bluuebunny/crossref_metadata_2025 huggingface dataset:
Vitamin D status and its influencing factors among pregnant women in Szeged, Hungary
Authors: Paulik Edit , Horváth E , Szabó A , Polanek E , Gyurkovits Z , Németh G , Orvos H
Published: October 2021

Background

During pregnancy vitamin D plays an important role in maternal and fetal immune regulation as well. The aim of our study was to evaluate vitamin D serum level and its influencing factors among pregnant women and their newborns.

Methods

A cross-sectional study was performed among women delivering at the Department of Obstetrics and Gynecology in 2019. Altogether 301 women were included into the study, who filled the questionnaire one or two days after delivery. Data collection was based on a self-administered questionnaire, health documentation, and maternal serum and infant cord-blood vitamin D laboratory tests. Vitamin D intake was evaluated by dietary and vitamin D containing dietary supplement intake. Statistical analyses (descriptive statistics, chi square, Pearson's correlation, Kruskal-Wallis test) were performed with the IBM SPSS 26.0 program. The study protocol was approved by the Research Ethics Committee of the University of Szeged (number: 4419). Written informed consent was obtained from each participant of the study.

Results

The average maternal age of the included women was 33.28 years. More than half of women did not eat sea fish during the pregnancy, 66.3% drank daily milk, 51.5% ate daily yoghurt, and 30.2% used daily margarine as a spread. During pregnancy 77.6% of included women took some kind of vitamin D containing dietary supplement with which their average daily vitamin-D supplementation was 17.19 microgram (SD = 22.45 microgram). The average serum vitamin D level was 52.81 nmol/L in mothers and 72.96 nmol/L in newborns' cord-blood. Only 12.1% of mothers, and 43.1% of their newborns reached the optimal (75 nmol/L) level.

Conclusions

Our results showed that dietary and supplementary vitamin-D intake are insufficient among pregnant women, and consequently vitamin D serum levels are also lower than the optimal among mothers and their newborns, consequently.

Grant support: University of Szeged, Faculty of Medicine, Hetényi Géza Grant

Key messages

Low vitamin D level is a global public health issue. Vitamin D supplementation during pregnancy is important to maintain the optimal vitamin D serum level.
Implementation of latent TB screening targeting high-risk migrants in primary care: engagement is key
Authors: Zenner Dominik
Published: October 2021

European countries are increasingly targeting migrant populations in latent TB programmes. Dr Zenner will describe recent initiatives to deliver these often complex screening programmes through primary care services, exploring lessons learned and best practice approaches.
SARS-CoV-2: serological evidence of circulation in Southern Italy in late 2019?
Authors: Marchi S
Published: October 2021

Background

Italy has been one of the first countries hit by the COVID-19 pandemic. On 22 February, 2020, clusters of infection in Northern Italy were reported and transmission was assumed to be local. The presence of SARS-CoV-2 in wastewaters in Italy in late December 2019 suggested that the virus has been silently circulating before the first autochthonous case was identified. This study aimed to retrospectively assess the presence of antibodies against SARS-CoV-2 in a sample population from Southern Italy in the last months of 2019.

Methods

Human serum samples were collected from late September to the end of December 2019 in a local laboratory in the province of Bari, Apulia region, Southern Italy. A total of 455 samples were tested for SARS-CoV-2 IgA, IgM, and IgG by commercial ELISA. Samples with borderline or positive result for at least one antibody class were further tested by in house-ELISA for IgA, IgM, and IgG targeting the receptor-binding domain (RBD) of the spike protein of SARS-CoV-2 and by micro-neutralization test (MNT).

Results

After commercial ELISA testing, 11 samples were positive for IgG, 3 for IgM, and 3 and 2 were positive and borderline for IgA, respectively. 8 samples (1.8%, 95% CI 0.8-3.4) were positive when tested by in house-ELISA: 5 (1.1%, 95% CI 0.4-2.5) for IgG and 3 (0.7%, 95% CI 0.1-1.9) for IgM. No samples were positive for in house-ELISA IgA or by MNT.

Conclusions

The results of this study showed that some samples collected before the first autochthonous case was detected in Italy had antibodies reactive to the RBD of SARS-CoV-2. The Apulia region has been less severely affected by the first epidemic wave than the northern regions; however, these results suggest the spread of SARS-CoV-2 in the population in the late months of 2019. Since the majority of SARS-CoV-2 infections does not require hospitalization, it is possible that many of these have gone unnoticed.

Key messages

The spread of SARS-CoV-2 in the Italian population could have already occurred in late 2019. The extent of SARS-CoV-2 infections in the population could be far greater than reported.
Pfizer-BioNTech vaccine side effects among healthcare workers in Malta
Authors: Cuschieri S , Borg M , Agius S , Souness J , Brincat A , Grech V
Published: October 2021

Background

COVID-19 vaccination is critical to protect healthcare workers (HCWs) from serious infection. The first vaccine approved for emergency use was the Pfizer-BioNtech vaccine. European countries received their first supplies at the end of December 2020. The European country of Malta started its vaccination roll-out immediately targeting HCWs. The aim of this study was to evaluate side effects.

Methods

An anonymous online Google Forms survey was disseminated to all HCWs via work e-mail addresses (29th March to 9th April 2021). This gathered demographic data and side-effects regarding pain, redness, and swelling at the injection site, fever, chills, fatigue, muscle/joint pains, headache, vomiting, and diarrhea severity following each dose (Likert scale). Descriptive, comparative, and multiple binary regression analyses were performed.

Results

There were 1480 responses (response rate 30.30%). The commonest side-effect (SE) was pain at the injection site (88.92% CI95%:87.21-90.42), with the majority reporting it as mild (51%) and moderate (43%). Fatigue reported by 72.97% (CI95%:70.65-75.17), with 42% reporting it as mild and 41% as moderate. Headaches reported by 44.28% (CI95%:41.74-46.80), with 51% claiming to be mild and 34% as moderate. Females had significantly (p = <0.01 respectively) more pain (OR:1.90), redness (OR:2.49), swelling at the injection site (OR:1.33), fever (OR:1.74), chills (OR:2.32), fatigue (OR:2.43), muscle (OR:1.54) and joint pains (OR:2.01), headache (OR:2.07) and vomiting (OR:3.43) when adjusted for age and HCW role. Younger individuals (18-34 years) reported higher SE rates than older adults. Localised SE was reported following both vaccine doses, unlike systemic SE that was mostly reported following second doses.

Conclusions

Females and young adults appeared to be more susceptible to SE among this study's cohort, however the nature of these SE was mostly mild or moderate. This is encouraging and should allay vaccine apprehension/hesitancy.

Key messages

Vaccination benefits outweigh the minor side effects experienced. Caring physicians should be notified of the female higher susceptibility to side effects. Vaccination should be encouraged among all eligible population.
Educational Level Inequalities in Cardiovascular Outcomes and All-Cause Mortality in Turkey: A Cohort
Authors: Erkoyun E , Ünal B , Sakarya S , Sözmen K , Dinç Horasan G , Ekinci B , Ergör G
Published: October 2021

Background

Recent decades witnessed an increase in the burden of non-communicable diseases including adverse cardiovascular outcomes in low- and middle income countries and the burden was not equal across socioeconomic strata. This study aimed to define educational level inequalities in cardiovascular outcomes and all-cause mortality in a six-years cohort in Turkey.

Methods

Non-communicable Diseases and Risk Factors Cohort randomly sampled two adults (>14) from each of the registered family physicians in Turkey in July 2011 (n = 18,477). The family physicians collected demographic data. Incident coronary heart disease (CHD), cardiovascular and all-cause deaths were obtained from electronic health records in the end of 2017. Ridit score transformation was applied to the educational level by gender (illiterate, primary school, secondary school, high school or higher) and then Relative Index of Inequalities by educational level were estimated using Poisson Regression for morbidity and Cox Regression for mortality.

Results

There were 17,847 participants in CHD and 18,461 in the mortality cohort. During six-years 1,026 cases were diagnosed with CHD, 185 cardiovascular and 769 all-cause deaths occurred respectively. The inequalities were not significant for all outcomes however Relative Index of Inequalities were close to be significant for CHD incidence among men and all-cause mortality among women (0.721 (0.507 to 1.025) and 1.721 (0.969 to 3.057), respectively).

Conclusions

This is the first-ever cohort in Turkey with the aim to define educational level inequalities in cardiovascular outcomes and all-cause mortality. The inequalities may not have been observed due to the low number of outcomes.

Key messages

In Turkey, there were no educational level inequalities in our cohort. The possible inverse inequalities among men and inequalities among women may arise with a longer follow up.
Socio-economic position and burden of ischemic heart disease in Finland in 2017
Authors: Paalanen L , Reinikainen J , Härkänen T , Tolonen H
Published: October 2021

Background

Ischemic heart disease (IHD) caused every fourth death in the European region in 2017. Furthermore, it accounted for about 12% of total disease burden estimated with disability adjusted life years (DALYs). DALYs summarize premature mortality (years of life lost, YLL) and morbidity (years lived with disease, YLD) in a specific cause. These disease burden estimates are customarily used to examine time trends or differences between countries or regions. However, they have seldom been calculated by socio-economic position (SEP), especially using individual-level SEP indicators.

Methods

We calculated DALYs for the Finnish 30+ year-old population in 2017. For YLL, we used Statistics Finland database for total population. For YLD, we used individual level data from the cross-sectional health examination FinHealth 2017 survey (n = 6538), which was linked with administrative register data. Population attributable fractions (PAFs) for selected IHD risk factors (smoking, blood pressure, total cholesterol and body mass index, BMI) were also calculated. Methodology published by the Global Burden of Disease study, such as disability weights for YLD and relative risks for PAFs, was applied where applicable.

Results

DALYs for IHD per 1000 population were 61.1 for men and 31.0 for women. Premature mortality (YLL) caused over 80% of DALYs. Burden of IHD morbidity (YLD) was higher in low education groups. In the total population, PAFs for IHD risk factors for men and women, respectively, were as follows: 17% and 8% for smoking, 56% and 58% for elevated systolic blood pressure, 25% and 28% for high cholesterol, and 27% and 24% for high BMI.

Conclusions

IHD morbidity was higher among low education groups. A large part of IHD burden was attributable to major cardiovascular risk factors, most markedly to elevated systolic blood pressure. In the future, the burden of disease could be increasingly assessed also by SEP.

Key messages

The burden of IHD in Finland was especially high among men, and majority of the burden was due to premature mortality. Over 50% of the IHD burden was attributed to elevated systolic blood pressure. Assessing the burden of diseases by socio-economic position provides a new perspective for examining socio-economic differences in health.
Improving Health through Green Deal and Climate Pact (motivation for WB Region)
Authors: Jevtic M , Belis C , Bouland C
Published: October 2021

The WB Green Agenda (WB GA) aims to implement the GD principles in this region and has defined five priority areas: climate, energy, mobility; circular economy, pollution reduction, sustainable agricultural and food production, and biodiversity. Some of the WB GA goals are strongly related to health: e.g. the continent's carbon neutrality by 2050, the ambitious climate policy, the reform of energy and transport sectors. The launch of the EU CP is an important opportunity for the WB to promote action in this area. For instance, promoting energy efficiency and supporting building renovation are directly related to the quality of life and hygiene of housing. Reduction or cancellation of coal subsidies as well as the region's withdrawal from the use of coal is of great importance for reducing externalities. In the WB, citizens are concerned about their health due to air, water and soil pollution and their reduction is in the common interest. To that end, it is necessary, inter alia, to: ratify the Convention on Long-range Transboundary Air Pollution and its protocols in each of the WB economies; to implement air quality strategies; and to strengthen air quality monitoring systems (and network accreditation). Appropriate processes are needed to reduce water and soil pollution, as well as to ensure the transformation of the agricultural sector. It is also necessary to harmonize the agricultural and food sector with EU standards for food safety, plant and animal health and environmental protection. To achieve the WB GA goals it is important to develop policy strategies based on the most up-to-date scientific studies for this region (JRC, 2020). On the basis of the analysis presented in this study we conclude that the processes associated with the GD and the CP will be of benefit for both individual and public health in the EU and in the WB.
Are public health experts providing useful information for the control of COVID-19 pandemic?
Authors: Bekker Marleen
Published: October 2021

The decision-making is always a complex process that should be based on best available scientific evidence and experts judgments. COVID-19 pandemic has added more complexity to this process, demanding a fluid, accurate and rapid respond from public health experts and science. This panellist together with the rest of speakers will help us to revise this process to identify possible gaps and space of future improvement.
2.P. Workshop: Disasters and mental health
Authors:   Organised by: EUPHA-CHR, EUPHA-PMH,   Chair persons: Martin McKee (UK)
Published: October 2021

Objectives

To better understand the mental health impact of disasters in general and specifically the mental health health impact of the COVID pandemic.

Humanity has witnessed disasters of all forms and from all causes across the globe in recent decades; we have seen the consequences on people, their health and on their mental wellbeing. The presentations of the workshop will present knowledge to answer the following questions: Could we have known and planned for what to expect when a pandemic like this was to hit? How were people's lives really affected by this pandemic and the subsequent measures taken? We do know that COVID 19 as a disaster had a wider scale of social impacts than it did physical ones. How does the isolation, inability to work as usual and general downturn of ordinary life impact on people? What if those persons already have a history of serious life events or of mental illness? We search for answers to these and other questions in this workshop of 3 differing perspectives: First, Prof. Sandro Galea will present knowledge on disaster and mental health, second we will identify specific impacts on mental health on older persons (Jutta Lindert) and third a view point from practice will help to better understand perspectives of those involved in giving care in the community during times of disaster such as the Covid-pandemic (Julian Mamo).

Key messages

Disaster have not only short but as well long term impacts on mental health. Disaster specific factors can be identifed which contribute to mental health in the aftermath of the disaster.
Mental health impact of the COVID disaster on older people – how does it feel to be a burden?
Authors: Lindert Jutta
Published: October 2021

The coronavirus disease 19 (COVID-19) pandemic is a disaster that has impacted lives globally. The purpose of this paper is to understand the linkage between the COVID 19 disaster and its impact on mental health of older people 70+. To reach this aim we reviewed the literature on disasters, COVID and mental conditions of older people (70+). The mental responses of the COVID disaster are multidimensional and potentially long-lasting. Rates of mental conditions of older persons vary widely due to exposure to COVID, country, population groups and methods used when conducting the study. We identified a multitude of factors contributing to mental conditions in older people, in general. We identified COVID-19 specific factors which have an impact such as threat to own life and threat to life of loved ones, interruption of behaviors and services, and physical as well as social isolation. Additionally, in older age, life events and feelings of being a burden contribute to mental conditions. To better understand the long impact of the COVID disaster on older people`s mental health we need to understand also the impact of past life events which may exacerbate the impact of the COVID disaster on mental conditions as well the impact of the current exposure to the pandemic.
2.Q. Workshop: Intersex human rights and wellbeing - Part I: From frameworks to ethics and lived experiences
Authors:   Organised by: EUPHA-SGMH, EUPHA-ETH,   Chair persons: Arjan van der Star (EUPHA-SGMH), Els Maeckelberghe (EUPHA-ETH)
Published: October 2021

Intersex newborns, children and adolescents frequently are subjected to not clinically necessary surgeries and other non-consensual treatments. According to the UN Factsheet Intersex, “Intersex people are born with sex characteristics (including genitals, gonads and chromosome patterns) that do not fit typical binary notions of male or female bodies”. The intersex movement, international and regional human rights bodies, clinical practitioners, bioethicists and researchers have contributed reflections and recommendations related to intersex human rights, wellbeing, health and healthcare. International intersex activism demands, among other claims, the cessation of not clinically necessary surgeries and other non-consensual treatments performed on intersex newborns, children and adolescents, as well as access to clinical records, continued healthcare and psychosocial support. International and regional human rights bodies have supported these demands, calling on member states to prohibit not clinically necessary intersex-related surgeries. The discussion in the field of intersex studies includes the review of human rights and bioethical principles, clinical and research practices, as well as lived experiences, social circumstances and healthcare needs of intersex people. The workshop series “Intersex human rights and wellbeing” is structured in two parts “Part I: From frameworks to ethics and lived experiences” and “Part II: From ethics to healthcare approaches and experiences”. The first workshop in the series aims at exploring theoretical frameworks, ethical aspects in intersex research and lived experiences of intersex people. The presentations provide a review of the human rights framework (Presenter: Morgan Carpenter, Australia), the presentation of a European research project on intersex wellbeing and rights (Presenter: Dr. Surya Monro, United Kingdom), reflections on relevant ethical aspects in intersex studies (Presenters: Dr. Amets Suess Schwend and Yessica Mestre Martínez, Spain), as well as the presentation of research projects on the lived experiences of intersex youth in Aotearoa /New Zealand (Presenter: Dr. Denise Steers, Aoteearoa/New Zealand) and cultural aspects in intersex healthcare in Italy (Presenter: Marta Prandelli, Italy).

Key messages

The protection of intersex people’s human rights, health and wellbeing requires a critical review of current clinical and research practices. Human rights frameworks, bioethics, public health approaches and social sciences can provide relevant contributions to this discussion.
Introducing intersex wellbeing and rights and the INIA programme
Authors: Monro S , Suess Schwend A , Aegerter A , Keating A , Mestre Y , Gramc M
Published: October 2021

Background

Intersex people are exposed to human rights violations all over the world. Ongoing practices of sex-normalising surgery and other medical interventions on minors too young to give informed consent encroach on their bodily autonomy. Little is known about the public health implications of bodies with variations of sex characteristics (VSC). What key issues do VSCs raise?

Methods

In 2020 the INIA international consortium began work on a large research programme to address intersex people's wellbeing and human rights from a variety of new and innovative perspectives. The programme will train a cohort of 10 early-stage researchers working collaboratively to develop knowledge that will inform policy making and practice across a range of key sectors. Drawing on critical intersex studies, the research projects are relevant to stakeholders who are concerned with supporting the wellbeing and rights of intersex people through knowledge sharing and development. The project received funding from the European Union's Horizon 2020 research and innovation programme under the Marie Skłodowska-Curie grant agreement No. 859869. Please see https://www.intersexnew.co.uk/.

Results

Indicative findings show that VSC could be an important area of public health work concerning diversity and equality. Early-stage results show a dearth of intersex visibility in key areas including social policy, education, and elder care. Intersex people and those with VSC face major health challenges and discrimination. There is a pressing need for appropriate healthcare.

Conclusions

The interdisciplinary INIA programme surfaces multiple discourses about intersex people and those with variations of sex characteristics. Projects of particular interest to public health practitioners and policy makers include those concerning multi-disciplinary healthcare, ethics, social policy, education, aging, and service user participation.
Data sharing as a prerogative and as challenge for genomics in personalised health
Authors: Becker R
Published: October 2021

Without data sharing, the approach of personalised healthcare will not work - from secondary opinions to finding similar patients to compiling a reference genome to research. The more data are being used and the more difficult it is as well to anonymise data, where this is ultimately impossible for genomic data related to a person, the more challenges are faced with regard to the privacy and legal frameworks. There is the need for effective arrangements for data-sharing across different institutions, communities, and contexts. There are different legal frameworks around processing health and genetic data across Europe and, there is a difficulty to share data outside the EU in general, which often hampers the data sharing despite the willingness of people to make their data available. It is important to develop common principles and legal frameworks that enable sharing of patient-level data for research in a way that is ethical and acceptable to patients and the public.
Mental wellbeing and engagement in health risk behaviours in German university students during the COVID-19 pandemic: Findings of a cross-sectional study
Authors: Busse H , Fialho P M , Stock C , Pischke CR , Buck C , Spatafora F , Kühne L , Zeeb H , Wendt C , Helmer SM
Published: October 2021

Background

Daily life of higher education students across the world changed profoundly in 2020 with the implementation of governmental and institutional measures to control the COVID-19 pandemic. We investigated mental wellbeing and engagement in health risk behaviours (HRB) in German university students at the start of the COVID-19 pandemic.

Methods

Data stem from the COVID-19 International Student Wellbeing Study (C19 ISWS). The web-based survey was conducted in May 2020 at four German universities. HRBs included tobacco and cannabis use, alcohol consumption, and engagement in physical activity. All HRBs were assessed retrospectively and at the time of data collection. Mental wellbeing was assessed using the 8-item Center for Epidemiologic Studies-Depression Scale (CES-D 8). We conducted multinomial regression analyses to investigate factors associated with changes in HRBs and latent transition analysis to identify substance use profiles.

Results

5021 students completed the survey (69% female; mean age 24.4 years, SD = 5.1). The mean score for depressive symptoms was 9.25 (SD = 0.67, range 0-24). Sixty-one percent of students reported consuming alcohol, 46% binge drinking, 44% inactivity, 19% smoking and 11% cannabis use. While smoking and cannabis use remained unchanged during the COVID-19 pandemic, 24% reported a decrease in binge drinking. Changes to physical activity were frequently reported, with 31% reporting an increase and 19% reporting a decrease in vigorous physical activity. Higher depressive symptoms were found to be associated with changes in HRBs. Five substance use behaviour profiles were identified, which remained fairly unchanged.

Conclusions

Engagement in HRBs remains at high level during the COVID-19 pandemic among German students. Depressive symptoms were found to be associated with changes in HRBs. Efforts to promote student health and wellbeing are needed in times of the COVID-19 pandemic and thereafter to prevent longer-term consequences.
Digital Public Health Role in promoting Mores Sustainable Care practices
Authors: Odone A
Published: October 2021

As digitalization is progressively permeating all aspects of healthcare. Here we will address how can we address the potential of applying digital tools to public health and discuss some key challenges. We have identified the strategic pillars for a successful European strategy for public health digitalization and we outlined how the approach being pursued by the European Public Health Association (EUPHA) applies to digital health. Here we will link these pillars to the impact on climate change. From a public health perspective, digitalization is being touted as providing several potential benefits and advantages, including support for the transition from cure to prevention, helping to put people and patients at the center of care delivery, supporting patient empowerment and making healthcare system more efficient and mitigate climate change.
The diabesity and COVID 19 pandemics association with climate change and the role of Telehealth
Authors: Correia J
Published: October 2021

Diabesity was considered the pandemic of the 3rd millennium until the Covid-19 pandemic. Recent evidence has highlighted how both pandemics are strongly associated: obese and diabetic patients are at increased risk of COVID 19 infection and have a worse prognosis when infected due to the impairment of the immune response to infections and due to the mechanical limits that make the management of these patients more difficult. There is also evidence that both pandemics are the cause and effect of climate change. Indeed, population growth, urbanization, motorized transportation and agricultural productivity increase greenhouse gas emission and consequently global warming. These factors are also incriminated in the diabesity pandemic by the promotion of the nutrition transition and physical inactivity. It has also been suggested that the emergence and dissemination of the COVID 19 outbreak, as well as other zoonosis, could be linked to this population and urban growth, encroaching into wildlife habitats leading to an increased interaction between humans and animals, providing opportunities for inter species infection. Telehealth interventions have proven to be effective in tackling both pandemics, by providing care to both patients with COVID-19 infections and for those with obesity and diabetes, without increasing the risk of potential exposure for patients, clinicians, and staff. Furthermore, these tools have shown to be a potent carbon reduction strategy in the health sector which can significantly reduce greenhouse gas emission. However, several barriers still need to be overcome for a widespread use of eHealth solutions. These require important adaptation on the part of the caregivers and their therapeutic approach, as well as the patient.
Health inequalities -development of a monitoring system in Finland
Authors: Jokela S , Kilpeläinen K , Parikka S , Lumme S , Martelin T , Koponen P , Koskinen S , Rotko T
Published: October 2021

Background

Health in Finland has developed positively in recent decades, but there are still large differences between population groups. Wide inequalities persist between socio-economic groups, for example by education, occupational status and income, in different domains of health such as self-reported health, morbidity, and mortality. Our aim in the sub-project of the Joint Action Health Equity Europe was to describe the status of national health inequality monitoring in Finland, and to present ideas for improving the situation, including the key indicators to be monitored.

Methods

Several nationally representative registers and population surveys are the key sources of health information in Finland. We summarized information on the current state of socioeconomic health inequalities and their development over the past decades to identify research based health topics and indicators, selecting those where clear differences have been identified between education or income groups among the working-aged people.

Results

We recommend 13 indicators to monitor and evaluate socio-economic health inequalities in the Finnish adult population. They cover five topics: health status, functioning, work ability, lifestyles and social factors. The recommended indicators are in line with the Nordic recommendation of inequality indicators and allow comparison between EU countries. This is the first step in developing a full monitoring system. The second step is needed to reach an agreement on the implementation.

Conclusions

High-quality population survey and register data make it possible to monitor health inequalities in Finland. Register-based data need to be supplemented with population surveys, both health interview and health examination surveys, to provide necessary information on risk factors, functioning and perceived health.

Key messages

The key characteristics of successful systematic monitoring of health inequalities are regularity, up-to-date information, validity of selected indicators and coverage of the most important phenomena. Monitoring enables identification of health needs which must be recognized in policy-making, targeting of services, regional benchmarking and support for health impact assessment in policy-making.
Associated factors of newborn mothers hand hygiene in neonatal intensive care
Authors: Sylla A , Soukaina L , Nani S , Hassoune S , Lehlimi M , Badr A , Hajjaji S , Chemsi M , Habzi A , Benomar S
Published: October 2021

Background

Globally infectious diseases remain the leading causes of child hood mortality and morbidity accounting for 65% of all deaths in under-five children which can be prevented if proper sanitation and hygiene measure undertaken. The aim of this study is to determine the factors associated to hand hygiene of newborn mothers in NICU of Ibn Rochd teaching hospital in Casablanca (Morocco).

Methods

A cross-sectional study was performed from 04 January to 15 April 2021. We included Moroccan couple newborn/mother presents in NICU during the study period. We used face to face interview using close ended questionnaire. The number of time per day the mothers used soap or alcohol for hand hygiene(<3; 3-6; >6 times per day) was used to measure the variable “hand hygiene practice” The Khi2 and Kruskal-wallis tests were used to test association between hand hygiene and potential associated factors. Associated factors with p ≤ 0.05 were considered as significantly associated factors of hand washing practice. Data were analyzed using R 3.6.3.

Findings

We included 89 couple mother/newborn. Forty five percent practice adequate hand hygiene (washing with soap or hand rub sanitizer) between 3 and 6 times per day. Factors significantly associated with hand hygiene were: mothers' residence (rural 33.7%; urban 66.3%; p = 0,026); prenatal visit number (visits number mean: < 3 times =3.67; 3-6 times = 3.30; > 6times = 5.08; p = 0,011).

Conclusions

The mothers from urban residence accessing more prenatal visits practice hand hygiene more frequently than single mothers from rural residence with limited access of prenatal visits. So this study suggests the training programs to enhance mothers hand hygiene practice should prioritize the mothers from rural residence who attended less prenatal visits.

Key messages

We can protect the fragile hospitalized newborn from infections by cheapest gestures like hand hygiene. Hand hygiene must be continually promoted targeting all actors involved about newborn care specifically newborn mothers.
Increasing the capacity of community health workers to manage the COVID-19 pandemic
Authors: Brinzac M , Ungureanu M , Ţînțaş C
Published: October 2021

In Romania, during the COVID-19 pandemic, the community healthworkers faced high risks of infection in their efforts to protect communities, due to exposure to psychological distress, fatigue and stigma, especially as they are the grass-root healthcare delivery workers. No proper training had been delivered to community health workers. We describe an intervention aimed at increasing Romanian community health workers skills and competencies. The objective of the training was to increase the capacity of community health workers and health mediators to adequately manage the COVID-19 pandemic in their communities, through the delivery of online training sessions focused on managing their communities and themselves. The courses addressed up-to-date information on SARS-CoV-2 virus, transmission, symptoms and methods of prevention and treatment of COVID-19, to community case management and addressing cross-cutting issues such as: disability, immunization, violence against children. A total of 144 sessions were delivered, totaling 288 hours, divided between eight trainers. During these 288 hours, 1658 community health workers and health mediators were trained, accounting for 75% of the community health workers and health mediators in Romania. The overall feedback was extremely positive, as the training provided the participants very useful information. Nonetheless, several learning points have been made regarding the provision of more hands-on examples and cases, an increase in the length of the course and in the number of courses, the delivery of the course - on site courses were demanded. The training contributed to increasing the capacity of community health workers and health mediators to adequately manage the COVID-19 pandemic. The training offered the basic knowledge and skills for community healthworkers and it offered a basis for offering large scale, online training for the Romanian health workforce, which could be used as a case study for other European settings.

Key messages

COVID-19 doesn’t affect everyone equally! We ought to equip our healthworkforce in the pandemic fight. Grass-root intervention for a better health - training the community health workers.
Symptoms of emotional difficulties and hyperactivity/inattention among children during the COVID-19 epidemic and associated lockdown: data from the SAPRIS project
Authors: Galéra C , Moulin F , Melchior M , Rouquette A
Published: October 2021

Background

COVID-19 limitation strategies led to widespread school closures around the world. The present study aims to provide a description of children's mental health and associated factors during the COVID-19 school closure in France.

Methods

We conducted a cross-sectional analysis in the SAPRIS study during the COVID-19 pandemic in France, relying on 2 ongoing national birth cohorts, ELFE and EPIPAGE 2. Using weighted multinomial logistic regression models, we estimated associations between children's mental health (i.e., hyperactivity/inattention and emotional symptoms; assessed by the Strengths and Difficulties Questionnaire), children's health behaviors, schooling, as well as sociodemographic and socioeconomic characteristics of children family.

Results

The sample consisted of 5702 children aged 8 - 9 years and 49.3% girls. Sleep disturbance and parents' dominant socio-professional category were associated with both hyperactivity-inattention (adjusted Odds Ratio (aOR)=2.10 95%Confidence Interval [1.85-2.38]; aOR=0.45 [0.33-0.61] respectively) and emotional symptoms and (aOR=6.33 [5.26-7.63]; aOR=0.62 [0.39-0.98] respectively). Specifically associated with hyperactivity/inattention were: male sex (aOR=2.51 [2.24-2.82]), presence of regular care and its pursuit during school closure (aOR=1.69 [1.33-2.15]), emotional symptoms (aOR=2.74 [2.23-3.37]), school situation (aOR=2.19 [1.69-2.82]), presence of tutoring and difficulties with it (aOR=2.56 [2.13-3.08]), type of housing (aOR=0.79 [0.70-0.89]). Factors associated with emotional symptoms were: presence of covid cases in the household (aOR=2.33 [1.92-2.82]), hyperactivity/inattention (aOR=2.94 [2.45-3.52]) and financial difficulties (aOR=1.71 [1.39-2.11]).

Conclusions

Policy makers need to balance pros and cons of closing schools, taking into consideration educational and psychological consequences for children and the various factors associated with mental health.
Risk and protective factors related to children’s symptoms of emotional difficulties and hyperactivity/inattention during the COVID-19 related lockdown in France: results from a community sample
Authors: Melchior M , Moulin F , El-Aarbaoui T , Herraz Bustamente J , Héron M , Mary-Krause M , Rouquette A , Galéra C
Published: October 2021

Objective

To contain the COVID-19 epidemic preventive measures including social distancing, economic shutdown, and school closures were introduced, carrying risk of mental health burden in adults and children. Although the knowledge base regarding children's response to trauma and adverse events has broadened, descriptions of their mental health during epidemics remain scarce. In particular, the role of family socioeconomic characteristics and parental mental health are poorly understood.

Methods

We assessed the correlates of children's emotional difficulties and symptoms of hyperactivity/inattention during the COVID-19 lockdown in a French community-based sample. 432 community-based parents (27-46 years, TEMPO cohort) and their children (mean age 6.8 +/- 4.1) were interviewed online. Children's symptoms of emotional difficulties and hyperactivity/inattention were assessed using the parent reported Strengths and Difficulties Questionnaire during the 5th week of home confinement. Family socioeconomic characteristics and parental mental health and substance use were assessed weekly during the first 5 weeks of home confinement. Data were analyzed using multivariate logistic regression models.

Results

7.1% of children presented symptoms of emotional difficulties and 24.7% symptoms of hyperactivity/inattention. The presence of psychological difficulties was significantly associated with family characteristics including financial difficulties (OR = 4.3) and parental symptoms of anxiety and depression (OR = 2.5). Children's sleeping difficulties and screen time were statistically significant in bivariate analyses but lost statistical significance in multivariate models.

Conclusions

Children's emotional and behavioural difficulties are associated with parental mental health and socioeconomic difficulties. In the COVID-19 epidemic, parents and professionals involved in caring for children should pay special attention to mental health needs.
Supporting the development of strategies of suicide prevention based on experience and lessons learned from Austria
Authors: Grabenhofer-Eggerth A , Ladurner J , Pichler M , Gaiswinkler S
Published: October 2021

The Austrian programme “Suicide Prevention Austria (SUPRA)” was selected as a best practice example to be implemented in other European countries as part of the Joint Action ImpleMENTAL. The main objective of the dedicated work package on SUPRA is to develop and/or scale up the suicide prevention strategies of the participating countries based on the best practice example, ensuring that specific components of SUPRA are carefully selected, taking into account the respective country context. To gain an in-depth understanding of the current situation and required resources in the field of suicide prevention in each participating country or region, a Situation and Needs Analysis (SANA) will be conducted. National/regional working groups will be trained and assisted in identifying elements of SUPRA to be pilot implemented, based on the results of the SANA and the priorities within the participating countries. Components of SUPRA include: (i) ensuring that suicide prevention is organisationally embedded and co-ordinated), (ii) support and treatment of high risk groups according to their specific needs, (iii) restriction of access to means of suicide with the aim of making access as difficult as possible), (iv) ensuring that awareness and knowledge of suicidality and about coping with psychosocial crises are widespread among the general population), (v) integrating suicide prevention programmes into other existing health promotion activities and into addiction and violence prevention measures, (vi) quality assurance of suicide prevention on the basis of scientific expertise and evidence. Participating countries are supported in developing draft national/regional strategies and in initiating (first steps towards) pilot-implementation of selected suicide prevention interventions through workshops, training sessions and webinars.
Information access and preventive measures during COVID-19 among migrants and general population
Authors: Skogberg N , Koponen P , Lilja E , Austero S , Castaneda AE
Published: October 2021

Background

Access to information and adherence to preventive measures are crucial for containing the COVID-19 outbreak. This study examines access to information and adherence to preventive measures during the COVID-19 pandemic among migrant origin persons and the general population.

Methods

Data from the Finnish MigCOVID Survey conducted 10/2020 to 2/2021 among persons aged 20 to 66 years was used (n = 3 668). Participants in Health 2017 follow-up survey were the reference group (n = 3 490). We examined age and sex-adjusted access to information by language skills and adherence to preventive measures (staying home if fluish; keeping a safety distance; wearing a face mask; good hand and coughing hygiene; avoiding traveling abroad; avoiding shaking hands with others; downloading the Koronavilkku contact tracing app).

Results

Persons with excellent Finnish/Swedish language skills (96.8%; 95% CI 95.0-97.9) reported receiving sufficient information more often those with intermediate (92.3; 95% CI 88.8-94.8) or basic (91.0%; 95% CI 88.0-93.3) language skills. Overall high adherence to preventive measures was observed both among the migrant origin and the general population. However, significant differences in the migrant origin population by region of origin were observed. More pronounced differences between migrant origin persons and general population persons were observed for avoiding traveling abroad (83.7%; 95% CI 81.1-86.0 vs. 96.6%; 95% CI 95.6-97.3) and downloading the Koronavilkku app (42.8%; 95% CI 39.8-45.9 vs. 64.3%; 95% CI 61.7-66.8).

Conclusions

Poorer perceived access to information by language skills points to the continuous need for use of simple language and multilingual communication materials. Self-reported adherence to key preventive measures campaigned by health authorities was generally high both among persons of migrant origin and the general population, although concerns were noted in adherence to these recommendation in some regional groups.

Key messages

Multilingual and multichannel communication is central in crisis situations to ensure adequate access to information among different population groups. Higher incidence of COVID-19 among migrant origin persons is likely related not only to information access and adherence to preventive measures, but also to various social and structural factors.
Access to services among migrant origin persons during COVID-19 pandemic: Finnish MigCOVID Survey
Authors: Skogberg N , Kuusio H , Lilja E , Austero S , Castaneda AE
Published: October 2021

Background

Compared with the general population, migrant origin persons had more difficulties in access to services already prior to the COVID-19 pandemic. This study examines the impact of the pandemic on the need and access to healthcare and social services among persons of migrant origin.

Methods

Data from the population-based Impact of the Coronavirus on the Wellbeing of the Foreign Born Population (MigCOVID) Survey was used. The survey was conducted in Finland among persons aged 20 to 66 years (n = 3 668 participated in the survey, participation rate 60%) between October 2020 and February 2021 with electronic and postal questionnaires and telephone interviews. Logistic regression was applied to examine age and sex-adjusted prevalence and 95 % confidence intervals (CI) for self-reported need and sufficiency of services (physician, nurse, dentist, mental health services and family services).

Results

Healthcare and family services were needed by 69.2% (95% CI 66.3-72.0). Services provided by the physician, dentist and nurse were needed most frequently. Women (74.5%, 95% CI 70.6-78.1) were more likely to report the need for health and family services than men (64.4%, 95% CI 60.0-68.5). Out of those who needed services, 34.9% (95% CI 36.1-38.3) reported that the received services were insufficient. Highest barriers were observed for mental health (45.5%, 95% CI 36.4-55.0) and dentist (33.9, 95% CI 29.6-38.6) services. Although difficulties were highly prevalent in a number of regional groups, persons originating from East, South and Central Asia had persistently high barriers in access to services.

Conclusions

Findings suggest that barriers in access to services have at least somewhat increased among persons of migrant origin during the COVID-19 pandemic. This may have both short and long-term consequences on the health and wellbeing of the migrant origin population. Of particular concern were high perceived barriers in access to mental health services.

Key messages

Barriers in access were reported by a third of persons of migrant origin who needed services. Particular difficulties were experienced in access to mental health services. The gap in access to needs to be acutely addressed to reduce both the short and long-term consequences of COVID-19 on the health and wellbeing of the population.