bluuebunny/crossref_metadata_2025 huggingface dataset:
COVID-19 vaccine hesitancy among Tunisian cancer patients in the Salah Azaeiz Institute of Cancer
Authors: Cherif I , Khiari H , M'ghirbi F , Mallekh R , Mezlini A , Hsairi M
Published: October 2021

Background

Vaccination against SARS-CoV-2 is the most effective way to stop the pandemic and to avoid its related deaths. COVID-19 vaccine hesitancy, represent now a major hurdle to achieve herd immunity. Cancer patients constitute a prioritized group for COVID-19 vaccination as they are particularly vulnerable to severe infection and death. The aim of this study was to assess vaccine hesitancy among cancer patients of the Salah Azaiez Institute (SAI) of cancer and to identify its knowledge and attitudes associated factors.

Methods

A cross sectional study was conducted among all inpatients aged above 18 years old during the month of February 2021. Participants were asked according to a well-structured questionnaire about knowledge (vaccine literacy) and attitudes towards COVID-19 vaccine. Vaccine literacy was assed using two scales (functional and interactive-critical scales) for which a global score was calculated ranging from 1 to 4. A lower score corresponding to lower vaccine literacy. Chi square test and student's t test were used to identify knowledge and attitudes associated with COVID-19 vaccine hesitancy. A p value equal or less than 0.05 was considered statistically significant.

Results

Two hundred cancer patients were included with a mean age of 54.4±12.7 and a gender ratio equal to 0.5. Sixty-five percent reported that they would not receive the COVID-19 vaccine. Vaccine hesitancy was associated with lower interactive vaccine literacy score (1.6±0.8 vs 2.0, p = 0.002), skepticism regarding COVID-19 vaccine efficacy and safety (73.8% vs 38.5%, p < 0.001) and believing that health authorities will not be able to vaccinate the majority of the population (71,2% vs 55.7% p = 0.037).

Conclusions

The proportion of COVID-19 vaccine hesitancy among cancer patients is high. Mass media campaigns for vaccine promotion should be enhanced. Physicians and health care workers play a key role in increasing acceptance and uptake of COVID-19 vaccine among high risk patients.

Key messages

Majority of cancer patients were unwilling to receive the COVID-19 vaccine. Patient education about the benefits of vaccination against SARS-CoV-2 should be an integral part of oncology visits.
Building resilience through integrated health systems strengthening: policy and planning analysis
Authors: Mustafa S , McDarby G
Published: October 2021

Health system strengthening towards universal health coverage and health security are key objectives promoted by health policy actors. However, bringing together these agendas has presented challenges. Health investments are often reactive and siloed e.g. emergency and humanitarian response programmes. There has been disinvestment in public health and primary health care (PHC), and limited linkages with allied sectors (e.g. environmental and animal health). There is a need to better understand policies that promote integration and enable effective response to threats such as COVID-19 in tandem with maintaining routine health system functions (e.g. PHC and essential individual and population health services). We conducted document analysis of national health sector, security and public health policies and plans and drew on perspectives of key stakeholders to investigate integration using a health systems resilience framework. We examined the extent and manner in which policies are integrated to enable national and subnational systems to prepare for, prevent and adapt to shocks while maintaining routine and essential functions. While we identified a recognition of the need for better integration to promote health security within health systems strengthening efforts and vice versa including strengthening governance, accountability and capacity for stewardship within national and local health and allied authorities, evidence of such an approach was limited. National laws to support IHR (2005) implementation were often outdated and insufficient to produce the policy environment for multi-sectoral working. In 2020, only 47% of national COVID-19 plans from 106 countries considered the maintenance of non-COVID-19 essential health services - a key component of health systems resilience. Policies which strengthen PHC services and preventative interventions can be cost-effective and efficient whilst bridging pandemic response and other essential functions of the health system.

Key messages

COVID-19 is an opportunity to promote and sustain greater integration and inter- and multisectoral engagement. Everyone can play a role to foster an integrated approach focussing on preventative, cost-effective health services to ensure health systems resilience.
Workplace mobbing and organizational intelligence - healthcare risk management in a crisis
Authors: Dimitrova D
Published: October 2021

Issue

Mobbing is the old syndrome of the new age. A phenomenon of invisible systemic group pressure on a selected dissident victim and a visible harassment that sticks strongly in a crisis. A victim with a strong character, a person competent and leadership skills to a degree that exceeds another placed leader, as an expression of his fear and frustration. The presence of mobbing is always an expression of a bad organizational culture. The opportunities for risk reduction are based in the creation of a highly effective, tactical-strategic flexibility and creative program of control, mediation and modeling of the risk factors leading to mobbing.

Description of the problem

A particularly interesting scene for the manifestation of mobbing is the academic environment. The manifestation of mobbing leads to serious losses, social isolation and has health consequences on the attacked and subjected to emotional pressure member of the team. A creative scientist and charismatic teacher, a wonderful and eroded specialist does not go unnoticed by the more mediocre. Circles are formed with different scope and degrees of trust in the initiator of the mobbing, who generates and manages directly several with the role of accomplices and indirectly dozens to hundreds of cowardly and sufficiently obedient performers.

Results

Basic human rights are violated and the organizational culture of the institution is compromised through mobbing. A process of a cyclical nature in which only the victim changes. The implementation of a policy of zero tolerance for mobbing is a starting point, but it is not enough for a lasting solution to a problem with the volume and nature of a socio-economic disaster.

Lessons

Mobbing is a conflict of interest in which the better prepared fall victim to the more mediocre. Insufficiently good level of management at all levels in the institution leads to mobbing when a competent and eroded member of the team appears.

Key messages

No one is protected from mobbing in bad and destructive management. A mobbing risk reduction program is applicable to each prevention indication at each level.
Predictors of hypertension self-care practice in primary health-care facilities of Sfax
Authors: Ketata N , Ben Ayed H , Ben Hmida M , Maaamri H , Yaich S , Kassis M , Feki H , Damak J
Published: October 2021

Introduction

Unmanaged hypertension is usually accompanied with complications leading to disability in older adults. It has been demonstrated that self-care practice is essential for blood pressure control and reduction of hypertension complications. This study aimed to estimate the level of implementation of HTN self-care practice and to identify their associated factors in Sfax, Southern Tunisia.

Methods

It was a cross-sectional study conducted in Sfax, Southern Tunisia from March to April 2020. A total of 6 primary health care facilities was approached for the study participants according to a single-stage cluster sample, by selecting six grapes randomly. A total of 270 participants were recruited, among whom 250 cases (92.6%) completed the questionnaire. Statistical analysis was performed using SPSS.24.

Results

A total of 250 hypertensive patients were included in the study, giving a male to female ratio of 0.77. There were 125 participants (50%) aged over 65 years. Overall, 137 cases (54.8%) had a high total self-care practice score. The independent factors of good HTN self-care practice were age over 65 (AOR=9.5; p < 0.001), university educational level of the participants (AOR=21.2; p < 0.001), as well as receiving a health education, by healthcare providers (AOR=2.5; p = 0.012) and family members (AOR=4.36; p = 0.004). Advanced hypertension stage (II and III) (AOR=0.45; p = 0.032) and chronic pulmonary diseases, including asthma (AOR=0.42; p = 0.027) and COPD (AOR=0.27; p = 0.016) were independently associated with poor HTN self-care practice.

Conclusions

Advanced hypertension stage, pulmonary co-morbidities, education level and lack of self-care education were predictive factors of poor self-care practice. These findings suggested that such factors should be considered when planning hypertension self-care education

Key messages

Hypertension self-care practice. Hypertensive patients.
Objective and subjective assessment of the neighborhood health environment, Limassol, Cyprus
Authors: Kleopa D , Panayiotou A , Kouta C , Middleton N
Published: October 2021

Background

While neighborhood audit tools are commonly assessed for inter- and intra-rater reliability, validity and relevance are not always demonstrated.

Methods

A stratified random sample of 45 neighbourhoods in Limassol were audited with the 150-item Cyprus Neighborhood Observational Tool for urban environments (CyNOTes). Ratings were correlated with census indicators of socioeconomic disadvantage. The extent to which residents' neighborhood assessment (Place Standard, N = 444) and self-rated quality of life (SF-36 in second sample N = 450) differed across neighborhoods classified according to domain were explored in mixed random effect models.

Results

CyNOTes items are organized in 9 domains (internal consistency=0.5-0.9) with a 3-factor higher structure. In seven, a stepwise pattern of lower mean ratings was observed across increasing socioeconomic disadvantage, for domains rated generally high across neighborhoods (e.g. lack of physical disorder) and low (e.g. outdoor spaces). Though not always statistically significant, a systematic pattern of higher self-rated health was observed in better-off neighborhoods across most domains. “Pedestrian environment” captured the largest difference for both physical (1.34 95%CI 0.42,2.26), p = 0.005 per tertile increase) and mental health (1.46 95% 0.54,2.40; p = 0.003). “Social contact” and “Safety: lack of security-related features” were more likely to be rated favorably in disadvantaged neighborhoods, however no associations with quality of life were observed. While the residents' assessment was often in the expected direction, more for built environment features, this was not always the case.

Conclusions

The study demonstrated the content, construct, criterion and predictive validity of an audit tool for supplementary profiling the built, physical and social health-related neighbourhood environment. Concurrent validity against residents' perceptions was not always supported, raising questions about differential expectations.

Key messages

Neighbourhood audits can provide useful supplementary information not captured by other community assessment methods and independent of residents’ perceptions. Depicting the social gradient in the neighborhood microenvironment can trigger and contextualize the conversation about place effects on health among Public Health research and policy community.
Non-driving older adults living in a rural hilly area are at high risk for poor physical function
Authors: Abe T , Okuyama K , Miyazaki R
Published: October 2021

Background

While some studies have found an association between built environments and physical function, it is unclear whether living in a hilly area is associated with poor physical function among older adults, and whether this association varies by car driving status. This cross-sectional study investigated the association between hilliness and physical function in community-dwelling older adults and whether it varied according to their car driving status.

Methods

Data were collected from 633 participants aged 60 years and older living in Okinoshima Town, Shimane prefecture, Japan, in 2018. Physical function was objectively assessed; < 1.0 m/s was defined as poor walking speed, and hilliness was measured by mean land slope within a 1000-meter network buffer zone around each participant's home using geographic information system. Logistic regression examined whether hilliness was associated with poor walking speed adjusted for sex, age, body mass index, current smoking, current alcohol consumption, exercise habits, current chronic disease, and living arrangements. A stratified analysis by car driving status was also conducted.

Results

A total of 159 (25.1%) participants had poor walking speed. After adjusting for all confounders, hilliness was positively associated with poor walking speed (OR = 1.07, 95% CI, 1.02-1.12). The stratified analysis by car driving status showed that living in a hilly area was positively associated with poor walking speed among non-drivers (OR = 1.10, 95% CI, 1.03-1.17), though there were no associations among drivers (OR = 1.00, 95% CI 0.92-1.08).

Conclusions

Our study found that a hilly environment was associated with poor walking speed in community-dwelling older adults in Japan. Moreover, car driving status potentially modified the relationship between living in a hilly environment and poor walking speed.

Key messages

Older adults living in a hilly environment were more likely to have poor walking speed, compared to those living in less hilly area. The stratified analysis by car driving status showed that non-driving older adults living in a rural hilly environment may be at high risk for poor physical function.
Natural radiation and high metal soil content are linked with higher cancer mortality rates
Authors: Katsifara A , Sazakli E , Jelastopulu E , Leotsinidis M
Published: October 2021

Background

General population is at continuous risk of exposure to both natural and anthropogenic pollutants via the oral, respiratory and dermal routes. In Greece, there are areas where the geological background is rich in both radioactivity and toxic elements, whereas anthropogenic activities, like lignite or metal mining, augment the general population exposure. The aim of the study was to compare cancer mortality rates among neighboring prefectures that share similar demographic and socio-economic characteristics, but differ in natural radioactivity and in carcinogenic metals' burden in soils.

Methods

Based on radiological and geochemical maps, five prefectures of North Greece with high radioactivity and metal's content in soil were chosen. Two similar prefectures with low radioactivity and metals' content served as control areas. Data about population structure and number of deaths due to neoplasms were obtained from the Hellenic Statistical Authority for a 15-year interval (1999-2015). Cancer mortality rates were calculated and compared between areas by Poisson regression.

Results

The total population in burdened areas was 660.091, while in the control areas was 207.117 (2011 Census). Mortality rates from burdened areas were higher than those in the control areas. Odds ratios ranged from 1.42 (95% CI: 1.35-1.49) to 1.79 (95% CI 1.71-1.88) for males and from 1.27 (95% CI: 1.19-1.35) to 1.85 (95% CI: 1.74-1.96) for females. For both sexes, the odds ratios ranged from 1.35 (95% CI: 1.30-1.41) to 1.80 (95% CI: 1.74-1.87).

Conclusions

Undoubtedly, our preliminary results reveal that residents in burdened areas are at higher risk for cancer death due to exposure to naturally occurring metals and radiation. Both the general population and the health authorities are unaware of these possible threats and no protective measures have been taken so far. Viable strategies to minimize or prevent these unintentional risks are of high priority in these areas.

Key messages

Population should be informed about the unintentional environmental exposures that pose health risks. Appropriate mitigation strategies should be implemented by the health authorities.
The behavioral risk factors of non-communicable diseases in the Russian Federation
Authors: Soshnikov S , Halfin R , Madyanova V
Published: October 2021

Background

Behavioral risk factors are one of the significant problems in Public health around the world. The authors of the current research are involved in The Global Burden of Diseases, Injuries, and Risk Factors Study, which provides a graded and complete estimation of risk factor exposure, relative risk, and attributable burden.

Methods

Relative risks we assessed as a function of exposure based on issued systematic reviews for the GBD 2019 study and meta-regression. The exposure levels for each year, age, gender, location included in the survey we calculated based on all available data sources using Gaussian Spatio-temporal regression, DisMod-MR 2.1, Bayesian meta-regression method.

Results

Behavioral risk factors determine a loss of 42.2% DALYs (56% in males and 28.5% in females) from all non-communicable diseases (NCD) in the Russian Federation. It causes 49% of all NCD-related deaths (62% in males and 37% in females). The main burden came from cardiovascular diseases (CVD). Behavioral risk factors affect 60% of DALYs (71.5% in males and 47.6% in females) burden and determine 54% of all NCD deaths (67% in males and 44.5% in females). In second place are neoplasms determined by behavioral risk factors on 39% of DALYs (51.6% in males and 23.6% in females) and 38% of deaths (53% in males and 22% in females).

Conclusions

Behavioral risk factors are one of Russia's most critical public health challenges; they affect about half of the loss of health of the population from non-communicable diseases. The appropriate policies for preventing non-communicable diseases that include consideration of behavioral risk factors, it is possible to achieve excellent results in preventing premature mortality and loss of public health. We have a great potential to reduce health losses from NCD in Russia.

Key messages

The behavioral risk factors determine almost half of all NCD-related deaths in the Russian Federation. Males in Russia are more susceptible to behavioral risk factors than females.
A proteomic approach of the different environmental conditions of Listeria monocytogenes
Authors: D'Onofrio F , Krasteva I , Schirone M , Torresi M , Tittarelli M , Pomilio F , Iannetti L , Di Febo T , Luciani M
Published: October 2021

Listeria monocytogenes is the ubiquitous food-borne pathogen which causes listeriosis, a disease with a high mortality rate, mostly transmitted through contaminated ready-to-eat foods. To better understand the systemic response of L. monocytogenes exposed at 3 environmental factors (T, pH and NaCl), the proteome of L. monocytogenes strain NRG 1749-2016, isolated from a meat product, was investigated to identify differences in the protein patterns of such pathogen. Four different conditions were carried out as follows: A) T 37 °C, pH 7.0, NaCl 0.5%; B) T 37 °C, pH 5.5, NaCl 7%; C) T 12° pH 7, NaCl 0.5%; D) T 12 °C, pH 5.5, NaCl 7%. The proteins belonging to cytosol (C1) and vesicles (C2) were isolated and purified by CelLytic B Cell Lysis Reagent and CelLytic IB Inclusion Body Solubilization Reagent according manufacturer's instructions. The analysis were conducted by SDS PAGE and Immunoblotting techniques. The protein concentrations were evaluated by Pierce BCA Protein Assay Kit. From preliminary results, the protein banding patterns generated by 1D SDS PAGE were found to be different at visual observation for C1 and C2, in A, B, C and D conditions. The presence of specific antigen-antibody immunocomplexes (Ag-Ab ICs) was identified by Immunoblotting, in C1 at 100, 60, 55, 35 and 25 kDa for all incubated conditions with a positive serum to L. monocytogenes. As regards C2, Ag-Ab ICs at 110 kDa were observed in A and B, Ag-Ab ICs at 80 kDa in C and D, Ag-Ab ICs at 60 kDa in A and D, while Ag-Ab ICs at 40 and 30 kDa in all conditions. The analysis of the proteome profiles shows an intra-strain variation in the protein patterns produced by L. monocytogenes during the adaptation at different environmental conditions. Further analysis will be carried out to better understand the systemic response of L. monocytogenes, in particular in order to characterize the immunogenic proteins highlighted by Immunoblotting and their role in the virulence expression of such pathogen.

Key messages

Understand how L. monocytogenes adapts physiologically to different environmental factors. Development of new detection method of L. monocytogenes and prevention strategies for listeriosis outbreaks.
Antimicrobial resistance of Listeria monocytogenes human strains and correlation to genomic data
Authors: Chiaverini A , Curi R , Gori M , Blasi G , Torresi M , Centorotola G , Di Francesco CE , Acciari VA , Pomilio F , Centorame P
Published: October 2021

Background

Studies checking antimicrobial resistance (AMR) of Listeria monocytogenes (Lm) are ongoing, coupled with disease surveillance. Lm resistant strains are reported and are increasing. The aim of the work was to investigate AMR of clinical strains of Lm collected from nine regions (mostly in Lombardy and Marche regions) from 2008 to 2020.

Methods

The dataset consisted of 233 Lm human strains collected from nine regions during the period 2008-2020. All the strains were tested using Sensititre™ Haemophilus Plate (Thermo Scientific, Milano, Italy). Results were expressed according to EUCAST breakpoints for Lm, S. pneumoniae and E. faecalis. Resistant strains were sequenced using Illumina platform, ABRicate was used to predict antimicrobial resistance genes and plasmids.

Results

Most of the strains were detected in Lombardy and Marche. The MIC results showed that 11 out of 233 strains were resistant, one to ampicillin, four to tetracycline and six to clarithromycin. Analysing the sequences, all the resistant strains showed to have a common antimicrobial resistant pattern (mprF, norB, FosX, (MLS)lin, lin and lmo0919). Genomic determinants for ampicillin and clarithromycin resistance were not detected. Indeed, only in 3 out of 4 resistant strains tetM was found. Meanwhile, plasmids were detected in 7 strains.

Conclusions

The distribution of the strains considered in this work did not reflect the real epidemiological situation in Italy, because their origin was mostly from two regions. The emergence of AMR also for Lm needs to be considered. Moreover, official breakpoints for Lm are not defined and to date limited to five antimicrobials excluding clarithromycin and tetracycline, where the pathogen showed resistance. Finally, the incongruence between phenotypic and genomic data suggests that the mechanisms involved in the resistance is not fully known especially for ampicillin. Further investigations are needed to improve the knowledge on Lm AMR.

Key messages

Monitoring AMR of Listeria monocytogenes is crucial, only effective drug in clinical cases should be used. Further investigations are needed to explore the mechanisms involved in antimicrobial resistance of Listeria monocytogenes.
Health impact assessment of a voluntary protocol to decrease salt in bread: what can we learn?
Authors: Costa L , Santos J , Alves J , Braz P , Brazão R , Costa A , Santos M , Assunção R , Caldas de Almeida T
Published: October 2021

Issue

Hypertension (HT) is a major and modifiable risk factor for cardiovascular diseases (CVD), which can be caused by excessive salt intake. Portugal has one of the highest mortality rate due to CVD in Europe, mainly due to HT. Thus, reduction of salt intake from food products is one of major strategies advocated to modify blood pressure (BP) and its impact on HT.

Description of the problem

The Portuguese population has excessive daily salt intake mainly due to bread consumption. Thus, in 2017 a voluntary ‘Protocol' was signed between stakeholders with the goal to reduce salt content in bread by 2021. Herein, using a Health Impact Assessment (HIA) approach we aimed to estimate the potential effect in BP from the implementation of this ‘Protocol'. Thus, two national surveys were used to find average values of salt intake and BP on population, while estimates of BP reduction were calculated based upon meta-analysis data.

Results

It was expected that the implementation of the ‘Protocol' could reduce salt ingestion and have a higher BP effect, mostly in more vulnerable populations. In fact, results showed that individuals with low educational level, men, aged and residents in the South region of Portugal were the ones that could more benefit from the ‘Protocol' implementation. However, this study found that the effects were be very low for all groups analysed, suggesting that only slight health gains can occur.

Lessons

The ‘Protocol' as a voluntary agreement is not sufficient to attain the public health targets devised. Following the HIA framework, further complementary and intersectoral integrated measures, through the use of compulsory food and fiscal policies preferably extended to other highly consumed food products, were thus recommended. HIA could be used as a comprehensive tool to assess health impacts, supporting at each national context the design and implementation of effective strategies to promote salt intake reduction and effectively prevent hypertension.

Key messages

The systematic use of HIA to design the appropriate policy framework and to inform adequately political decision-making is crucial to promote health and prevent Non-Communicable Diseases. Voluntary agreements should be complemented by other integrated measures to improve the efficacy of policies aiming to reduce salt intake and prevent hypertension.
Sustainable initiatives to limit the spread of corona-virus among Danish school teachers
Authors: Rueskov Poulsen VD , Nabe-Nielsen K , Larsen I , Vibe Fuglsang N , Juul Nilson C
Published: October 2021

Background

Schoolteachers play an important role in limiting the spread of corona-virus among pupils while carrying out their core tasks. This double role affects teachers' mental health negatively. Still, open schools are important for pupils' learning and wellbeing. Hence, it is crucial to identify viable strategies for virus control that can be implemented in schools without draining teachers' resources. Thus, our aim was to analyze the sustainability of interventions aimed at hindering spread of virus in public schools.

Methods

The qualitative data consisted of 700 free text responses from a survey among 1332 Danish schoolteachers from Nov 25 to Dec 9, 2020, i.e. when facing the second wave of the COVID-19 pandemic. Using Thematic Network Analysis, we analyzed the participants' answers to the question “What initiatives to prevent the spread of infection would you be able to carry out for a longer period of time?”

Results

Most initiatives consumed resources (financial, staffing, time, mental, and relational) to an extend that was unacceptable for the participants. Improved hygiene and ventilation were sustainable initiatives given that the allocation of responsibility was clear. The sustainability of using visor/facemask was compromised by its negative effects on social interactions and by stigma. Isolation of teachers, when having been in contact with infected pupils, had major consequences for the teachers' private life. Finally, the sustainability of initiatives to keep a physical distance was challenged by implications related to the possibility of comforting younger schoolchildren and teaching activities demanding proximity to pupils.

Conclusions

It should be ensured that schools have the resources needed to hinder spread of virus while delivering high quality teaching. In addition, our findings suggest that school leaders clarify the prioritization between preventive initiatives and core tasks, and inform about responsibilities and academic expectations.

Key messages

Actions to make preventive initiatives sustainable within school environments are highly needed to keep schools open during this and future pandemics. Policies should ensure that schools have the resources needed in order to hinder spread of virus while delivering high quality teaching.
Cancer biomarkers testing in Russia: implementation issues and ways to improve
Authors: Mishurovskiy G , Meretukov D , Glushenko A , Kravchenko A , Kakorina E
Published: October 2021

Background

In 2019 Russian Ministry of Health launched the federal program “Oncology”. Its main goals include an increase of 5-year cancer patient survival up to 60% or more by 2024. An improvement in survival may be achieved by prescribing innovative cancer drug regimens, which require prior molecular diagnosing. Healthcare in Russia is state-funded and every constituent territory defines the list of molecular tests available and their costs independently. The aim research was to perform a comparative analysis of molecular testing costs and availability in all 85 units of Russia.

Methods

The data for the research was obtained from the rate agreements of Territorial Compulsory Medical Insurance Funds of each territory, available online. The list of biological markers analyzed was based on local guidelines and included EGFR, ALK, ROS1, BRAF, KRAS/NRAS, BRCA1/2, HER2, PD-L1 and MSI.

Results

At the time of research, only 50 territories had all tests included in the rate agreements. 35 territories had only some of these tests available or stated the availability of “molecular diagnostics” with a fixed cost for any test falling into this category. The titles and costs of same molecular tests varied between different territories with up to 10-fold difference in cost for certain tests. The mean number of tests planned for payment by the state was 7 per 10,000 population per year, though the estimated number of tests required is 17.4 per 10,000 population per year.

Conclusions

Our research revealed significant variation in molecular testing naming, availability and costs. This complicates planning and funding of cancer diagnostics programs and obstructs the process of drug prescription, making it difficult to achieve an improvement in patient survival. The situation could be amended by the development of standardized test naming and cost calculation.

Key messages

Almost half of Russia’s constituent territories have legal obstructions to perform some or every of essential oncological molecular tests, which hinders improvement in survival of cancer patients. The naming and cost calculation of molecular tests in Russia’s Territorial Insurance Funds are not standardized, causing inadequate funding and reduced availability of molecular diagnosing.
Clustering of health behaviours and association with sociodemographic factors among adults in Japan
Authors: Satoh M
Published: October 2021

Background

Health behaviours (HBs) commonly co-occur, acting synergistically. Little is known about the clustering of HBs in the Japanese population. Therefore, this study aimed to investigate the clusters of HB patterns and sociodemographic factors related to the clusters in the Japanese population.

Methods

Data used in this study was obtained from the Japanese and Keio Household Panel Surveys. The responses of 1,554 questionnaires (aged 27 − 65 years) were analysed. The surveys probed HBs (alcohol consumption, smoking, vegetable and fruit consumption, breakfast consumption habits, and physical activity) and sociodemographic characteristics. Latent class analysis was used to identify the clusters, and latent regression was used to investigate sociodemographic characteristics related to the clusters by gender.

Results

Two HB clusters were identified: ‘inactive, moderately healthy' and ‘inactive, high alcohol consumption, poor nutrition'. Age in the 60s indicated significantly higher odds ratios (ORs) of the ‘inactive, moderately healthy' cluster in men and women [OR = 1.820, 95% confidence interval (CI)=1.109 − 2.985, p = 0.018; OR = 3.865, CI = 1.830 − 8.163, p = 0.000]. In men, living with families and higher education levels indicated significantly higher ORs of the ‘inactive, moderately healthy' cluster (OR = 1.812, CI = 1.078 − 3.047, p = 0.025; OR = 2.236, CI = 1.698 − 2.943, p = 0.000). In women, being married, higher socioeconomic status, and higher education levels indicated significantly higher ORs of the ‘inactive, moderately healthy' cluster (OR = 2.097, CI = 1.309 − 3.359, p = 0.002; OR = 2.068, CI = 1.092 − 3.917, p = 0.026; OR = 2.516, CI = 1.563 − 4.051, p = 0.000).

Conclusions

Policymakers must recognise HB clusters unique to Japanese adults and have to build effective strategies based on understanding gender differences and similarities in sociodemographic factors associated with HB clusters.

Key messages

Interventions for multiple HB simultaneously should be designed and developed. Health behavior patterns have to be clarified for targeting population when interventions are built.
Gender as a determinant of lifestyle in young university students
Authors: Sánchez-Rojas IA , Castro-Jiménez LE , Argüello-Gutiérrez YP , Aguirre-Rueda DM
Published: October 2021

Introduction

Lifestyles is part of the subject's personal decisions, resulting from the exposure and interaction of factors such as living conditions, behavior patterns, socio-cultural elements, a set of norms, habits, and routines, which affect negatively or positively the health, but since it is a personal decision, it is detached from determinants such as gender. Therefore, the objective of the study was to identify the differences in the lifestyle of university students according to gender.

Methods

Analytical cross-sectional study. The FANTASTIC questionnaire was applied to 187 students with an average age of 20.5 years from the Santo Tomás University in Bogotá and Bucaramanga, Colombia. A chi-square test was performed for each qualitative question and an ANOVA for the quantitative data resulting from each factor, taking gender as the basis of analysis. Statistical analyzes were processed in SPSS 25.0, at a significance level of p ≤ 0.05.

Results

It was found that women walk daily for more than 30 minutes (p = 0.00; 95% OR: +4.0 women); men are more likely to smoke (p = 0.001; 95% OR: +2.6 men) and drive after drinking alcohol (p = 0.012; 95% OR: +2.5 men); performance of periodic medical check-ups (p = 0.007; 95% OR: +2.0 men) and compliance with traffic orders (p = 0.004: 95% OR: +2.9 men) and seat belt use (p = 0.006; 95% OR: +1.0 men) is higher in men. Significant differences were found between tobacco consumption (p = 0.001), and alcohol (p = 0.013), physical activity (p = 0.011) and other behaviors (p = 0.001).

Conclusions

Men are more likely to engage in risky behaviors, such as tobacco and alcohol consumption and less physical activity; therefore, gender is a determining factor for the adoption of healthy lifestyle habits.

Key messages

The lifestyle of the university population is influenced by gender, which is why promotion and prevention campaigns must be differential between men and women. Sex is a determining factor for a healthy lifestyle.
Increasing planning targets is not enough: health workforce management in rheumatology in Germany
Authors: Kuhlmann E , Bruns L , Hoeper K , Witte T , Ernst D , Jablonka A
Published: October 2021

Background

Health workforce shortage in German rheumatology and its negative impact in healthcare are increasingly recognised. Health policy has increased staffing targets, but effective intervention strategies are lacking. This paper aims to systematically map the rheumatology workforce and to explore opportunities for intervention, thus contributing to better health workforce management.

Methods

The WHO National Health Workforce Accounts (NHWA) provided a conceptual framework for the mapping exercise. Four major sets of indicators were selected, comprising staffing levels, health labour market flows, skill-mix and education/training. Comparison of age-groups and time series was applied to explore trends. Public statistics and other secondary sources served the analysis, using descriptive methodology.

Results

Rheumatologists nearly doubled in absolute numbers since 2000, but this trend shows a problematic demographic bias. Between 2000 and 2019 numbers increased markedly in the groups aged +50 years, but only about 9% in younger groups under 50 years. Most alarming, since 2010 the group 40 to 50 years showed a reverse trend and strong decreases. In 2019, absolute numbers of rheumatologists working in healthcare after retirement-age exceeded those aged 40 and under. Since 2015 an expanding workforce trend overall flattened, but strongest in the hospital sector; annual inflows do not show relevant growths.

Conclusions

Health workforce assessment reveals negative demographic trends and decreasing appeal of the specialty especially to men, thus highlighting a need for more effective health workforce management. Intervention strategies should target innovation in resident training and task shifting and improve gender equality.

Key messages

Health workforce trends indicate that new health policy planning targets cannot be met with an available stock of rheumatologist. The WHO NHWA provide a useful toolbox to map health workforce trends and identify weaknesses and gaps.
The public’s views on responsibility for medical errors in the Republic of Kazakhstan
Authors: Tsigengagel O , Glushkova N , Khismetova Z , Korostova Ye , Kussainova D , Sovetbekov D , Alchimbayeva M , Rakhypbekov T
Published: October 2021

Background

Healthcare professionals, public committees and leaders, as well as and people in positions of responsibility, deeply apprehensive with improving patient safety in Kazakhstan. Patient attitude towards of medical error is relatively well studied in developed countries of the world, but little is known about Central Asian countries, especially post-soviet space. This study aimed to analyze the attitude towards medical errors, depending on whether the respondents themselves or their relatives had this experience in the Republic of Kazakhstan from 2019 to 2021.

Methods

The study included two hundred sixty-seven participants. The statistical analysis of data on medical error was performed for the whole country. Data on medical error from public were retrieved for the period 2019-2020. Respondents were asked about the causes of and solutions to the challenge of preventable medical errors and what the consequences of medical error should be.

Results

A total of 40.8% (109/267) of respondents confirmed that they had experienced problems regarding medical errors while 59.2% (158/267) had not encountered any medical errors in their life experience. Nearly one in three Kazakhstan's adults agree that cause of medical errors is lack of professional qualifications of health professionals 36.3% (97/267). The respondents noted that hospital administration 47.6% (127/267) should be held accountable for medical errors, followed by the health professionals 25.5% (68/267).

Conclusions

There were significant differences between the regions of the country in the causes of medical errors in the opinion of public, as well as in indicators of the degree of responsibility for and response to medical errors. There is a need for further study of the causes and attitudes of public, which may have helped to better understand the challenge of medical errors in Kazakhstan.

Key messages

There is a need to performing regular analysis and evaluation to find out the cause of the problem and taken into account in deciding regarding the medical error. We recommend raising awareness about medical errors and the need for incident reporting, introducing training and learning workshops, and improving medical error reporting.
Reducing gaps in incindent reporting: an integrated information system
Authors: Nante N , Pasquetti E , Diodati G , Kolarikkal MJ , Riganelli P , Gentile AM
Published: October 2021

Background

In Hospitals,interventions aimed at identifying adverse events are based on voluntary reporting by health care professionals. We evaluate the incident reporting system in a Private Clinic which provides medical-surgical-rehabilitative health care services both to NHS and Private Patients.

Methods

A retrospective study was carried out by retrieving reports of adverse events that occurred from January 2011 to December 2015(processing of the years 2016-2020 is ongoing).Data were obtained from various information sources: institutional incident reporting; reports for administrative and insurance purposes; surveillance activities of the health management; organizational environmental reports; tabulations of transfer to the emergency department.

Results

A total of 306 adverse events were recorded during the study period. The most reported were transfers(51%), followed by falls(31%).Among those reporting adverse events, the main ones were Doctors(44.72%), followed by Nurses(9.15%) and Physical Therapists(1.41%).The institutional incident reporting system detected 42.5% of the adverse events, underestimating at least 57.5%; moreover, only 27.7% of the events were reported in more than one of the above sources.We are now processing the 2016-2020 data,which can be presented at the EPH Conference.

Conclusions

It is necessary to use several information sources to reconstruct a reliable epidemiology of adverse events in the hospital,in order to structure an effective system of audit and quality improvement.

Key messages

Only an integrated risk assessment can promote changes in clinical practice. Reducing gaps in reporting tools means increasing the safety, effectiveness and efficiency.
Infectious illnesses of young children: financial burden for rich countries - a literature review
Authors: Graichen J
Published: October 2021

While childcare assistance has indisputable positive effects on female employment and economic growth, children attending day care centres show a considerably higher number of infections compared to those raised at home. This is not only a substantial threat to the well-being of families, but also a major economic burden for society. This review aims at examining studies that describe and quantify the costs of illnesses that are possibly transmitted in kindergarten to enable development of policies and interventions. A scientific literature search was performed. The electronic databases PubMed and Medline were searched with keywords and MeSH terms (Cost of Illness; Health Care Costs; Child). Articles were considered relevant, if published after the year 2000 in English, if conducted in Europe, USA or Australia, examining contagious illnesses (respiratory, influenza(-like), gastrointestinal diseases) of children and if not solely focused on hospitalization costs. A total of 504 records were identified. After abstract and full text screening, 15 articles were selected. No article summarizes all illnesses that are possibly transmitted in kindergarten, studies rather estimate costs for one diagnosis or one symptom group only. Main cost buckets considered are direct medical, direct non-medical and indirect costs (mainly due to loss of workdays of caregivers). Focus and perspective of the studies and thus the quantification of costs differs widely (e.g., for respiratory illnesses per non-hospitalized case one study claims 123 vs. 49 Euro in neighbouring countries). Existing cost of illness studies cannot easily be combined to one overall cost estimation for sick kindergarten children, which is needed to foster public health actions and to enable cost-efficient design. However, solely looking at single illnesses already reveals the big potential which comes with reducing contagious illnesses in the child age and thus, the urgent need to action to relieve children and society.

Key messages

The economic burden arising from contagious illnesses among kindergarten children is substantial and reveals the need for policies and interventions to relieve children and society. Further research is needed to get a comprehensive view of cost of illnesses for children with illnesses transmitted in kindergarten to enable cost-efficient design of interventions.
Analysis of infant mortality caused by sudden infant death syndrome in the Russian Federation
Authors: Panchina A
Published: October 2021

Background

Sudden infant death syndrome (SIDS) is one of the leading causes of infant death and it caused the death of 40 thousand babies around the world in 2017. In the Russian Federation, there are no large and long-term studies of the epidemiology of SIDS.

Methods

A descriptive study of infant mortality associated with SIDS in the regions of the Russian Federation in 2019 according to the Federal State Statistics Service.

Results

In 2019, SIDS caused the death of 259 children and ranked 7th in the structure of infant mortality. The infant mortality rate due to SIDS was 0.17 per 1000 live births (median for the regions of the Russian Federation - 0.13, IR 0.0 - 0.27). The infant mortality rate due to SIDS among the rural population was 0.27 per 1000 live birth in the relevant area, among the urban population - 0.14, among boys - 0.20, among girls - 0.15 per 1000 live birth of the corresponding sex. From 2008 to 2019, the indicator in the Russian Federation decreased by 56% (in 2008 - 0.39 per 1000 live birth). The highest infant mortality rate due to SIDS in 2019 was recorded in the Far Eastern Federal District (0.31 per 1000 live births), the lowest was in the Central FD (0.10). SIDS was not recorded in 28 constituent entities, in 4 of them there was not a single case for the period from 2013 to 2019. In 21 regions, the infant mortality rate was higher than 0.27 per 1000 per live birth. The relative risk of SIDS was quite variable across the regions of the Russian Federation.

Conclusions

The analysis revealed the scatter of the infant mortality rate due to SIDS among the regions of the Russian Federation. It is necessary to study the problem of SIDS at the state level to explain the results.

Key messages

The development and implementation of programs for the prevention of SIDS should be based on the study of the epidemiology of this pathology in each region separately and in the country as a whole. Significant differences in the infant mortality rate due to SIDS among the regions of Russian Federation require detailed study.