic differences in COVID-19 deaths in the Netherlands evolved throughout the pandemic, especially after introduction of ethnicity-oriented COVID-19 prevention measures. We investigated associations between ethnicity and COVID-19 deaths across first wave of the pandemic, inter-wave period, and second wave in the Netherlands.

Methods

We obtained multiple registry data from Statistics Netherlands spanning from 01 March 2020 to 14 March 2021 comprising of 17.4 million inhabitants. We estimated incidence rate ratios (IRRs) for COVID-19 deaths among ethnic groups using Poisson regression models and adjusted for relevant socio-demographic factors. We used similar models to estimate IRRs for non-COVID-19 deaths among ethnic groups.

Results

Ethnic minority populations exhibited higher risk of COVID-19 deaths than the Dutch origin population throughout various study periods. The most elevated risk of COVID-19 deaths was in populations originating from low- and middle-income countries, especially those with Turkish, Moroccan, and Surinamese background. The elevated risk of COVID-19 deaths among ethnic minority groups (as compared to Dutch origin population) was higher in inter-wave period (4 times higher) and second wave (2 times higher) when compared to the first wave (1.5 times as higher). Ethnic differences in COVID-19 deaths were larger compared to non-COVID-19 deaths.

Conclusions

Ethnic differences in COVID-19 deaths persisted across first wave, inter-wave period and second wave in the Netherlands despite introduction of ethnicity-oriented prevention measures. Research on explanatory mechanisms and novel prevention measures are needed to address the ongoing differences in COVID-19 deaths across ethnic groups.

Key messages

• Ethnic differences in COVID-19 deaths persisted in the Netherlands despite introduction of ethnicity-oriented prevention measures.We therefore call for better prevention measures.

• Well known drivers of SARS-CoV-2 infection such as household wealth, did not explain our findings calling for an in-depth understanding of drivers of ethnic differences in COVID-19 deaths.
Unseen abilities – how refugee women with disabilities experience social participation
Authors: Scheer S , Mondaca M
Published: October 2022

Background

In the European context, refugee women especially those with physical disabilities are confronted by many unequal conditions that have an impact on their health and social wellbeing. To address these, it is important to understand refugees’ social participation and integration process. Furthermore, the purpose of the study is to identify refugee women's resources and their strengths in their everyday life that are related to current problems and needs.

Methods

This research project is embedded in occupational science theories which include the effect of social and environmental issues on an individual's health and wellbeing. An ethnographic, longitudinal study using visual and narrative methods was used to explore the phenomena of the everyday life and social participation possibilities of five refugee women with physical disabilities living in Stockholm, Sweden. Moreover, to illustrate the process of meaning-making, the frame of intersectionality was used within the whole research process.

Results

Through the lens of intersectionality, it was possible to determine gender, ableism, religion, and ethnicity issues as influencing factors concerning health and social participation. The women's narratives illustrate accessibility, e.g. public transport as a big resource in comparison to the country they came from. Still, to be a woman, a refugee, and having a disability at the same time is a challenge for social participation. One reason is less consideration of disabilities in the integration process. Having faith was mentioned as a safe place and using the public transport to independency. However, the women stress, that they want their abilities to be used instead of experiencing being limited by their disabilities.

Conclusions

In conclusion, the women emphasize being engaged in the hosting community. Health and social policymakers should consider the refugee women's voices to develop integration strategies with and not for refugee women with disabilities.

Key messages

• Through the lens of intersectionality, refugee women's narratives bring new insights about social participation.

• Refugee women with a disability want to engage in the hosting society and become active members.
Evaluating Mood and Anxiety Disorders in Canada Through a Gender-Based Analysis Plus (GBA+) Lens
Authors: Yeretzian ST , Sahakyan Y , Abrahamyan L
Published: October 2022

Background

The prevalence of mental disorders continues to increase worldwide. We assessed the prevalence and associated factors of mood and anxiety disorders in the Canadian population using a Gender-Based Analysis Plus (GBA+) lens on a nationally representative survey.

Methods

A secondary analysis of the 2017-2018 Canadian Community Health Survey (CCHS) - Annual Component was conducted using a GBA+ lens, an analytical process to incorporate sex, gender, and other intersecting identity factors into research, programs and policies. Sampling and bootstrap weights were applied to account for complex sampling design. Chi-square test and multivariable logistic regression models were used to assess associated factors of mood and anxiety disorders.

Results

2017-2018 CCHS included 113,290 observations, representative of 98% of the Canadian population over the age of 12. Mood and anxiety disorders were more prevalent among females than males (11.0% vs 6.4% and 11.6% vs 6.3% respectively, p < 0.001). Logistic regression analyses revealed higher odds for both disorders for those who were female, unemployed, smokers, homosexual or bisexual, had low education and income levels, suffered from food insecurity or had disabilities. Statistically significant interactions were observed between sex and factors such as age, income, employment and sexual orientation. Of those who had a mood or anxiety disorder, 5.0% reported having unmet mental health care needs compared to 1.0% of the general population (p < 0.001). Those reporting unmet mental health care needs were more frequently younger, females, single parents, with disabilities, lower income and food insecurity.

Conclusions

Females in Canada continue to be affected by mood and anxiety disorders at higher rates than males. Strategies for preventing mental health disorders and improving mental health care must be tailored towards the needs of specific groups. We recommend the use of GBA+ as a guide in both research and policymaking.

Key messages

• This study provides estimates of the present state of mood and anxiety disorders in the Canadian population using secondary data from a cross-sectional, nationwide survey conducted through 2017-2018.

• The application of Gender-Based Analysis Plus (GBA+) helps with the systematic evaluation of healthcare disparities and development of targeted strategies to address gaps in mental health.
The within-person relationship of school climate and mental wellbeing in adolescence
Authors: Bjørnøy Urke H , Kristensen SM , Årdal E , Wiium N , Bøe T , Gaspar deMatos M , Larsen T
Published: October 2022

Background

School climate is recognized as important for adolescent mental wellbeing. However, there is a lack of longitudinal studies, and most research focus on school climate as an antecedent of mental wellbeing while the relation could be in the opposite direction or bidirectional. Further, no study has examined this relation with analyses that separate between- from within-person variability to properly assess intraindividual developmental processes.

Methods

Using a random-intercept cross-lagged panel model we investigated the longitudinal reciprocal relations of perceptions of a caring school climate and mental wellbeing across three time points (T1, T2, T3) in adolescence, and if socioeconomic position (SEP) predicted perceptions of a caring school climate and mental wellbeing at each time point. The sample consisted of 1508 Norwegian adolescents (60.7% female; baseline mean age = 16.33, SD = .62).

Results

Results showed positive cross-lagged effects at the within-person level from mental wellbeing to later perceptions of a caring school climate across all time points (T1->T2 b=.12* [.01, .22], T2->T3 b=.12* [.01, .23]), but no similar effects in the opposite direction. Positive concurrent effects from SEP were observed at one time point for mental wellbeing (T1 b=.10* [.01, .19]), and all time points for perceptions of a caring school climate (T1 b=.12* [.02, .22], T2 b=.11* [.02, .20], T3 b=.12* [.02, .22]), indicating SEP to be related to intraindividual fluctuations mainly in perceptions of a caring school climate.

Conclusions

The findings support a unidirectional temporal relationship from mental wellbeing to perceptions of a caring school climate and underscore the importance of investigating the subject longitudinally and as a function of within-person fluctuations. From a public health view, the findings support the importance of systematic efforts to promote mental wellbeing to facilitate positive school experiences of adolescents of all social classes.

Key messages

• The study found a unidirectional temporal relation at the within-person level in adolescents where mental wellbeing predicted perceptions of a caring school climate, but not the other way around.

• The findings underline the importance of systematic public health efforts to promote mental wellbeing as one avenue to facilitate positive school experiences of adolescents of all social.
Primary health care reforms in Slovenia: leveraging existing structures to expand care
Authors: Polin K , Scarpetti G , Albreht T , Petrič V , Vracko P
Published: October 2022

Primary health care (PHC) in Slovenia is delivered mainly by a network of 63 public community-based primary health care centres (CPHCs), serving as entry points to the health system. Here, multidisciplinary teams provide an array of preventative, diagnostic, therapeutic, palliative, and health promotion services under one roof. Since 2011, several reforms in PHC highlight integrated care. A national scale-up of Family Medicine Practices is underway, where all family medicine teams include a 0.5 FTE registered nurse to improve prevention, early diagnosis and care coordination of chronic patients. Health promotion centers (HPCs) are being introduced in CPHCs to support people in healthy lifestyle, with currently 28 HPCs managed by CPHCs and supported operationally by the National Institute of Public Health. New mental health centers facilitate access to comprehensive mental health care. In 2020, dedicated temporary COVID-19 units in CPHCs played a key role in treating mild/moderate cases and shielding hospitals from overburden. Regarding implementation, pilots have been critical to creating a strong evidence base to enable sustainable (sometimes external) financing, while innovations capitalize on existing links between Slovenia's primary care and public health functions and the Ministry of Health for governance and the flexibility of the multidisciplinary, multiple-practice care model represented by CPHCs. Though this has eased their initial introduction into existing structures, challenges remain. These include dissatisfaction among family physicians due to high administrative burden and an outdated CPHC governance model that limits managers’ authority as well as workforce shortages in public health and primary care. Financial incentives, task shifting, and adjustments to education and training have been used to mitigate these issues. Slovenia's experience may serve as a case study for countries interested in improving their primary healthcare services.
10.B. Round table: Shelter in place: lessons from policy making during the COVID-19 pandemic in three countries
Authors:   Organised by: University of Augsburg (Germany),   Chair persons: Verina Wild (Germany), Angus Dawson (Australia)
Published: October 2022

The key aims of the workshop are: (1) to engage in early discussion of the findings of this timely project and gain critical feedback from the EUPHA audience, (2) discuss and debate with the audience comparable and contrasting experiences from across Europe. This workshop will outline and discuss results from a project, funded by the Volkswagen Foundation, about the experience of decision-making and the implementation of non-pharmaceutical public health measures (such as social distancing, school closures, lockdowns etc) in the early stage of the response to COVID-19 (the pre-vaccine phase) in three countries (Germany, Israel and Australia). The project combines both empirical research in the form of qualitative interviews with key stakeholders as well as theoretical and conceptual ethical analysis. These methods are integrated to propose a comprehensive ethics assessment building upon the resources of public health ethics to improve the capacity for ethically sensitive decision-making in the future. Key objectives will be: (1) to record some of the relevant values that are explicitly appealed to by stakeholders, (2) to record any implicit values visible in the decision-making process, (3) discuss some of the value conflicts that arose during decision-making, (4) tentatively suggest lessons to be taken into account in future pandemic policy making. The format of this workshop will be a roundtable with a series of short (5 minute) presentations from five panellists, all part of the project, as set out below (25 mins). The chair will then invite questions on matters of clarification arising (max. 10 mins) before inviting members of the audience to provide short comments documenting and reflecting upon their similar or contrasting experiences in their countries (20 mins) before a brief conclusion (5 mins).

Key messages

• Ethical values are implicitly or explicitly used to justify proposed and actual policy choices, even during a pandemic. Discussion of such values is useful for refinement of future pandemic policy.

• It was common to assume that everyone had the same access to information and ability to respond etc. However, a great, more explicit focus on disadvantaged or vulnerable groups would be beneficial.
Severity in a Norwegian hospitalized injury material (N = 177,663) by two severity measures: threat-to-life and threat of disability
Authors: Madsen C , Lund J
Published: October 2022

We conducted a registry-based cohort study of all individuals aged 25-64 years residing in Norway by 1st of January 2008 (N = 2,535,213). This cohort was followed from 2008 through 2014 using inpatient registrations for acute hospitalizations due to all-cause injuries, getting 177,663 cases of hospitalized persons (incidence rate of new cases: 102.1 pr 10,000 person-years at risk). We derived two measures of severity: threat-to-life using the International Classification of Disease-based Injury Severity Score (ICISS) (Stephenson et al 2004; Gedeborg et al 2014), and threat of disability using long-term disability weights (DW) from the Injury-VIBES project (Gabbe et al 2014), also based on the ICD-codes. We found the following distributions of the hospitalized persons (N = 177,663): 1) Threat to life (ICISS): High threat to life: 4,186 (2.4 %); Lower threat to life: 173,477 (97.6%). 2) Threat of disability (Injury Vibes DW): High probability of long-term disability (DW-score < 0.807): 36,573 (20,6 %); Medium probability of long-term disability (DW-score 0.807-0.947): 97,590 (54,9 %); low probability of long-term disability (DW-score >0.947): 43,530 (24.5 %). Correlation between ICISS-score and the Injury Vibes disability weight score was moderate (r = 0.418, p < 0.001). The presentation will end up in a discussion on which of these two severity measures could be used for comparing burden of injuries across countries.

References

Gabbe BJ, Simpson PM, Lyons RA, et al. (2014) Association between the Number of Injuries Sustained and 12-Months Disability Outcomes: Evidence from the Injury-VIBES Study. PLos ONE, 9(12):e113467. DOI: 10.1371/journal.pone.0113467.

Gedeborg R, Warner M, Chen LH, et al. (2014) Internationally comparable diagnosis-specific survival probabilites for calculation of the ICD-10-based Injury Severity Score. J Trauma Acute Care Surg, 76(2):358-65. DOI: 10.1097/ta.0b013e3182a9cd31.
Effectiveness of a health literacy intervention targeting kidney patients and professionals
Authors: Boonstra MD , Gurgel do Amaral MS , Navis GJ , Stegmann ME , Westerhuis R , de Winter AF , Reijneveld SA
Published: October 2022

Background

Chronic kidney disease (CKD) patients with limited health literacy (LHL) experience a faster kidney decline. To counteract this, we developed Grip on your Kidneys (GoyK). This intervention targets patients’ communication and self-management. It trains health care professionals (HCPs) competences to support patients with LHL. This study aims to test the effectiveness of GoyK on patients’ health and self-management, HCPs’ communication competences, and the quality of consultations.

Methods

A clustered and non-blinded quasi-experimental study was conducted, including 161 patients with mild to severe CKD and 48 HCPs from Dutch general practices and nephrology clinics. Patients (n = 77) and HCPs (n = 30) in the intervention group received GoyK. In the control group, patients (n = 76) had routine visits with HCPs (n = 19). Between March 2021 and June 2022, data were collected with questionnaires and from patient records at baseline (T0), 4 months (T1) and 9 months (T2). Primary outcomes were patients’ self-management and HCPs’ use of health literacy communication strategies.

Preliminary results

At T1, the intervention improved the days per week patients exercised (B = 1.00, 95% confidence interval, CI = 0.35-1.65, P = 0.003), and Likert-scale reported (1-4) fluid intake (B = 0.37, CI = 0.10-0.63, p = 0.006). The intervention had a positive effect on several outcomes related to how patients perceived the consultation quality, and improved the reported use of communication strategies by HCPs at T1 (B = 0.68, CI = 0.35-1.01, p = <0.001). We found no effects on other patient outcomes, like activation for self-management or salt intake.

Conclusions

Our health literacy intervention, targeting CKD patients with LHL and HCPs, improved lifestyle behaviors of patients and the quality of consultations. A further strengthening of other self-management behaviors and on HCPs’ competences is needed, also to reach sustainable effects in the care for patients with LHL.

Key messages

• A health literacy intervention, targeting patients and professionals simultaneously, improved the patients’ self-management and care consultations.

• Training of HCPs improved their competences to support patients with LHL, and care organizations and studies need to implement education on this topic.
Socio-demographic determinants of infectious disease knowledge in Armenia
Authors: Sargsyan Z , Grigoryan Z , Sahakyan S , Kelenjian K , Hayrumyan V , Agopian A , Harutyunyan T
Published: October 2022

Background

There is substantial evidence that infectious disease knowledge (IDK) predicts people's behavioral intentions and preventive practices. Since level of IDK varies across socio-economic contexts and imposes a substantial burden on vulnerable groups, we aimed to assess the relationship between socio-demographic factors and IDK in the adult population of Armenia.

Methods

A cross-sectional nationwide phone survey was conducted in the capital Yerevan and all Armenian provinces in 2021, using a stratified two-stage cluster sampling to complete a sample of 3,483 respondents. The questions on socio-demographic characteristics and IDK were included in a multi-domain structured survey questionnaire. Four questions measured IDK; a summative IDK score (0-4) was used in bivariate and multivariate linear regression analysis.

Results

Females constituted 71.0% of the sample. The mean age was 49.5 years. About 68% of the study participants had some vocational (12-13 years) or university degree education and 54.4% were employed. About one fifth of the respondents reported family monthly expenditures of less than 100,000 Armenian drams (AMD) ≈ $200, while the majority reported spending 101,000AMD to 400,000 AMD per month. The mean IDK score was 2.48. In the adjusted analysis, being female, holding a higher education level, being employed, having younger age and higher family monthly expenditures were positively associated with IDK score.

Conclusions

Our findings suggest that there is a gap in IDK affecting specific population groups such as older people, those with incomplete or secondary education, unemployed and financially disadvantaged people. Educational interventions and campaigns should target these groups to minimize the gap and ensure even prerequisites for good health.

Key messages

• Gender, age, education level, employment status and income level all independently influence population’s infectious disease knowledge.

• Health communication campaigns on infectious disease knowledge should particularly target males, older people and socially disadvantaged groups.
The COVID-19 HL School Principal Survey (Wales) linked to routinely collected anonymised health data
Authors: Marchant E , Seaborne M , Brophy S
Published: October 2022

Background

Evidence before the pandemic suggests that school headteachers report high work-related stress and psychological/physical burden compared to other professional groups (1). There is an evidence gap exploring the effects of the COVID-19 pandemic on senior leaders in schools who have experienced high demands as a result of COVID-19. This is important because in the UK, teacher retention is policy priority.

Methods

The COVID-19 HL: School Leadership Survey aimed to explore the burden and stress that school leaders in Wales, UK experienced during COVID-19, part of a global study with the COVID-HL network (3). 172 school leaders (62% female) from 130 primary (age 3-11) and 30 secondary schools (age 11-16) completed an online survey between July-Nov 2021, exploring topics such as work-related stress and mental health. A unique aspect is the use of data linkage using the SAIL (Secure Anonymised Information Linkage) Databank. SAIL is data repository containing individual-level, anonymised population-scale data for Wales.

Results

Initial descriptive findings show 54% of senior leaders have depression (WHO-5), and lower wellbeing scores compared to other UK professions. 83% report moderate-high perceived stress (Perceived Stress Scale) and physical (38%) and mental (57%) work exhaustion. The next stage of this study is to perform data linkage of survey responses to health records and administrative data. Logistic regression analyses will examine wellbeing and work-related stress with outcomes including mental health (e.g. anxiety/depression) diagnosis and time off work.

Conclusions

Preliminary results show high levels of stress, exhaustion and low wellbeing amongst school leaders in Wales. The next part of this study will examine this in greater detail using data linkage of routine records. Data linkage allows this sample to be extrapolated to population level to theorise work-related stress for all school leaders in Wales.
Household deprivation, comorbidities and COVID-19 hospitalization in 690,115 children/adolescents
Authors: Dragano N , Dortmann O , Timm J , Mohrmann M , Wehner R , Rupprecht CJ , Scheider M , Mayatepek E , Wahrendorf M
Published: October 2022

Background

Studies document that adults in disadvantaged socio-economic positions have elevated risks of a severe course of COVID-19, but it is unclear if this holds true for children. We investigate in this population-based study whether young people from socio-economically disadvantaged households in Germany had a higher risk of COVID-19 hospitalization compared with more affluent counterparts. We also examined if differences were related to comorbidities that predict severe courses in children.

Methods

We included data from all 690,115 children and adolescents (0-18 years) enrolled in a statutory health insurance carrier. Daily hospital diagnoses of COVID-19 were recorded from 1.1.2020 to 13.7.2021. Logistic regressions were used to compare children from households with an indication of poverty (e.g. long- or short-term unemployed) with children from households with insurance holders in regular employment. We also assessed socio-economic characteristics of the area of residence. We controlled for age, sex, days under observation, nationality, and comorbidities (e.g. obesity).

Findings

A COVID-19 hospital diagnosis was a rare event (n = 1637). Children of long-term unemployed parents had a 1·36 times (95% CI 1·21-1·51) higher adjusted odds of hospitalization compared with those of employed parents. Elevated odds were also found for short-term unemployed or low-wage employment. Those living in poor areas had a 3·02 (1·81-5·22) higher odds of hospitalization than those in less deprived areas. Comorbidities were strongly related to hospitalization, but their adjustment did not change main estimates for household deprivation.

Discussion

Results suggest that children from poor households are at higher risk of severe courses of COVID-19 than their affluent counterparts. This underlies the need to implement effective Public Health strategies to protect deprived children from COVID-19 and other infectious disease even in high income countries such as Germany.

Key messages

• Children and adolescents from poor families seem to be at higer risk for sever courses of COVID-19.

• Comorbidities were no key mediating factor in this study.
Psychotherapy – A Sound Investments In (Mental) Health Capital?
Authors: Turunen J , Gluschkoff K , Kausto J , Selinheimo S , Koskinen A , Väänänen A
Published: October 2022

Introduction

The concept of health capital views health as a form of capital that produces healthy time to individual. This stock of capital - health that is - can decrease or increase. The potential of psychotherapy as individual's investment to (mental) health capital has been rarely studied in population level.

Objectives

The aim of our study is to shed light on the returns on individual-level investments in health capital. We consider the use of psychotherapy as an investment in health capital. This investment offers potential returns for individual as a higher level of subsequent income. However, these returns are potentially heterogenous: we aim to show to whom the use of psychotherapy is a sound investment in health capital.

Methods

We model the effects of mental health, and subsequent treatments such as the use of psychotropics and psychotherapy on income using two-way fixed effects regression.

Results

Preliminary results show that different parts of working-age population seem to have different potential returns related to the use of psychotherapy. These heterogenous effects are related to previously reported socioeconomic status related disparities: the level of human capital i.e. income and education play a role in the profitability of the individual level investment made in the health capital by the use of psychotherapy.

Conclusions

The use of psychotherapy has heterogenous effects on the income of individuals. The potential of this investment to produce health capital varies with education, the level of income prior to the use of psychotherapy.
Distinctive mental health profiles in the working population: A nation-wide study from Finland
Authors: Väänänen A , Kausto J , Gluschkoff K , Kokkinen L , Selinheimo S
Published: October 2022

Introduction

Studies on mental health inequalities are usually based on limited sets of mental health indicators.

Objectives

Using a large number of mental health indicators, we explored whether it is possible to identify similar hierarchical rankings regardless of mental health indicators (incl. psychotherapy) among employees representing different socio-demographic statuses, and which groups of employees have the highest mismatch between mental health symptom and treatment.

Methods

Employees representing different occupational classes and employees from four different areas of Finland were studied and compared. We used national register data to define psychotropic medication (purchases), sickness absence for mood disorders, and the use of psychotherapy between 2017 and 2019 and national survey data from the FinHealth 2017 Study to define the level of psychological symptoms (BDI, GHQ). We assessed the risk of each outcome by population group separately for men and women, and estimated the mismatch between symptoms (BDI/GHQ caseness) and treatment (psychotropic drugs/therapy).

Results

In all the studied groups, the prevalence of mental health indicators was mostly considerably higher among women than men. The risk of register-based mental health indicators was typically higher among lower non-manual employees. In the case of some mental health indicators, we observed significant interactions between occupation class and region. Some stark mismatches were detected between symptoms and treatment in some populations, whereas at the other end of the spectrum, the correspondence between symptoms and the mobilization of care was rather high.

Conclusions

Although gender is strongly linked to mental health indicators, occupational class and region influence mental health profiles in the population. There are considerable inequalities between populations in the level of professional care associated with mental health problems.
Time at home during the COVID-19 pandemic: a prospective examination of psychosocial health in people with and without type 2 diabetes using digital phenotyping
Authors: McInerney A , Schmitz N , Matthews M , Deschenes S
Published: October 2022

Introduction

Societal restrictions due to COVID-19 have had a profound effect on our ability to connect with one another and limited our personal mobility. There is evidence that loneliness, social isolation, and psychological distress increased during restrictions for people with diabetes. Fluctuating restrictions provide a unique opportunity to utilise continuous GPS data from personal smartphones (digital phenotypes) to explore the relationship between time-at-home and psychosocial health for people with diabetes. This study aims to (1) describe the digital phenotypes of time-at-home during varying societal COVID-19 restrictions for people with and without type 2 diabetes and (2) to explore associations between these digital phenotypes and loneliness, social support, and other psychosocial factors and compare for people with and without type 2 diabetes.

Methods

Data come from a longitudinal observational study in the Republic of Ireland that ran between March and August 2021. Participants are seventy-four adults (64.8% female; median age-group = 50-54) with (N = 40) and without (N = 34) diabetes. Continuous GPS data were recorded for 2 months through the Beiwe smartphone application. Loneliness (UCLA-3), social support (MSPSS), diabetes stigma (DSAS-2; diabetes cohort only) as well as other demographic, psychosocial, and lifestyle questionnaires were assessed at baseline, 1 month, and 2 months follow-up.

Analysis

GPS data are being processed. The GPS-derived features of time-at-home, overall movement, and location variance will be computed. Associations between these digital phenotypes and psychosocial factors will be explored and changes over time examined using multilevel modeling.

Conclusions

We expect this study to be the first to describe and compare the digital phenotypes of people with and without diabetes during varying societal COVID-19 restrictions, providing new insights into the effects of such policies on the psychosocial health of people with diabetes.
Green space availability and mental health – results from a cross-sectional study in Northwestern Germany
Authors: Sisenop F , Lindert J
Published: October 2022

Background

A relationship between green space and health has been shown in several epidemiological studies. The impact of different types of green space is still relatively unknown. To start filling this gap, we looked at associations between different green space types and health outcomes (depression and mental health).

Methods

Data are obtained from a cross-sectional study (n = 479). Depression (assessed with PHQ-9) and mental health (assessed with GHQ-28) are dependent variables. Availability of green space in the surrounding neighborhood was assessed as independent variable by the percentage of green space ( > =1ha) within a 250m radius participants residence. Survey data were analyzed using IBM SPSS 26 and Geo data using QGIS 3.18.0.

Results

N = 479 participants of a cross-sectional study in 2018 provided data (49.4%, n = 240 women; 49.6%, n = 239 men). Participants had a mean age of 57.55 years (SD: 18.80, min-max:18-95), majority (75.2%, n = 360) were married or partnered, had a lower educational qualification than A-levels equivalent (56.8%, n = 272), were not employed (53%, n = 254), had a net household income of at least 3. 000€ per month (40.1%, n = 192) and at least sometimes financial worries (51.4%, n = 246). Green areas without agricultural areas show an association with frequency of depression (B(SE)=0.056(0.024), p = 0.018). This contrasts with green spaces including agricultural areas, where there is no statistically significant association (B(SE)=0.007(0.012), p = 0.564).

Discussion

We found an association between type of green space and depression. Further studies are needed to establish a grid for assessing characteristics and quality criteria of green spaces. However, it can already be assumed that there is an association between quality of green spaces and psychosocial outcomes.
The relationship between well-being and digital health literacy in university students from Romania
Authors: Ungureanu M , Coman MA
Published: October 2022

Background

Digital Health Literacy (DHL) gained traction in recent years in the health promotion and well-being field as a possible protective factor.

Methods

A cross-sectional survey was conducted using a self-reported web-based questionnaire on students enrolled at a university from Romania between December 2020 and February 2021. Descriptive statistics, correlation tests, and logistics regressions were employed to analyze the relationship between DHL, well-being, subjective social status (SSS), and future anxiety among students.

Results

The data set included 1381 valid surveys (out of 1877 total surveys) completed by students aged between 18 and 39 years (mean = 21.9, SD = 3.701), the majority (69%) being males. Most of the students were studying at Bachelor level (83%), while the rest were Master or PhD students. Responses showed that 49% of the students expressed low well-being, 48% expressed a high level of future-anxiety and 59% considered they have a low SSS. For the DHL subscale of evaluating the reliability of the information, 56% of students had limited DHL, while for the subscale of determining the relevance of information, 64% of students presented limited DHL. The DHL subscale of adding self-generated content showed the highest correlation with well-being, followed by the determining relevance of the information subscale. Sufficient DHL was associated with higher levels of well-being when controlling for age, gender, and study program.

Conclusions

Well-being is influenced by actions such as adding self-generated health content, determining the relevance of health information, and anxiety for the future, all being important actions in health promotion. Individual factors such as age and gender are also relevant in mediating the relationship between DHL and well-being.
Digital health literacy and well-being of students at Sofia University – Bulgaria
Authors: Patias I , Kaloyanova K
Published: October 2022

Background

During the Covid-19 pandemic the students in the Faculty of Mathematics and Informatics at Sofia University ‘St. Kliment Ohridski’ applied their abilities for searching health-related information and use it as a factor to improve their well-being.

Methods

The study used the Questionnaire developed by Dadaczynski, K., Okan, O. & Rathmann, K. in 2020 as COVID-19 Health Literacy Survey: University Students (COVID-HL Survey), and the respective Scale Documentation under the Public Health Centre Fulda (PHZF) at the Fulda University of Applied Sciences & Interdisciplinary Centre for Health Literacy Research at Bielefeld University. 216 students, almost 13% (12.78%) of 1.690 students approached, participated.

Results

There is a correlation as our students reported Very easy or easy to the question how easy they deal with the coronavirus information on the Internet - with 71% choosing from all the information they find, 91% using the proper words to find the information, and 71% finding the exact information. Those results were achieved as our students reported feeling over the last two weeks 27.12% very low, 18.08% low, and only 54.80% high (>50) well-being, measuring the dimensions of psychological general well-being by the WHO-5.

Conclusions

Our students reported they can search and retrieve the appropriate information on the coronavirus or related topics, and they are satisfied with the information found. Our students’ abilities to search and retrieve health-related information are applicable even under the pandemic pressure, where they contribute to the improvement of their well-being feelings. [This research is supported by the National Scientific Program “eHealth” in Bulgaria.]
Digital health literacy and well-being in university students in Germany
Authors: Dadaczynski K , Messer M , Rathmann K , Okan O
Published: October 2022

Background

Digital communication technologies had a crucial role during the COVID-19 pandemic, with the internet and Social Media as highly frequented sources for retrieving health information. University student's health and well-being were highly affected and most interaction with peers and professionals migrated to the digital realm, which made digital health literacy (DHL) a key competence to navigate digital health environments. The main goal of the study was to explore DHL of students in Germany.

Methods

A cross-sectional online survey among students (N = 14916) from 130 universities in Germany was implemented as part of the global Covid-HL Network, collecting data on DHL, physical and mental health, SoC and sociodemographics. Data was analyzed using univariate, bivariate and regression analyses.

Results

Assessing the reliability of information (5964/14,103, 42.3%) and determining commercial interest of information posed the most difficult tasks (5489/14,097, 38.9%). Difficulties were revealed for finding information (4282/14,098, 30.4%). Female students reported lower DHL and social media use was associated with lower judgment skills. 38% of all students reported low and very low well-being and 29% reported at least two health complaints weekly, while health outcomes follow a social gradient (lower SES and gender). Regression analysis showed significant association between SoC and well-being (OR: 1.2-2.03) and health complaints (OR: 1.58-1.71). Higher future worries were with low well-being (OR: 2.83) and multiple health complaints (OR: 2.84).

Conclusions

There is an urgent need to enhance DHL and SoC of students and implement health promotion strategies, using target group specific intervention. Gender and socioeconomic differences must be taken into account and interventions could be delivered within the university. Measures should also address student mental health.
11.J. Workshop: Enabling participation of vulnerable groups in primary health and long-term care
Authors:   Organised by: Bielefeld University (Germany),   Chair persons: Kerstin Haemel (Germany), Anja Dieterich (Germany)
Published: October 2022

Enabling individual and collective participation or vulnerable people in health and social care is fundamental to achieving equitable, people-centered care. However, for vulnerable groups and clients, unfolding opportunities for participation in their care is closely related with experiences of empowerment and disempowerment. The workshop focuses on primary health and long-term care, as those are the pillars of resilient health care systems able to meet the complex care needs of vulnerable people. From a public health perspective, the facets of participation range from providing access to comprehensive services for people in need, to developing a shared understanding between clients and health professionals regarding clients’ everyday and care preferences, to sharing decision-making on health and care matters. In this workshop, we will discuss how helpful public health interventions between individual, professional and systemic-structural approaches should or could be designed, to (better) enable participation of vulnerable groups in primary and long-term care. The workshop presentations draw on empirical research with members of vulnerable groups, health professionals and key informants in care policy and practice conducted in Brazil, Germany, India, and Spain. By focusing on different primary and long-term care settings as well as vulnerable groups (undocumented persons, older people in need of care, people living with chronic illnesses) we will address and discuss the following questions:

• What ideas can we find to strengthen participation of vulnerable groups in primary and long-term care settings?

• Which opportunities and barriers are involved?

• How can individual, professional, and structural approaches ‘fit together’ to enable greater participation of vulnerable groups in their (self-)care?

Key messages

• Practitioners’ efforts to enable participation have to be accompanied by qualification- and governance-oriented public health approaches to achieve patient oriented health and social care systems.

• Present barriers and opportunities for vulnerable groups are instructive indicators for broader challenges towards comprehensive people-centered care.