bluuebunny/crossref_metadata_2025 huggingface dataset:
Why declare events? What to draw from experience feedback?
Authors: Nicoulet I , Isambert A
Published: November 2019

Issue

In France, the reporting of significant radiation events for nuclear activities is a mandatory system since July 2007 following the accident of oncology in Epinal. Later, the directive 2013/59/EURATOM states that Members of the European Union shall ensure that a system of experience feedback is in place for the dissemination of lessons. In France, it was implemented in 2011 through the publication of a newsletter, “Patient safety: Paving the way for progress” on radiotherapy, it is now extended to medical imaging. Until 2015 the number of reported events was stable but steadily decreasing in radiotherapy since 2016. Lack of time to report, lack of awareness and training of doctors, fear of consequences in terms of communication on the establishment that reports and in terms of control by the ASN following the report may explain the decrease. Educational actions need to be lead to reaffirm the objectives of reporting and reinforce the interest of experience feedback. The French Nuclear Safety Authority decide to focus a newsletter on international reporting systems and Experience feedback based on the reflections of a French institutional working group.

Results

According to professionals it is sometimes difficult to report an event with impact on patients, easier to work on near miss and even easier to work on events happening elsewhere. Reporting an incident is thus a collective action. The experience feedback process allows learning in order to improve practices in the future and address three aspects: Benchmarking, Prospective risk analysis for the techniques/devices which have never been used in a centre, Analysis of concrete cases during feedback experience meetings. The limit of the current systems is the difficulty in finding precise information due to shortcomings in its structure. A simplified system is needed.

Lessons

Reporting events on websites highlight new events and enable the solutions implemented elsewhere to be disseminated in our own networks.

Key messages

Reporting adverse events or near miss has a collective impact. Experience feedback allows dissemination of lessons and prevents incidents.
Survey-based experiential learning - means of raising professional awareness in developing countries
Authors: Hodza-Beganovic R , Berggren P , Hugelius K , Edelbring S
Published: November 2019

Background

Healthcare in post-war Balkans is still under development. Healthcare changes towards more complex clinical scenarios that need different competencies around patients. This study reports on survey based learning to increasing professional awareness for developing sustainable healthcare settings using an experiential learning approach.

Methods

In this study, researchers and educators identified non-technical skills concepts on individual, team, and organizational levels. These concepts were contextualized into the local setting through interactive workshops. Two pediatric surgery clinics in Kosovo and Bosnia and Herzegovina participated who were part of an international clinical skills training project. The tools and surveys were: Johari window, Kolb’s learning style questionnaire, team members exchange quality scale, the IPEC framework for interprofessional competence, Team STEPPS observation tool and organizational models.

Results

A model is developed for contextualizing core concepts on professional awareness into a local developing healthcare setting. It entails three steps conducted in consecutive workshops:

Identifying research-based concepts on professional competence on individual, team and organizational levels. Facilitating local contextualization of these concepts by using surveys in interactive workshops. Agreeing on indicators to maintain high professional awareness.

Conclusions

Capacity-building in public health can be conducted through increasing professional awareness. Professional awareness can be approached in individual, team and organizational dimensions. Established core concepts of non-technical skills can be contextualized in other cultures through a survey-based experiential learning approach.

Key messages

Professional individual, team and organizational awareness is a vital part of conducting efficient healthcare. The professional awareness can be enhanced through processing core concepts in a local context through facilitated workshops.
Benefits from a tabletop exercise in a Heat-Health Action Plan in Amadora, Portugal
Authors: Cabral M , Leite A , Freire Rodrigues E , Vaz D , Calé E , Silva A
Published: November 2019

Issue

National guidelines for Heat-Health Action Plans (HHAP) in Portugal exist since 2004. These guidelines are further developed and implemented at Local Public Health Units (LPHU) together with local partners. Tabletop exercises are a useful tool to improve preparedness. Despite the long experience with HHAP there has not been any tabletop exercise in Amadora.

Description

Amadora’s LPHU organized a tabletop exercise with local partners to improve HHAP preparedness (12th July 2018). It included: LPHU, city hall, civil protection services, local social services, primary healthcare services, local public hospital, and firefighters. The exercise hypothesized a scenario of an unprecedented increase of temperature for an extended period of time, activating the highest level of warning (red) and action in the HHAP.

Results

During the exercise several issues were identified. Some partners were not clear about the pathway established for red warnings and partners were not aware of relevant HHAP activities. Also, from the 8 sites listed as climate shelters, only 2 were deemed as adequate for using in this scenario, even though they have been listed for several HHAP. Due to the exercise, it was possible to conduct an inspection of said shelters, which hadn’t took place yet due to the lack of resources. It was possible to find out that only one shelter was fit for purpose. Additional private facilities were identified as desirable shelter locations during the exercise. A few weeks later, a red warning was issued and clarification arising from the tabletop exercise was useful to properly implement measures.

Lessons

Despite the perceived frequent and good communication among partners of the HHAP, several issues - mainly regarding the adequacy of shelters - were identified with a tabletop exercise. It also improved preparedness for the following HHAP warning. As such, tabletop exercises should be promoted within HHAP.

Key messages

Despite developing heat-health action plans for several years, with the involvement of community partners, unidentified constraints existed in Amadora, Portugal. Tabletop exercises should be used more frequently, as we were able to identify and solve constraints within our heat-health action plan using one.
Development and preliminary psychometric properties of Mental Health Promotion Scale
Authors: Kadioglu H , Karaca S , Eren N , Yurt S
Published: November 2019

Background

There is no valid and reliable scale for assessing mental health promotion ability for adults in Turkish language. The purpose of this study was to develop a scale to mental health promotion ability for adults and to test the validity and reliablity of this scale.

Methods

This methodological study was conducted in Istanbul over the period October 2016- May 2018. The three rounds of the Delphi study were cunducted to develop the items of the scale and to determine the content validity. Thirty- three experts were participated in the Delphi study. A convenience sample of 452 adult people was recruited. The scale was tested for construct validity with Exploratory Factor Analysis (EFA), after which the scale’s reliability was evaluated for item-total correlations using Pearson’s correlation analysis and for internal consistency with Cronbach’s Alpha.

Results

At the end of the first Delphi round, 160 items were compiled. Experts reached consensus on 93 items of scale at the end of the third Delphi round. In the first EFA, twenty two factors with eigenvalues greater than 1 explained 65.2% of the total variance. Items with factor loadings of less than .30 and those that appeared in more than one factor with differences of less than %10 were removed from the scale one by one and the analysis was repeated. In the last EFA of the 47-item scale, twelve factor was found with an eigenvalue greater than 1 that explained 64.3% of total variance. The scale’s item-total correlations ranged between .36 - .62 and Cronbach’s coefficient alpha was calculated to be .93.

Conclusions

This scale was found to be valid and reliable. It can be used to assess the mental health promotion ability of adults who native Turkish speaker.

Key messages

The Mental Health Promotion Scale has been found to be valid and reliable. The Mental Health Promotion Scale can be used to assess of mental health promotion ability for adults.
Antidepressant use in over-indebted individuals compared to the general population in Germany
Authors: Warth J , Beckmann N , Puth M-T , Tillmann J , Porz J , Zier U , Weckbecker K , Weltermann B , Münster E
Published: November 2019

Background

About ten percent of European households across all socioeconomic groups are considered over-indebted due to ongoing difficulties meeting financial commitments and living expenses. Studies found an association between over-indebtedness and physical and mental health such as depression independent of standard socioeconomic status measures. However, antidepressant use in the over-indebted population has been understudied. In view of the substantial economic and social burden of mental illness in Europe, the aim of this study was to examine the association between over-indebtedness and antidepressant use in Germany to advance the understanding of socioeconomic inequalities in mental health.

Methods

We conducted a cross-sectional survey among clients of 70 debt advice agencies in North Rhine-Westphalia, Germany, in 2017 (OID), and merged data with the first wave of the German Health Interview and Examination Survey (DEGS1) representative of the general population. We used descriptive statistics and multiple logistic regression analysis to examine antidepressant use in the previous 7 days (OID: n = 699; DEGS1: n = 7115).

Results

Antidepressant use was more frequent in the over-indebted (12.3%) compared to the general population sample (5.0%). After adjustment for age, sex, education, employment, marital status and chronic disease, over-indebted respondents were more likely to use antidepressants than the general population sample (aOR 1.83; 95% CI 1.35-2.48).

Conclusions

Prevalence of antidepressant use was higher in the over-indebted compared to the general population. The association between over-indebtedness and antidepressant use cannot be fully explained by standard socioeconomic measures. Over-indebtedness reflects a relevant public health issue that needs to be addressed in health care, social policy and research. There is an urgent need to develop public health activities that specifically target those at risk of mental illness and over-indebtedness.

Key messages

Over-indebtedness is associated with antidepressant use. Public health interventions are needed to prevent adverse health effects of over-indebtedness and safeguard access to care according to need.
The Good Behavior Game: when the classroom becomes the playground for life skills (Toulon area)
Authors: Sondey J , Taurel N , Khem C , Negre L , Birocchi S , Reynaud-Maurupt C
Published: November 2019

Children presenting disruptive and antisocial behavior are more at risk of developping health and life complications. The “Good Behavior Game” (GBG) is an American classroom behaviour management program implemented by trained teachers. Its effectiveness in public health has been shown by several scientific studies. The program was recently adapted for France by the GRVS, Nice. During 2017-2018, four schools - 1,400 children- benefitted from the GBG program, conducted in the Toulon area by the CODES 83 under the supervision of the GRVS. During their bi-monthly visits to the 29 teachers in training, coaches collected data reports on the past games, and observed a live GBG session. They discussed then with the teacher to build the best classroom management strategy.

Does the GBG help pupils improve their peer relationships? What can the program realistically bring in terms of classroom wellbeing? Those questions are crucial to assess, children’s quick benefits, as well as the development of life skills as protective factors for healthy living.

Based on the coaches’ observations and feedbacks with the teachers, preliminary results tend to demonstrate that the GBG help pupils improve their peer relationships, notably by evoking cooperation and inclusive behaviors. Pupils present a more positive state-of-mind whether to give a personal opinion, to share speaking time, learn patience, to make collective decisions, to be aware of one’s need, to peacefully deal with disagreement, to explain instructions to one another, to ask for another point of view. More active and peaceful approaches to conflict resolution have been noticed. The program seems to enhance wellbeing at class including positive peer interactions and self-appreciation.

Regarding the experiment in the Toulon area, GBG has a strong potential to develop social and life skills of children. GBG seems to work towards better self-esteem, a key lever for peer-pressure resistance and for making healthy choices.

Key messages

The “Good Behavior Game” (GBG) creates a positive environment in the classroom, leading children towards positive peer interactions. GBG enhances protective factors against peer-pressure an important determinant of risky behavior.
Identifying People with Dementia in Electronic Primary Care Records in the UK
Authors: Kang S , Lewis S , Gladman J , Wardt V , Gibson J
Published: November 2019

Background

Many epidemiological questions need to be answered regarding dementia, including the causes, prognosis, comorbidities, and treatment of the condition and complications. A routine electronic primary care dataset provides a way of investigating some of the complicated factors with rich information. However, there has been concern regarding whether dementia is recorded well enough.

Methods

This study has therefore explored this by conducting a systematic review to understand how dementia has been identified previously in primary care databases in the UK, and added to this by exploring additional terms and symptoms, and medications that might be helpful in identifying people with dementia. The study estimated the prevalence and incidence rates of dementia in The Health Improvement Network (THIN) database and compared with other longitudinal studies using the comprehensive list of diagnostic codes.

Results

The estimated incidence rates per 1,000 person-years for the 60+ age group who had any of the first diagnosis among the Quality Outcomes Framework (QOF) defined codes, Other diagnoses, Dementia symptoms and Prescribed medications were 2.5, 4.7, and 15.9 in 1995, 2004, and 2015 respectively. The estimated prevalence were 2.8, 3.2, and 10.2 in 1995, 2004, and 2015 respectively.

Conclusions

The codes related to dementia symptoms (represented by mini-mental state examination, the six item cognitive impairment test, referral to memory clinic and behaviour assessment) seem to cover a broad definition of dementia or pre-existing dementia population in the UK primary care records. At least, using of the Other diagnoses (represented by dementia annual review, senile/presenile dementia and dementia monitoring) in addition to the QOF defined codes, and Prescribed medications were evidenced that will not missing out a number of people with dementia.

Key messages

The codes related to dementia symptoms seem to cover a broad definition of dementia or pre-existing dementia population in electronic primary care records in the UK. Nevertheless, the codes about non-specific or temporary symptoms may need to be used carefully as it is possible for memory or cognitive function to be impaired temporarily due to other factors.
Child protection in medicine - closing gaps in continuing education through e-learning
Authors: Maier A , Hoffmann U , Fegert J M
Published: November 2019

Background

Child abuse is a major problem across Europe. The consequences are often serious and long-lasting disorders which, in addition to the individual burden, are extremely costly for the national health system. It is important to prevent or recognize child abuse at an early stage and to provide adequate help to those affected. Health professionals are privileged first contact persons for the victims. However, the WHO assumes that about 90% of cases of child abuse in medical institutions remain unknown. It is therefore important to train health professionals in this field. For this reason, in Germany an E-Learning course on child protection in medicine is currently being developed and evaluated. This article is intended to present the results of the accompanying evaluation of the E-Learning course.

Methods

The accompanying evaluation collected and analyzed the graduates’ opinion on the course, its contents and the topic of child protection in medicine in general. Knowledge and competence levels were surveyed before and after the course and evaluated with a t-test for related samples.

Results

The evaluation of the course showed a high relevance of the topic of child protection in medicine and the rather low attention paid to the topic in the medical field. The course was, however, assessed very positively and the majority of graduates were already able to apply what they had learnt in their daily work. The pre-post design showed a significant increase in knowledge and skills as a result of the course.

Conclusions

It turned out that the E-Learning course on child protection in medicine closes an existing gap in the continuing medical education system. The evaluation also shows a success of the program and thus a reduction of uncertainties in child protection procedures among health professionals. A corresponding E-Learning offer for other European countries should be considered in order to address the comprehensive problem of child abuse across the whole of Europe.

Key messages

Too little attention is paid to child protection in the medical field. E-Learning can effectively train health professionals in child protection, has a wide reach and is flexible in use.
Evaluation of Cyber Bullying and Self-Esteem in High School Students
Authors: Aydoğan S , Ünsal A , Arslantaş D , Atay E , Öztürk Emiral G
Published: November 2019

Background

Cyber bullying (CB) is a repetitive use of information and communication technologies to harm other individuals. In recent years, CB has become more common among adolescents with the increase in availability of technological devices and technological developments. CB may harm the emotional, social and psychological development of the individuals of developmental age and social relations. CB is reported to be higher in people with low self-esteem. The aim of this study is to determine the frequency of CB among high school students, to examine some variables which may be related and to evaluate self-esteem.

Methods

This is a cross-sectional study conducted between 1 May-30 June 2018 among high school students in Sivrihisar. The study group consisted of 712 students which 60.1% were female, 39.9% were male and the mean of ages was 16.3±1.2 years (ranged 13-20). CB was evaluated with 2nd Revision of the Revised Cyber Bullying Inventory (RCBI-II) and self-esteem was evaluated with Rosenberg Self-Esteem Scale (RSES). Chi-square, logistic regression and Spearman correlation analyses were used to analyze the data.

Results

The frequency of CB was 57.6% (n = 410). The frequency of CB was higher in men (OR:1.45,CI:1.01-2.1), the group who accept the friendship request of the people they don’t know in the virtual environment (OR:1.84,CI:1.22-2.78), who had problems with anyone on internet (OR:2.27,CI:1.54-3.35), who tells about something that can’t speak in real life (OR:2.13, CI:1.48-3.06), who share the problem orginated from online communication with anyone around (OR:1.48, CI:1.03-2.15). There was a positive weak correlation between the scores of the RCBI-II and RSES.

Conclusions

CB is a common problem among high school students. There is a weak negative relationship between the level of CB and self-esteem. It may be useful to increase the awareness of students, parents and teachers on the subject and to provide psychological support to students to reduce the level of CB.

Key messages

It is remarkable that the self-esteem of cyber-bullies is low. Risky behavior on the internet is an important risk factor for cyber bullying.
An online health status report to support public health in Belgium
Authors: Scohy A , Devleesschauwer B , Renard F
Published: November 2019

Issue

Monitoring population health is crucial for policymakers. In Belgium, health monitoring only existed at regional level, with no integrated view at country level.

Policy/tool

The Health Status Report (HSR) project developed a tool for centralizing key health indicators. The HSR aims to support policymakers in multiple ways: as a ’warning signal’, by contributing to the planning of health policies, and as an assessment tool for those policies. Rather than being exhaustive, the HSR selects key indicators to highlight important needs. These indicators have been identified through literature and consultations with experts and stakeholders. Topics include life and health expectancies, mortality, morbidity, and lifestyles, with an important focus on socioeconomic inequalities. Good results and health gaps are underlined with international comparisons, trend analyses, and comparisons with reference values. By disaggregating the data by sex, age, geographic level or socio-economic level, specific health needs are identified.

Results

The main outcome of the project is a continuously updated website: www.healthybelgium.be. The report highlighted that, although the Belgian health status is rather good, there is room for improvement: for some indicators Belgium lags behind other European countries; regional disparities remain important, with most indicators revealing a better health status in Flanders than in Brussels and Wallonia. Socioeconomic disparities also remain very important, and for some indicators even tend to worsen. Comparing the Belgian health status to that of the EU-15 results in more severe conclusions than in international reports.

Conclusions

We developed a new tool to support public health policy in Belgium through benchmarking and trend and disparity analyses of several health indicators. The tool will be expanded in the next years, integrating for instance the results of the Belgian national burden of disease study.

Key messages

We developed an online health status monitoring tool to inform policymakers. The rather good health status hides important regional and socioeconomic disparities in Belgium.
What do patients consulting in a free STI center know about HIV transmission and prevention?
Authors: Duteil C , de La Rochebrochard E , Piron P , Segouin C , Troude P
Published: November 2019

Background

Despite therapeutic progress, HIV remains a public health issue with about 6400 new HIV contaminations each year in France. HIV prevention relies on health education, early screening, treatment as prevention, post and pre-exposure prophylaxis. Patients’ visits to free sexually transmitted infections (STIs) screening centers (CeGIDD) are opportunities to spread prevention messages. This study aimed to assess level of HIV knowledge in a Parisian CeGIDD to improve prevention messages.

Methods

The study included patients older than 18 who came for STIs testing between August 2017 and August 2018 and who understand written French language. Data were collected by a self-administered electronic questionnaire filled in before medical consultation. It included sociodemographic data and knowledge regarding HIV transmission and prevention.

Results

The study included 2002 patients. The median age was 27 years and 66% were men. More than 96% of patients know that HIV transmission is possible through unprotected sexual intercourse and through needle exchange. However, some misconceptions persist: 20% of patients believe that HIV transmission is possible from using public toilets and 22% by mosquito bite. Prevention measures perceived as “absolutely or rather efficient” by patients were: using condom (97%), requesting a screening test from his partners (91%), getting screening tests regularly (90%), choosing his partners correctly (62%), having sex with few different partners (50%). Half of patients heard of post-exposure prophylaxis (51%).

Conclusions

Main modes of HIV transmission are well known (unprotected intercourse and needle exchange). However, false beliefs regarding prevention may lead to risk behavior (doing screening test regularly doesn’t protect against HIV) and need to be explored. Moreover, assessment of variation in level of HIV knowledge according to patient’s profile may help to target prevention message according to specific populations.

Key messages

Main modes of HIV transmission are well known. False beliefs regarding modes of prevention need to be explored to target HIV prevention messages.
A six-years point prevalence survey of healthcare-associated infections in an Italian hospital
Authors: Gentili A , La Milia D I , Vallone D , Di Pumpo M , Vangi G , Berloco F , Cambieri A , Damiani G , Laurenti P , Ricciardi W
Published: November 2019

Healthcare-Associated Infections (HAIs) are among the most serious public health problems in Europe representing the most frequent adverse event during care delivery. Despite their limitations, point prevalence surveys of HAIs are often preferred to prospective surveillance, since they provide a feasible estimate when resources are limited.

The aim of this study was to analyze the results of a six-years point prevalence survey of HAIs in a teaching acute care hospital in Italy and to investigate the main risk factors of HAIs in the acute-care hospital. A point prevalence survey to detect HAIs was carried out in Gemelli Hospital during the last 6 years, from 2013 to 2018. Inpatients of any age in Gemelli Hospital were eligible for inclusion. Patients in outpatient areas were excluded. HAIs were identified according to diagnosis guideline from ECDC in 2011. Statistically significant differences were tested through t-test and Chi-square test. Multi-variate analysis was performed to evaluate the impact of regressor factors for predict HAI’s prevalence. The statistical significance level was set at p < 0.05. The point prevalence ranged from 3,16% in 2017 to 6,64% in 2013. Pneumonia and surgical site infections (SSI) were the most frequent HAIs during the 6 years, with a rate of 27,31% and 26,20% respectively of all HAIs. The multiple logistic regression showed that length of stay at the moment of detection, urinary catheter, CVC and antibiotic therapy are useful to meaningfully predict HAI prevalence, with a regression coefficient (adjusted R2) of 0.2780.

Thanks to proper hospital policies, the point prevalence of HAIs does not seem to increase through the years, even though it is still too early to draw any conclusions. Pneumonia and SSI represented each one more than a quarter of all the HAIs, as reported also in literature. There is a strong association between length of stay at the moment of detection and HAIs but it is hard to understand which one is the cause of the other.

Key messages

Point prevalence from 2013 to 2018 seems to be stable. An accurate incidence survey is needed in order to identify the main risk factors of HAI and to realize more specific hospital programmes. Length of stay at the moment of detection is useful to meaningfully predict HAIs prevalence although the cause-and-effect relationship is still not clear.
Alcohol-related attendances in French emergency departments in 2017
Authors: Fouillet A , Palle C , Charpentier S , Caserio-Schönemann C
Published: November 2019

Background

France is one of the leading countries in terms of daily alcohol consumption per inhabitant. Alcohol is a major concern for emergency department (ED) since it accounts for a large part of their resources and increases behavior problems resulting in violence against staff. Individual information of French ED attendances registered in OSCOUR network are daily collected by Santé publique France, the French Public Health Agency. This study aims at describing alcohol-related ED attendances (ARA) in 2017 in France.

Methods

The OSCOUR network included 677 ED in 2017 recording 92% of national attendances. ARA were identified through the main and associated medical diagnoses coded by physicians using ICD10. The study considered acute alcohol intoxication, dependence syndrome/withdrawal state, other mental disorders and intoxications due to alcohol, chronic complications and intentional self-poisoning by alcohol. The number of ARA was analyzed by age group, gender and region.

Results

1.4% of total attendances were associated to alcohol consumption (202,184 attendances) in 2017. 68% of ARA were due to acute alcohol intoxication and 14% for dependence syndrome/withdrawal state. The highest proportions of ARA were observed for people aged 40-59 yo and 18-24 yo, particularly for women. Regions of North and West metropolitan France and La Réunion Island had the highest proportion of ARA among the total number of attendances.

Conclusions

The part of ARA in France is consistent with figures provided in international studies using similar data. This proportion is similar with proportion of major public health issues like influenza, that represented 1% of the total ED attendances from November 2016 to February 2017 and reached 1.8% in January (month of the epidemic peak). Consequences of alcohol use represent a heavy burden for ED and the health system in France. This is all the more true as ARA are underestimated due to the low coding rate of associated medical diagnosis in ED.

Key messages

1.4% of total French ED attendances were associated to alcohol consumption in 2017. This proportion is close to the proportion of influenza attendances in ED.
Who does use ENDS in Russia? Results from Russian tobacco control policy evaluation survey EPOCHA-RF
Authors: Gambaryan M H , Kalinina A M , Popovich M V , Starovoytov M L , Drapkina O M , Boytsov S A
Published: November 2019

Background

Electronic Nicotine Delivery Systems (ENDS) become popular in Russia. Still little is known about use of these products.

Aim

To assess patterns of active and passive exposure to ENDS in Russian population.

Methods

Data from Russian tobacco control policy evaluation survey (2017-2018) are analysed, conducted on the basis of multistage territorial random sample of 11625 respondents: 6569 smokers, 2377 former smokers and 2679 never smokers 18years and older in 10 Russian Federal subjects.

Results

38.8% of the respondents were familiar with ENDS, with the highest proportion in the youngest age group (18-24): 53.8%(p<.0001). 9.3%had tried ENDS, among 18-24 years old - those were 23.5%(p<.0001). The amount was significantly higher among recent quitters (in last 3years)-17.2%, and current smokers-13% compared with former (quitters for more than 3years) and never smokers. Of those 26.4% used ENDS regularly-with highest proportion among 18-24years old (29.1%), and current smokers (27.1%). This comprises 2.5% of respondents as regular ENDS users, and 6.8%-among the youngest group. Half of the smokers had tried to quit by means of ENDS, of those 69% failed to quit smoking, and 79% could neither give up smoking nor ENDS. However, only 18% ENDS users agreed that e-cigarettes cause addiction, and 37% even denied the fact. Those were mostly the youngest respondents (45%). Vaping was not allowed at homes of 67.4%respondents, at workplaces-of 65.6%. 14% of respondents had witnessed vaping at workplaces, 55.8% in public places, 20.3% cafes, restaurants and bars. 51.4% had been exposed to secondhand aerosols of ENDS and 73.2%-among 18-24years olds. 37%found exposure to the aerosols annoying, with significant differences between never/former smokers (58% and 50.3%) and recent quitters and current smokers (39.3% and 29.2%).

Conclusions

Young people are mostly exposed to ENDS in Russia. Strong legislation should be considered to regulate ENDS and protect people from their exposure.

Key messages

Electronic cigarettes are mostly prevalent among the youngest age groups, current smokers and recent quitters in Russia. ENDS do not help smokers to quit: vast majority of smokers who used ENDS for this purpose failed to give up both smoking and electronic cigarettes.
Challenges in a population-based registry of cardiovascular disease in Shiga, Japan
Authors: Fujii T , Arima H , Yamamoto T , Sawayama Y , Takashima N , Kita Y , Tanaka S , Miyamatsu N , Miura K , Nozaki K
Published: November 2019

Background

Stroke and cardiovascular disease are one of the leading causes of death and disability in Japan. In order to investigate current burden, we conduct a population-based registry of cardiovascular disease in Shiga Prefecture, Japan since 2012. We will demonstrate challenges in conduct of the registry study.

Methods

In 2012, we established the Shiga Stroke Registry (SSR), a multicenter population-based registry study designed to build a complete information system for the management of stroke in Shiga Prefecture, Japan. The registry uses local monitoring, combined with remote data collection and quality control systems, to create an integrated surveillance system among a network of all acute care hospitals with neurology/neurosurgery facilities and smaller hospitals with rehabilitation facilities in the region. In 2019, study name has changed to Shiga Stroke and Heart Attack Registry (SSHR) and additional registration of coronary heart disease and aortic disease have started. Each case is reviewed and adjudicated by 2 or more specialists.

Results

In the financial year of 2018 (from April to March), a total of 4809 stroke cases were identified. From December 2018 to April 2019, a total of 515 coronary heart and aortic diseases were identified. A total 10 nurses work full-time for the registry and it takes average of 1 hour to collect information for each patient. Challenges in conduct of the cardiovascular registry involve regulatory and ethical approval, funding, associations with local hospitals, non-standardized hospital diagnosis, staff training for comprehensive data collection including pathophysiology, examination and treatment, and quality control of data collection.

Conclusions

SSHR is a population-based registry of wide range of stroke and cardiovascular disease in Shiga Prefecture, Japan. In order to keep quality of the data, we put a lot of efforts on staff training and quality control.

Key messages

Population-based registry of wide range of stroke and cardiovascular disease in Shiga, Japan. In order to keep quality of the data, we put a lot of efforts on staff training and quality control.
A claims-based algorithm to identify cancers in a French retired self-employed craftspeople cohort
Authors: Goulard H , Homère J
Published: November 2019

Background

In France, possible long-term effects of past occupational exposure to carcinogen in the French retired self-employed craftspeople (RSEC) was studied in the ESPrI cohort. For health surveillance, a passive epidemiologic follow-up was set up, using algorithms based on medico-administrative databases developed to identify retiree with incident cancers.

Methods

A total of 15,030 RSEC were invited between 2005 and 2009 to fill the questionnaire about social and demographic characteristics, occupational history, frequency of activities involving potential exposure to asbestos fibers. For health surveillance, health-related French administrative databases were used. Since 2009, healthcare data from 7,544 ESPrI retirees had been annually extracted from the national health insurance cross-fund information system (Sniiram), include the French hospital discharge database system (PMSI) and the registered Long-Term Diseases database (LTD). The objective was to track incident cancers (ICD-10) and their date of diagnosis using algorithm based on 1) hospital stay with principal, related or associated diagnosis; 2) historic of the registered LTD which was available for each retiree.

Results

Among 7 544 ESPrI retirees, matching through medical records, 256 different incident cancers from asbestos-related localizations were identified between 2011 and 2017, 243 in men and 13 in women - a total number of 105 lung cancers, 122 colorectal cancers and 29 others cancers (mesothelioma, larynx, ovarian, oesophagus, pleura cancers).

Conclusions

A passive follow-up by using French national health administrative databases in order to evaluate the potential health effect of occupational asbestos exposure offered the advantage of reducing the risk of attrition and decreasing the total cohort cost. In 2019, a study was set up with then French cancer registries to evaluate algorithm’s performance.

Key messages

A claims-based algorithm developed by the French public health Agency to identify incident cancers. Epidemiological follow-up of ESPrI cohort provides indicators on the health of retired self-employed craftspeople.
Modeling the impact of changes in tobacco use on individual disease risks
Authors: Djurdjevic S , Baker G
Published: November 2019

Philip Morris International has developed a Population Health Impact Model (PHIM) to estimate the effects of marketing Reduced-Risk Products on population health. The PHIM creates a disease-specific risk profile for each individual based on their age and smoking history.

To create a risk profile, the PHIM calculates, at each year of age, the excess relative risk (ERR=relative risk [RR]-1) by multiplying an individual’s equivalent dose (ED) by the ERR for smoking vs. never smoking. ED is defined as 0 at birth and stays at 0 while the individual is a non-smoker. Once tobacco use starts, the individual’s ED rises toward the relative exposure (RE) corresponding to the product used. Following quitting or change of product, ED moves toward the new value of RE. The model uses estimates of age- and disease-specific current smoking RRs and ERR half-lives following cessation, derived from meta-analyses of published data.

Estimates of the half-life of excess risk are also used when estimating rise in ERR following initiation or change in ERR following a change in product use. We apply the method to data for the four main smoking-related diseases; lung cancer, ischemic heart disease, stroke, and chronic obstructive pulmonary disease.

For a given disease and age group, the PHIM can derive estimates of the average ERR for each individual in the population studied. Given an overall estimate of absolute population risk, the PHIM can then also be used to derive estimates of absolute risk for each individual.

Key messages

Health impact modeling can be used to understand the individual and population impacts of introducing reduced risk tobacco products. Footnote: *Reduced-Risk Products are products that present, are likely to present, or have the potential to present less risk of harm to smokers who switch to these products vs continued smoking.
Cancer incidence trend in northern tunisia: 1994-2009
Authors: Dhaouadi S , Cherif A , Osman M , Hsairi M
Published: November 2019

Background

Cancer is a major public health problem in Tunisia. The objectives of this study were to describe the epidemiological pattern of cancer for all and main cancer sites in Northern Tunisia during the period 2007-2009 and to analyze it’s incidence trend between 1994 and 2009.

Methods

Cancer registry of Northern Tunisia was the source of data for the identification of patients for this study. This registry notify, since 1994, all cases of malignant tumor in people living in the District of Tunis, Nabeul, Zaghouan, Bizerte (North East) Beja, Jendouba, Kef and Siliana (North West). Cases were codified using the third version of International Classification of Diseases for Oncology. Demographic data were provided by the National Statistical Institute. Incidence trend analysis was achieved by using JoinPoint Software.

Results

During the period 2007-2009, the age-standardised incidence rate of all sites combined was 149.2/100 000 person-years and 112.3/100 000 person-years respectively among males and females. The sex ratio was 1.26. The mean age at diagnosis was 58.28±16.77 years. The most common sites for males were: lung, bladder, prostate and colorectal; while for females, they were breast, colorectal, thyroid and cervix uteri. Local stage at diagnosis was observed in 37.7% of cases. The highest incidence rates were observed in the District of Tunis and in the governorates of North East. The trend incidence cancer of all sites combined during the period from 1994 to 2009 was significantly risen except for stomach cancer among males and cervix uteri among females with annual percent changes of -2.5% and of -4.1% respectively.

Conclusions

Despite the existence of a national cancer strategy in Tunisia, many barriers affect the implementation of interventions; while the trend cancer incidence continues to rise particularly in males. Strengthening prevention strategy of this scourge is strongly recommended.

Key messages

Cancer is a major public health in world and in Tunisia. Prevention must be applied to reduce the incidence of cancer.
Research for road safety by multidisciplinary approach in Benin: From ’ReMPARt’ Unit experience
Authors: Glele Ahanhanzo Y , Kpozehouen A , Sambieni E , Hounkpe Dos Santos B , Daddah D , Aïna A , Poncelet M , Ouendo E M , Levêque A
Published: November 2019

Issue/Problem

Road crashes are the primary cause of death within the 15-29-year-old age group. In Benin, there is no policy of road safety. The establishment of effective policies requires objective data that can guide decision-making. Research institutions are poorly integrated in this process. To fill the gap in scientific evidence and to participate in the decision-making, the Department of Epidemiology and Bio-Statistics of Regional Institute of Public Health, along with partners, set up a unit research dedicated to road safety, the UR ReMPARt.

Description of the method

UR ReMPARt, based on multidisciplinarity and intersectoriality, is the first initiative of its kind in the African sub-region. Its mission is to contribute to political decision-making on the subject of road safety via research development and on a template of sustainability of interventions. The intervention strategies are: training, research development, and knowledge transfer.

Results

Created in May 2017, this research unit is organized around academic and professional competences from different countries. Assessment after two years shows four continuous training sessions on different themes, the development of doctoral research projects, and activities of expertise. Three Ph.D. thesis and five masters students in epidemiology are also in training to reinforce the unit. The partnership contains dedicated consortiums for the mobilization of resources in favour of the research and training for road safety.

Lessons

Intersectoriality and multidisciplinarity are requisite to guide the relevance of the research and provide the adequate answers on the matter of road safety. The research and the targeted transfer of results remain key foundations to direct decision-making. The reproducibility of this initiative must take in consideration those principles and constitute an opportunity of sharing of experience and networking in favour of the joint cause that is road safety.

Key messages

Research in road safety cannot be one way vision. Building political decisions around conclusive data is henceforth an obligation to integrate in our practices.
The role of preimplantational diagnostics in comtemporary reproductive medicine - a survey
Authors: Semerdjieva M , Angelchovska A , Bakova D
Published: November 2019

Background

Preimplantational diagnostics is a relatively new technique for diagnosing genetic and other abnormalities in different stages of fetal development. It provokes serious research interest and objections due to its probable consequences - the possibilities for selective abortion based on a selective approach to people depending on their hereditary peculiarities. In this connection, we conducted the present survey on society’s attitude towards some aspects of preimplantation diagnostics.

Methods

114 subjects (21 men and 93 women), aged between 18 and 60 years (mean 28.44±1.16), participated in an anonymous survey.

Results

69.3% of respondents expressed their strong support for the application of preimplantational diagnostics. We report a dependance of approval on respondents’ educational degree – participants with a secondary education approve in the smallest degree of preimplantational diagnostics p=0.004 (χ2=15.40). When comparing the results by respondents’ age, it is worth noting that those older than 41 years approve in a greater degree of preimplantational diagnostics p=0.001 (χ2=28.03) – most commonly these are people with a Master’s degree. It is more common for men to think that preimplantational diagnostics should be used for determining physical traits (colour of the eyes, hair etc.) and sex p=0.05 (χ2=5.73). As an explanation to their positive answer some respondents give the existence of sex-related genetic diseases. Therefore, even when the smallest doubt is present the so-called sexing should be conducted.

Conclusions

The participants in the survey approve of the use of preimplantational diagnostics in strictly observed rules and conditions. With the present laws in force there are numerous unresolved aspects and issues. More than half of the participants (66.7%) think that contemporary reproductive technology (incl. preimplantational diagnostics) could influence positively the attempt to overcome the demographic crisis in Bulgaria.

Key messages

Preimplantational diagnostics is a relatively new technique for diagnosing genetic and other abnormalities in different stages of fetal development. We conducted the present survey on society’s attitude towards some aspects of preimplantation diagnostics.