bluuebunny/crossref_metadata_2025 huggingface dataset:
Effectiveness of Mois sans tabac 2016, a French social marketing campaign against smoking
Authors: Guignard R , Richard J-B , Andler R , Pasquereau A , Quatremère G , Nguyen-Thanh V
Published: November 2019

Background

In October 2016, Santé publique France, the National Public Health Agency, launched a social marketing campaign aiming at triggering quit attempts among smokers: “Mois sans tabac”, inspired by the English ’Stoptober’. This campaign sets smokers the objective of being smokefree for one month, in November. It combines a national mass-media communication with provision of cessation help services (quitline, website, mobile application, self-help kit) and local actions, in connection with the health regional agencies. The study aims at evaluating the effectiveness of this intervention.

Methods

The effectiveness evaluation is based on a specific analysis of the 2017 Health Barometer, a random survey representative of the population living in metropolitan France conducted between January and July 2017 on a sample of 25,319 individuals aged 18-75 years-old. The participation rate was 48.5%. Multivariate logistic regressions allowed testing the association between recall of the campaign and quit attempts (QA) in the last quarter of 2016, adjusted for sociodemographic confounders (N = 6,341). Respondents who attempted to quit were contacted at one-year for a follow-up.

Results

Nearly one in six daily smokers (15.9% [14.9-17.1]) reported making a 24-hour QA in the last quarter of 2016, and 18.4% [15.5-21.3] of them reported that it was related to Mois sans tabac, which represents approximately 380,000 QA [310,000-440,000] related to the operation. Among smokers who made a QA, 31% have been abstinent for at least 30 days [27%-34%] and 18% [15%-21%] reported they did not smoke anymore in 2017. Recall of Mois sans tabac was associated with QA in the last quarter of 2016 (aOR=1.3 [1.1-1.6], p < 0.01) and with cessation in 2017 (aOR=2.4 [1.4-4.2], p < 0.01), and odds-ratios increased with frequency of exposure and number of sources of information.

Conclusions

These results show that the first edition of Mois sans tabac was successful in triggering quit attempts among smokers.

Key messages

Mass-media campaigns for smoking cessation, combined with provision of help services and local actions, can be effective for triggering quit attempts. Importing foreign social marketing programs can be effective.
Opticourses: promoting healthier food purchases at no additional cost in low-income households
Authors: Tharrey M , Perignon M , Dubois C , Gaigi H , Darmon N
Published: November 2019

Introduction

Healthy diets are generally more expensive than unhealthy diets, explaining why socially disadvantaged individuals perceive food prices as a barrier to improve their diets. It is thus crucial to develop strategies enabling the achievement of good nutritional quality with a low budget, taking into account actual beliefs and expectations of the target population. A co-construction approach is thus recommended, involving participants at each step of the intervention to maximize its impact.

Methods

The “Opticourses” program was launched in 2010 with a feasibility study, followed by an intervention research in 2012-2014, in order to develop and evaluate a prevention program aiming at improving the nutritional quality of food purchases at no additional cost in a socioeconomically disadvantaged population. In order to implement activities tailored to the target population, participants were involved in the development of the protocol and the tools of the intervention and evaluation processes.

Results

Opticourses’s workshops (8 to 12 participants) include different activities displayed in four 2h sessions around real food purchases of participants, and games and exchanges aimed at promoting food and food choices of good nutritional quality for their price. The intervention research showed improvements in food purchasing behaviors of Opticourses participants. A transferability phase was conducted in 2015-2017. Since 2017, Opticourses is spreading in several regions of France, through training of professionals, in particular the courses organized by the Health Education Regional Committee (CRES) in the South of France.

Discussion

Bringing an original, concrete, co-constructed and scientifically based response to an everyday life problem is the main strength of the program. One important risk of failure for such prevention program is the underestimation of the requirements of the intervention research, in terms of time and human and budgetary resources.

Key messages

From a research point of view, getting access to new food purchasing data will allow a continuous refinement and innovation in the improvement of the diet for people with budgetary constraints. By focusing on food purchasing, a familiar activity that most adults feel able to handle, the Opticourses program is engaging and pragmatic, in accordance with health promotion principles.
Appropriate approaches for improving health promotion literacy in adolescents – a systematic review
Authors: Florescu S , Mihaescu Pintia C , Sasu C , Ciutan M , Scintee S G , Sfetcu R , Vladescu C
Published: November 2019

Background

Adolescents are exposed to various risks for their health: substance use, Internet overuse, video game addiction, unhealthy diet (reduced intake of fruits and vegetables, fast food culture), low physical activity, overweight, stress, violence, unsafe sexual behaviours, self-medication. Health literacy is defined as the knowledge, motivation and competence to access, understand, appraise and apply right information to make decisions in terms of healthcare, disease prevention and health promotion. Despite the advancement of theoretical models, many national and international health promotion programs, the percentage of unhealthy behaviours still persist in young age. Objective: Current review proposes to assess the implementation and effectiveness of various interventions in order to identify possible success or failure factors.

Methods

Comprehensive Systematic review was performed. After three steps data searching (in PubMed, SCOPUS, Cochrane, PsycINFO, Google Scholar) and critical appraisal, 63 studies out of 739 were fully retrieved.

Results

Implementation aspects as intervention types (single or combined targeted risk factors), type of audience (students, parents, school staff, communities), settings (home, school or outdoor), type of organization (face to face, groups, online), professional or peer-led, communication type (written materials as brochures, posters or videoconferencing) or effectiveness measures were extracted and synthesized. Important features of context such as funding, European or government programs were used for clustering the studies.

Conclusions

Health literacy interventions in adolescents need the involvement of education staff and parents participation. Health literacy for adolescents has to take into account cultural context, language, psychological features of each age; either digital or non-digital interventions cannot elude face to face communication between adolescents and their parents, academics or peers.

Key messages

Health literacy school-based interventions are effective but the content for adolescents audience should rely on guidelines provided by interdisciplinary teams of experts. Health Literacy interventions in adolescents should be age-appropriate and do-not-harm precautions must always be taken in order to avoid prejudices, body-image or self-esteem concerns.
Using retrospective process analysis to identify lessons learned from a community health initiative
Authors: Schluefter C , Albrecht M , Fischer J E , Georg S , Hoffmann K
Published: November 2019

As the WHO-Health-in-all-Policies-concept suggests many of the health-related aspects of the social, physical and economic environments can be modified within the community setting. In reality, developing and implementing population-based health initiatives is often challenging for both communities and researchers. To guide future efforts of community health initiatives, we systematically analyzed challenges we encountered and the lessons learned.

We systematically reviewed daily logbooks, meeting minutes and press releases about the initiative to identify successes, unexpected challenges and barriers in its implementation. Comments from two reflective workshops held in the partner community identified additional areas of knowledge. Retrospective content analysis of these sources uncovered emerging process-related themes.

Success was evident in a high degree of citizen participation in initiative-related forums. Challenges included a greater need to a) develop a common vision before starting initiative activities, b) establish an effective collaboration between community residents and our team, c) create more transparent lines of communication, foster trust and better manage community expectations. Establishing a project office in the community for regular updates, trust building and partnering with a professional communication agency were key steps that helped turn some challenges into successes. Barriers identified were missing resources both within the community and our team, a limited time period and limited possibilities of reach into all systems within the community (e.g. kindergartens).

The use of the method of retrospective process analysis helped to uncover detailed insights into the operational implementation process of a community health initiative. These insights serve as a transfer of practical knowledge, which intends to enable researchers and practioneers within communities to plan and conduct their community health initiatives to large success.

Key messages

Analyzing the process of health initiatives retrospectively uncovers detailed insights into implementation processes and helps to understand successes, challenges and barriers of the initiative. Insights into the implementation process of health initiatives function as guidance to other researchers and practioneers to support future efforts in the field of community health.
Perceived needs of elderly for living a self-reliant life: implications for municipal health policy
Authors: Dierx J
Published: November 2019

Background

The population in the Netherlands and in the municipality of Oss is getting older in good health and wellbeing, living more independently and self-reliant with changing needs of support (Hilderink, 2018). However, offered support by health care and wellbeing professionals has not changed. Since it is unknown whether offered support matches the changed needs, the municipality of Oss wanted to know what elderly perceive supporting them in self-reliant life so they could be empowered by more effective supported and more efficient use of staff and finances. Results might have implications for more municipalities with an aging population.

Methods

41 Elderly (age 65-92 y) in Oss were invited to enjoy a meal prepared by their grandchildren at their school and attend a Structured Interview Matrix-session (O’Sullivan et al., 2013) at the same time to map their perceived needs for an self-reliant life. Collected voice recorded data were transcribed and analyzed using thematic analysis (Braun & Clarke, 2006).

Results

Results show that elderly prefer living independently, self-reliant and being self-supporting as long as possible first in physical mobility (walking, biking, driving a car), second in socially with respectively their children, friends and neighbors and third in financially independency. When inevitably getting dependent, they prefer help from children, friends and neighbors for practical daily living activities (e.g. cleaning, gardening, groceries). However, concerning medical care they prefer health and wellbeing professionals with general practitioner and municipality as gateway.

Conclusions

Elderly want to be self-reliant as long as possible, living in their own house and neighborhood. When getting dependent, they prefer friends and neighbors for assistance in daily living and support from health and wellbeing professionals only for medical assistance with a key role for the municipality and general practitioner.

Key messages

Elderly prefer living a self-reliant life as long as possible in their own house and neighborhood. Municipal health services are perceived to play a key role in supplying adequate support from Health and wellbeing professionals.
Participatory action research for global antibiotic stewardship network in CPLP: mixed-method study
Authors: Maia M R , Lapão L V
Published: November 2019

Background

Antibiotic stewardship services (ABS) contribute to antibiotic resistance (AR) global monitoring. Aiming at co-implement an ABS network within the Portuguese-speaking setting (CPLP), by enabling the evidence translation and second opinion between the countries, we surveyed Cape Verdean (CV) health professionals (HP) perceptions about AR prevention and control, assessing ABS opportunities.

Methods

A Design Science with Participatory Action Research establishes a contextualized ABS process. This mixed-method study addressed the first 2 stages, the problem and objectives. Quantitative study considered the HP’s answers (56 HP; 2 hospitals) to a questionnaire, about their perception on AR and ABS. Qualitative study set-up 10 open-ended structured interviews, clinical shift observation in 2 pilot-services (1 hospital), and meetings with key-elements for ABS, including leadership.

Results

Key-stakeholders for ABS multidisciplinary teamwork were identified. Preliminary results are: 1. HP reveal some knowledge but lack of awareness on AR and ABS (eg. 34% don’t recognize the AR local threat); 2. The absence of guidelines and lack of access to key-information affect prescribing confidence (eg. only 46% HP consider microbiology results in deciding antibiotherapy); 3. Priorities for a pilot service are the lack of qualified HP, the need to optimize material resources management and stock procurement, and the need for better access to patient’s clinical and prescription information; 4. Digital resources and telemedicine system can be facilitators. Top-down communication and support are essential for the ABS process sustainability.

Conclusions

A Global ABS network can be important in promoting prevention and effective control of AR, reducing differences between the CPLP countries. In CV, an educational program to support the co-design of ABS service and a decision-support information system are identified priorities. Digital health, like telemedicine, can be ABS facilitators.

Key messages

The implementation of a Global Antibiotic Stewardship network, aiming at reducing Portuguese-speaking Countries differences, could be leveraged by a Participatory Action Research process. An educational program, a decision-support information system and the telemedicine are key for the Global Antibiotic Stewardship network implementation success.
Knowledge of Romanian young women regarding HPV and cervical cancer
Authors: Brinzac M , Coci A , Ionaşcu V
Published: November 2019

Romania has the highest prevalence of cervical cancer in Europe. Cervical cancer is ranked the fourth deadliest cancer and the first among women aged between 15-44 years. In Romania, this type of cancer has 4443 new cases annually and is responsible for 1909 deaths. Lack of sexual education was linked to the increased prevalence rates of cervical cancer. Romania has a two-fold incidence rate than Finland, Luxembourg and France, countries which have sexual education courses.

HPV is the most prevalent risk factor for cervical cancer and this disease is the third most common cancer among women and the second most common among women aged between 15-44 years.

The design of the present study is quantitative as the data was gathered through an online questionnaire. The target group was selected through some pre-established parameters based on the previous searches on Facebook and Google like age, sex, HPV, vaccine, immunization, cervix, cervical cancer. The sample was represented by all the women that reach the parameters aged between 18- 24 years. The results show the knowledge on HPV, HPV vaccination and cervical cancer to be good as for all the questions more than half of the sample had an adequate understanding. In contrast, the overall tendency of the sample was for most of them to be aware of the existence of the mentioned diseases, of the testing process and vaccine existence, but then to lose their expertise when having to give details on the concepts reminded. This trend was noticed in all section as the first questions assessed their awareness of the HPV, cervical cancer, Pap- smear and vaccination, while the following needed a more comprehensive knowledge (i.e. 94.5% of the sample heard of Pap-smear while only 58.7% what it is).

The results have highlighted the gap in the knowledge of Romanian women and the need of campaigns and policies targeting this area. This study can form a basis for the development of such programs as it emphasizes the under-developed areas.

Key messages

Presenting a snapshot of the knowledge of young adult women on HPV and cervical cancer. Putting the groundwork for future studies and policies.
Strategies to achieve HPV-related disease control in Italy: results from an integrative approach
Authors: Acampora A , Grossi A , Colamesta V , Barbara A , Causio A , Calabrò G E , Boccia S , Cicchetti A , de Waure C
Published: November 2019

Background

Vaccination against Human Papilloma Virus (HPV) might allow controlling HPV-related diseases but coverage in Italy is far from the optimal goal. This project aimed at identifying strategies to promote HPV vaccination in Italy.

Methods

an integrative approach including a systematic review and a two-step panel consultation was used to identify strategies for improving coverage among adolescents who are already target of the national campaign and promote vaccination in further targets. The systematic review followed PRISMA recommendations and the panel consultation relied on the administration of questionnaires in the first step and on a televoting system during a consensus conference in the second one. Ten experts were involved belonging to Gynecology, Public Health, General Practice, Pediatrics and Consumers. Recommendations relied on a set of criteria drawn from the Evidence to Decision framework.

Results

The systematic review led the identification of three main strategies to improve coverage respectively based on reminds, education and multicomponent approaches. Following the evaluation of selected criteria, namely relevance of benefits, evidence strength, feasibility, equity, acceptability and costs, a strong recommendation was formulated on the use of reminds tailored to vaccine recipients or their parents whereas a moderate one was developed on the use of reminds directed to health professionals. A moderate recommendation was released on the implementation of multicomponent interventions. The panel consultation also supported the elaboration of a strong recommendation on the promotion of vaccination among women treated for HPV-related diseases, fertile women not yet vaccinated and 25 years old women. Catch-up initiatives, in particular among women and men 18 years old, were also identified as strongly recommendable.

Conclusions

This project led to identify several valuable strategies to strengthen HPV vaccination at national level.

Key messages

Using reminds tailored to vaccine recipients or their parents is strongly recommended while using reminds directed to health professionals and multicomponent interventions are moderately recommended. It is strongly recommended to promote HPV vaccination among women treated for HPV-related diseases, fertile women not yet vaccinated and 25 years old women.
Challenges in handling congenital anomalies clusters: a recent mediatic example in France
Authors: Regnault N , Beltzer N , Boudet-Berquier J , Gomes E , Bauchet E , Gallay A ,   limb reduction cluster investigation group
Published: November 2019

Issue

In 2018 in France, reports of aggregated cases of isolated transverse limb reduction defects, a rare congenital anomaly (1.7 for 10,000 total births) generated a large mediatic interest with environmental factors overtly pointed out. Our aim is to describe the investigations carried out and to share the challenges we met.

Description of the response

Over a period of 5 years (2010-2015), 3 aggregates were signaled by health professionals in 3 different areas in France. Investigations included case ascertainment, epidemiological analyses, and search for a common exposure. Standardized Incidence Ratios were computed using the 6 French registries’s data as reference. In one area, the local registry performed a concurrent analysis using satscan. Parents filled a questionnaire addressing environmental and occupational exposures. Environmental databases were consulted as well as animal health surveillance data.

Results

Fourteen cases met the case definition. The excess of cases was ascertained in two aggregates located in a two small towns in the western part of France and comprising respectively 3 children born in 2007-2008 (SIR: 87.8 CI95%:[17-256]) and 4 children born in 2011-2013 (79.8 [2.5-204.2]). The third signal included 7 cases born between 2009 and 2014 residing in 7 towns located above the Alps and did not yield a significant excess when related to expected cases in the administrative subdivision (0.94 [0.38-1.95]). The concurrent analysis found a significant excess, generating a lengthy debate. None of the investigations identified a common cause or notable exposure. Delayed feedback and negative conclusions led to incomprehension among families.

Lessons

Informing stakeholders timely is crucial but communicating effectively about methods used and negative results can be challenging.

Key messages

Congenital anomalies clusters are sensitive topics. Cluster investigations involve a scientific and a societal component that must both be taken into account in organizing the public health response.
Depression, anxiety stress and associated factors among university students in France
Authors: Herrmann K , Déchelotte P , Ladner J , Tavolacci M P
Published: November 2019

Background

Graduate education is associated with many life changes and stressful events for students, potentially causing depression, anxiety and stress. Prevalence of these disorders and potential associated factors are not clearly identified.

Methods

A cross-sectional study was conducted among university students in France. The students filled out a self-questionnaire recording depression anxiety and stress with the DASS21. High” and “very High” intensity symptoms were grouped into “presence” of depression, anxiety and stress and “moderate” “light” “normal” were grouped into “absence” of depression, anxiety and stress. Curriculum, perceived academic pressure, financial difficulties, smoking, binge drinking and eating disorders were also recording.

Results

A total of 1,202 students were included of which 17.8% were healthcare students. The sex ratio (M:F) was of 0.42 with a mean age of 20.0 years. Prevalence of depression, anxiety and stress were respectively 16.4%, 26.4% and 16.0%. After multivariate analysis, female gender was associated with presence of stress (AOR=1,41 IC 95% [1,03-1,93]). High level of perceived academic pressure (AOR=2,13 [1,61-2,82], 2,05 [1,57-2,68], 2,35 [1,72-3,22]) financial difficulties (AOR=1,33 [1,03-1,73], 1,54 [1,19-1,99], 1,37 [1,04-1,82]) and eating disorders (AOR=2,46 [1,83-3,31], 2,36 [1,75-3,19], 2,21 [1,63-23]) were associated with presence of depression, anxiety and stress. Binge drinking (AOR=1,48 [1,05-2,09]) and smoking (AOR=1,46 [1,01-2,13]) were associated with anxiety.

Conclusions

These results show prevalence of depressive, anxiety and stress symptoms among students. Poor mental health is related to academic and financial difficulties, and is associated especially with eating disorders. There is a pressing need to prioritize mental health of college students through the national public health policies. Additional studies are needed to better understand the relationships between these different factors.

Key messages

There is a significant prevalence of depression, anxiety and stress symptoms among Rouen students. Depression, anxiety and stress symptoms among students are associated with high level of perceived academic pressure, financial difficulties and presence of eating disorders.
Reflective citizens as a tool for well-being and public health achievement (Novi Sad, Serbia)
Authors: Jevtic M , Flasar I , Mojovic M
Published: November 2019

Issue/Description

Reflective Citizens (RC) as ’psycho-social transitional spaces’ - were established in 2005, when Serbia joined the International Listening Posts (LP) Network of OPUS (Organization for Promoting Understanding of Society). Recognizing the need for more reflective citizens’ spaces, for continuously ongoing work through social trauma, Psycho-Social section (PSS - GAS Belgrade) began organizing them more often and in different cities. Serbian RC developed specific conceptualization and methodology, carefully integrating aspects of LP, group analysis, group’s relations, and social dreaming, which are still in the process of evaluation and improvement.

Results

RC in Novi Sad have started in 2014, with a huge enthusiasm, as a team work of PSS. It is recognized that Novi Sad, as a multinational and specific multicultural environment could develop Applied Reflective Citizens - Citizens’ dialogue in cultural spaces in Novi Sad, as supportive and open space for all citizens who wish to develop themselves, multiculturalism, tolerance and better social environment. At the seven workshops organized by now, the beginning was marked by a session of social dreaming. Free psychosocial associations in thinkrooms have defined the topics: loneliness, helplessness, walls and borders, migrations, diversity, mental malnutrition, the presence of evil and the need for goodness, lack of communication... and on the basis of them, the corresponding hypotheses.

Lessons

Applied Reflective Citizens have become the support and open space for all citizens who want to contribute to multiculturalism, tolerance, a better social environment, understanding the environment and building incentive bridges in communication through dialogue and also to contribute to a positive cultural climate, building cultural capacities and fostering cultural dialogue through mutual reflection, thus contributing the quality of life, which is of public health significance.

Key messages

Reflective Citizens can be a contribution for improving health in community through fostering dialogue and mutual reflection. Reflective Citizens give an open space for all citizens who want to contribute to multiculturalism, tolerance, better social environment, thus contributing quality of life, and to public health, also.
Interventions to reduce stress, anxiety and depression symptoms in teenagers – a systematic review
Authors: Florescu S , Mihaescu Pintia C , Ciutan M , Sasu C , Sfetcu R , Scintee S G , Vladescu C
Published: November 2019

Introduction

Stress, anxiety and depression symptoms are frequent in teenagers. Objectives: To identify the interventions effectively able to prevent or reduce anxiety, depression and psychological stress in adolescents; to assess the effectiveness, feasibility and transferability of the interventions.

Methods

Comprehensive systematic review was performed. Three steps searching strategy using the databases: PsycINFO, PubMed, SCOPUS, Cochrane Library, and Google Scholar identified 679 studies and reviews. Critical appraisal was performed by 2 reviewers, data extraction performed on finally selected 59 reviews, RCT, cohort studies focused on sample size, geographical context, setting, description of intervention, measures of primary and secondary outcomes.

Results

The considered interventions are: Internet-based multifaceted cognitive bias modification training (CBM), Internet (iCBT) or school-based cognitive behavioral group training (CBT), Social skills training (SST), Metacognitive therapy, Psychosocial Support Intervention, organized sports participation and voluntary outdoor play, school-based resilience-focused intervention, assertiveness group training, short-term psychoanalytic psychotherapy (STPP), brief psychosocial intervention (BPI), Guided Parent-Delivered Cognitive Behaviour Therapy (GPD-CBT), Internet-based self-support method.

Conclusions

Interventions for promoting mental health in adolescents have to combine parenting programs with leisure activities and balanced curriculum; various approaches (physical activity, music, sports participation) should be tailored into the national, community and school contexts. Resilience factors (relationship with parents, communications with peers), development of help-seeking behaviours and available self-help programs could support early detection and assistance. Most interventions showed positive effects on short and medium term and potential transferability.

Key messages

Regular screening for childhood adversities and traumas and screening of symptoms as feeling sad, hopeless, worried should be performed in adolescents as they get older. Besides mental health risk factors, interventions should target developmental risk factors in transitional stages from childhood to adolescence and from adolescence to young adulthood.
Benefits of non-drug interventions for people with suicidal crises in unipolar depression
Authors: Berger E , Fuchs S , Baier N , Peters H , Busse R
Published: November 2019

Background

Depression is one of the most common and serious diseases worldwide: According to WHO, more than 300 million people worldwide were affected by depression in 2015. In this group, the suicide rate is about 20 times higher than the population average. In Germany, around 10,000 people take their lives each year, many of them suffering from depression. The Institute for Quality and Efficiency in Health Care commissioned the Department of Health Care Management at the Berlin University of Technology to conduct a Health Technology Assessment on whether non-drug interventions influence coping with suicidal crises in unipolar depression.

Methods

A systematic search of primary studies and systematic reviews (e.g., in MEDLINE, PSYCINFO) was performed to assess the benefit of ambulatory crisis intervention programmes or psychosocial interventions compared to another non-drug treatment, drug treatment, inpatient treatment or no treatment/waiting list in adult suicidal patients with unipolar depression regarding patient-relevant outcomes (e.g., suicide attempts, suicidal ideation, depression).

Results

The search yielded a total of 4,159 hits. After two rounds of screening for relevance and removing duplicates, 4 studies remained for inclusion in the qualitative and quantitative analysis. The studies present RCTs assessing the effects of cognitive behavioural therapy (CBT) of the 2. and 3. wave - all short-term programmes focussing on suicidality. Results indicate a benefit of CBT compared to standard treatment, depending on the outcome, on the “wave” and on the time of follow up assessment.

Conclusions

There is some evidence on benefits of CBT for adult patients with suicidal crises in unipolar depression. However, the quality of the included RCTs is weak and evidence on benefits of other non-drug interventions in outpatient care is missing. Further research is needed to identify effective interventions, especially for the vulnerable weeks immediately after suicide attempt.

Key messages

Short term cognitive behavioural therapy with suicidal prevention elements may influence coping with suicidal crises in unipolar depression positively. Further research is needed to identify effective interventions for the vulnerable weeks immediately after suicide attempt.
Suicide in Polish migrants to Scotland
Authors: Gorman D R , Mackie P , Czarnecka M , King R , Wojcik W
Published: November 2019

Background and Methods

Suicide amongst the 91,000 Polish nationals living in Scotland has been identified as a concern by the Polish Consulate. The adult suicide rate in Poland is 20.8 / 100,000 EASR population (Eurostat Suicide and Undetermined combined 2012-15). This is significantly higher than the 2012-16 Scottish level of 14.1 / 100,000 National Records of Scotland (NRS).

We set out to establish the picture for Polish migrants in Scotland and for 2012-16: ascertained the number of such deaths from National Records of Scotland (NRS) describing the epidemiological features; andreviewed Crown Office files of each person - extracting key information from police and pathology reports.

Results There were 68 suicide deaths in the 60 months. We estimated the European age standardised suicide rate (EASR) for all Polish residents in Scotland as 21.6 / 100,000 (95% CI 13.4 - 31.4) a suicide rate consistent with Poland not Scotland. The male:female ratio of 5.8:1 also mirrors Poland (vs. Scotland’s 3:1 ratio). Polish men have a significantly higher rate than Scottish men - 31.5 vs 19.4 / 100,000. The suicide rates of Polish and Scottish women are very similar (5.4 vs 7.3 / 100,000 respectively).

Crown Office Records

A key finding is how similar the circumstances surrounding suicide deaths in both Polish and Scottish people are. In particular unemployment /irregular work, shift and manual work, relationship problems and alcohol use are all common.

For Polish people in Scotland the challenges and stresses of the ’migrant experience’ are superimposed onto other life events. Difficulties working in an English-speaking environment (and being unable to discuss emotional health), not knowing about the NHS Scottish public services and the lack of family and community networks to offer social support are all common.

Conclusions

Actions are at four levels: National- the suicide action planEmployersNHS - staff awareness and monitoring trendsPolish community groups

Key messages

Polish migrants to Scotland have a much higher rate of suicide than Scottish people - consistent with that in Poland. Addressing suicide requires examining factors in migrant and ethnic minority groups.
Gender differences in depression across Europe: a systematic review of cross-national studies
Authors: Hagen D , Goldmann E
Published: November 2019

Background

Across countries and cultures, depressive disorders are more common among females than among males; however, the magnitude of gender differences varies between populations and may be a result of different country-specific social policies and cultural factors. This systematic review seeks to synthesise evidence from nationally representative, cross-national studies across Europe (EU-28 plus Switzerland and Norway) and to describe the impact of country-specific factors on gender differences in depression.

Methods

PubMed, Web of Science, PsycInfo, and Embase were searched through March 2019 for peer-reviewed, nationally representative studies that included at least two European countries, used structured assessment for depressive disorders or symptoms, and reported or allowed for the calculation of gender ratios or differences. No restrictions on language or publication date were applied. Risk of bias was assessed using a tool specifically designed for population-based prevalence studies.

Results

Twenty-one studies were included in this review, ten of which were based on surveys limited to older populations. Despite the use of different analytical approaches, metrics, scales, and cut-off points, depressive disorders were more common among females than among males in all but a few instances, with substantial variation in the magnitude of gender differences between countries and across studies. There is evidence of smaller gender differences in Northern Europe and greater gender gaps in Southern and Eastern Europe, as well as among older populations.

Conclusions

Despite methodological heterogeneity between studies, there is evidence that gender differences in depression vary substantially across Europe. These differences may be associated with welfare state regimes and appear to be less pronounced in younger cohorts. Further cross-national research on gender disparities in depression between age groups, birth cohorts, and ethnic subpopulations is warranted.

Key messages

While depressive disorders are more prevalent among females than among males in virtually all of Europe, the magnitude of gender differences varies substantially between countries. There is some evidence that gender differences in depressive disorders are greater in countries with weaker welfare states and lower macro-level gender equality, as well as among older populations.
Farmers’ health and wellbeing in the context of changing farming practice: a qualitative study
Authors: Bondy M , Cole D
Published: November 2019

Background

Farming continues to change globally, with steady industrialization, globalization and climate change and disproportionately high reports of stress and suicide. Little research has been done to understand how changes to farming impact mental health. We aimed to understand how Canadian farmers understand their stressors and experience their health.

Methods

We recruited 16 small-medium scale, diversified farmers through farm organizations in Grey-Bruce counties in Canada. We interviewed them about their perception of changes in farming, associated stressors, mental health and well-being, and community supports. Using a constructivist paradigm, we coded each interview, discussed results, and formulated emergent themes using thematic analysis.

Results

Farmers’ relationship to change was complex with both benefits and challenges of changing farm practices, technology and weather for health - a “double-edged sword”. Farmers described the resilience associated with farming which connects them to the land “essentially being at one with place.” Farmers’ work required them to be active, an asset for keeping them healthy, but also a challenge if mobility became restricted. Farmers’ noted overwhelming stress but stated “...the last thing most farmers want to do is admit that they are stressed or have a mental health issue.” Yet “...if you don’t have strong mental health then you can’t really be resilient and cope with the stresses of climate change and all the things that will happen on a farm.” They voiced a perceived lack of support from governments - dealing with bureaucracy, community - experience of isolation or stigma, and health services - an over-stretched, often distant system.

Conclusions

Farmers’ understandings from Canada will be compared to literature from Europe to demonstrate relevance inform public health programs promoting mental health in rural communities, advocacy for government supports to diversified farmers and evaluation of intervention programs.

Key messages

Farmers experience change as a double edged sword with benefits and challenges for health and mental health. Public health needs to intervene to meet farmers where they are and to advocate with farmers for further support.
Abortion and psychological distress in Icelandic women
Authors: Vilhjalmsson R
Published: November 2019

Background

Previous research into the psychological consequences of abortion has presented misleading results, as some studies suggest negative consequences and others do not.

The current study focuses on the relationship between having or not having an abortion and psychological distress in the form of depression, anxiety and anger.

Methods

The study uses data from 792 female participants in a random national health survey of Icelandic adults, age 18-75. The survey was conducted in the Spring of 2015. Respondents were given the option of answering an anomymous study questionnaire via mail or online (response rate 58%). The questionnaire asked respondents about psychiatric and physical conditions requiring medical attention in the past 12 months, stressful life-events in the past 12 months, and ongoing life-strains. Female respondents were asked whether or not they had had an induced abortion in the past 12 months. Psychological distress during the past week was assessed with the depression, anxiety, and anger subscales of the SCL-90 checklist.

Results

Women who had had an abortion (2% of female respondents) reported higher levels of anxiety, depression, and anger than other women. The differences were statistically significant when controlling for age, education, family income, previous psychiatric and physical conditions, and previous stressful life-events and life-strains.

Conclusions

The study indicates that women who have had an abortion are worse off psychologically than other women, and the difference is only partially accounted for by previous mental and physical health, or previous stressful circumstances. Health services for women considering abortion should be carefully considered, psychological distress assessed, and ways explored to ameliorate the distress they may experience following the abortion.

Key messages

Abortion is related to higher levels of anxiety, depression and anger in Icelandic women. Health services for women considering abortion should be carefully considered and psychological distress assessed.
Validating record-linkage based methodology for addressing health survey non-participation
Authors: McMinn M A , Martikainen P , Härkänen T , Tolonen H , Pitkänen J , Leyland A H , Gray L
Published: November 2019

Background

As a consequence of declining levels of participation in health surveys, the results purported to be population-representative may be biased. Traditional adjustments for non-participation, such as weighting, can fail to correct for such biases. We aim to validate our developed methodology, which simulates non-participants, and compare results from the inferred sample to the ’gold standard’ sample of participants and true non-participants, and participants alone.

Methods

Participants and non-participants of the Finnish Health 2000 survey, and a contemporaneous population sample are available, with alcohol-related hospitalisations and deaths (“harms”, individually record-linked for all Health 2000 invitees). Synthetic observations on non-participants were simulated through comparison of participants and population sample. Alcohol consumption of true and inferred non-participants were multiply imputed based on harms and education as well as age and sex, assuming data are Missing At Random (MAR). Results are compared via the relative differences (RD) between the inferred sample and 1) gold standard sample, and 2) participants alone.

Results

Average weekly estimates for men are 129g in the inferred sample, and 130g in the gold standard (RD -1.2%, 95%CI -2.0, -0.4%), and 35g for women in both samples (RD -0.8%; -1.9, 0.3%). Estimates for men with secondary levels of education had the greatest RD (-1.9%; -3.3, -0.5%). Comparisons between the participants and the inferred sample revealed few differences.

Conclusions

All RD between the inferred and gold standard samples lie within our ±5% acceptability limits, in support of the use of our methodology for adjusting for non-participation in health surveys. However, under MAR, there are no significant differences between the results generated from the inferred sample and the participants alone. Further work exploring Missing Not At Random scenarios is required to ensure utility for reliable population health monitoring.

Key messages

Survey weights alone cannot adjust for non-representativeness, but we have shown that data linkage can be used to match the characteristics and outcomes of the selected sample. Non-participation in health surveys may be adjusted for using our methodology, with further exploration into alternative missing data scenarios required.
Tobacco smoking and binge drinking among university students in three European countries, 2009-2017
Authors: Tavolacci M , De Bruyn S , Van der Heijde C , Vonk P , Ladner J , Van Hal G
Published: November 2019

Background

Attention is needed on students as high levels of substance use are often part of the university experience. The aim of the study is to identify the trend of tobacco smoking and binge drinking among university students (US) of Belgium, France and the Netherlands over a 9 years period.

Methods

Three repeated cross-sectional studies in US were performed in 2009-10, 2012-13 and 2016-17 in university of Antwerp (Belgium), Amsterdam (the Netherlands) and Rouen (France). US between 18 and 25 voluntarily filled out a self-administered anonymous questionnaire. The socio-demographic characteristics (age, gender, curriculum, job and accommodation) of the US were collected. Tobacco smoking and binge drinking in the previous 12 months were also collected. The trend test of Cochran-Armitage was used for comparisons.

Results

In 2010, 1388 US were included in Antwerp, 1907 in Amsterdam, and 1137 in Rouen. In 2013, 1665 US were included in Antwerp, 3590 in Amsterdam, and 1488 in Rouen. In 2016, 2347 US were included in Antwerp, 4157 in Amsterdam, and 1011 in Rouen. Female gender was 63.4% in Antwerp, 68.7% in Amsterdam and 65.4% in Rouen. The prevalence of tobacco smoking was respectively in 2010, 2013 and 2016: in Antwerp: 31.0%, 33.5% and 27.6% (p = 0.008); in Amsterdam: 13.7%, 16.5% and 17.0% (p = 0.003); in Rouen: 21.3%, 23.7% and 23.5% (p = 0.21). The prevalence of binge drinking (more than once a month) was respectively in 2010, 2013 and 2016: in Antwerp: 16.2%, 12.3% and 16.7% (p = 0.30); in Amsterdam: 26.5%, 27.4% and 26.5% (p = 0.82); in Rouen: 8.6%, 16.6% and 7.1% (p = 0.44).

Conclusions

Risk behaviours as tobacco smoking and binge drinking in US show a different prevalence according to country. Tobacco smoking decreases in two countries and frequent binge drinking did not change during the 9 years period. Further analyses need to be conducted taking into account the curriculum and the socio-demographic characteristics.

Key messages

Risk behaviours as tobacco smoking and binge drinking in university students show a different prevalence according to the European country. Binge drinking does not worsen for 9 years among university students.