bluuebunny/crossref_metadata_2025 huggingface dataset:
Revisiting the Science-Policy Interface: Lessons from the Swiss Response to the COVID-19 Pandemic
Authors: Meyer S , Frahsa A
Published: October 2024

Background

In the wake of the COVID-19 pandemic, Switzerland found itself grappling with unforeseen challenges, particularly in the realm of the science-policy interface. Despite various post-crisis reflections on ‘lessons learned’, a cohesive and comprehensive assessment of these pivotal interactions has been notably absent. We aim to contribute to closing this gap by mapping interactions at the science-policy interface and critically analyze the interaction between researchers and policymakers during the COVID-19 pandemic in Switzerland.

Methods

Using Critical Discourse Analysis, we examine the sociopolitical influences on the discourse surrounding science-policy interaction. Our dataset includes tweets from Swiss National COVID-19 Science Task Force members, Federal Office of Public Health members, and government representatives, as well as print media articles and official press releases from public health departments. Drawing on Foucault’s notion of power-knowledge dynamics, we explore how researchers and decision-makers interact in the public sphere.

Results

Key aspects identified: (1) power struggles surrounding accountability and role clarity among stakeholders, (2) the dual role of print and social media as both vehicle for dissemination and communicator shaping public perception, and (3) the pervasive ambiguity in science-policy collaboration throughout the Swiss COVID-19 response.

Conclusions

Our study emphasizes the importance of reflective learning, drawing on insights from the COVID-19 pandemic. It reveals the complexities in navigating public health crises, emphasizing the challenges of transparency, accuracy, and delineation of responsibilities. These dynamics stress the need for continuous evaluation and refinement of strategies to foster collaboration between researchers and policymakers for effective pandemic preparedness and response.

Key messages

• Understanding and Addressing Power Dynamics in Science-Policy Interactions.

• Necessity for continuous evaluation to enhance collaboration between researchers and policymakers for future preparedness and response efforts.
Enhancing Labor Market Participation of Older Adults: Health and Workplace Adaptations
Authors: Reine I , Rajevska O
Published: October 2024

Background

The labor market dynamics for older adults have significantly shifted due to extended life expectancy and evolving socioeconomic conditions. This study examines the prerequisites for older adults to remain longer in the labor market across various European countries, emphasizing the interplay between health status, workplace adaptations, and economic factors.

Methods

This cross-sectional study analyzed data from several European surveys focusing on older workers. The methodology included logistic regression to evaluate the impact of health status and workplace adaptations on continued employment among older adults. Data were further stratified by country to assess regional differences in employment patterns for this demographic.

Results

Preliminary results indicate that older adults with access to workplace adaptations-such as flexible working hours and ergonomic interventions-show a significantly higher likelihood of remaining in the labor market (OR = 2.3, 95% CI 1.8-2.9). Additionally, those reporting good to excellent health were 1.5 times more likely to continue working compared to their peers with poor health outcomes. The results also highlight substantial regional variability, with Scandinavian countries showing higher employment rates among older adults compared to Southern European regions.

Conclusions

The data strongly support the need for policy interventions that promote health maintenance among older workers and encourage employers to implement adaptive measures. Such strategies are likely to enhance the labor market participation of older adults, contributing to economic stability and reducing the potential strain on social security systems. Innovative public health policies aimed at supporting aging workers are crucial for sustaining workforce productivity in the face of demographic shifts. NordForsk supports the study Sustainable working-life for aging populations in the Nordic-Baltic region, Project No.: 139986.

Key messages

• Workplace adaptations and good health significantly extend working life among older adults.

• Regional differences in employment for older workers highlight the need for tailored public health policies.
The Health-Employment-Longevity Nexus: Implications for Retirement Age Policies in European Countries
Authors: Tur-Sinai A , Gottlieb D
Published: October 2024

Background

Advances in medical knowledge and technology have led to increased general and healthy life expectancy in Europe. Combined with declining fertility rates, these trends have resulted in an aging population. Many European countries have been reluctant to adjust the retirement age, putting pension funds and Pay-As-You-Go social insurance systems at risk. Linking entitlement age to life expectancy could mitigate this risk and extend working life, but such policies are politically unpopular. This study investigates the empirical relationship among self-perceived health, employment, job quality, and life expectancy in the European context.

Methods

The study analyzes the determinants of self-rated health using the SHARE database, combined with general and healthy life-expectancy data from EUROSTAT and, where missing, the WHO, focusing on European countries.

Results

In Europe, both past and present employment improve self-rated health. Job quality has a detrimental effect on self-rated health for women and a positive effect on men. Life expectancy and healthy life expectancy raise self-rated health, while poverty rates negatively affect it. Job quality is widespread among European women, and its negative effect on health rises with age. For European men, job quality has a positive effect, peaking around age 56. The effects of employment and job quality on self-rated health are simultaneous. In European countries with an elasticity >1, healthy life expectancy rises faster than general life expectancy at higher ages, suggesting an improved ability to work at older ages. This finding indicates that adjusting the retirement age could be a powerful tool for improving the sustainability of social insurance systems in Europe.

Conclusions

For younger European women, it may be rational to set higher retirement-age increments and put them on a declining course as they age, considering the gender-specific age dynamics and job quality effects on health.

Key messages

• In Europe, employment and job quality significantly influence self-rated health, with gender-specific effects that vary with age and impact retirement age policies.

• Adjusting retirement age in line with healthy life expectancy could improve the sustainability of European social insurance systems, considering health-employment dynamics.
Cross-national characteristics and differences in type 2 diabetes: Malta versus Luxembourg
Authors: Cuschieri S , Cuschieri A , Grech E , Samouda H , Ruiz-Castell M
Published: October 2024

Introduction

Type 2 diabetes mellitus (T2DM) is a significant global health concern, requiring a thorough understanding of its population-level features and impact. This study aims to compare the characteristics of T2DM in Malta and Luxembourg, two European nations with distinctive healthcare systems and societal attributes.

Methods

Data from national health surveys conducted in Malta and Luxembourg, encompassing various factors such as socio-demographics, medical history, biochemical metrics, and anthropometric measurements, were analysed to investigate the features of T2DM. Comparative analyses were conducted utilizing chi-square tests, independent t-tests, and multivariable binary regression.

Results

Malta (8.23%) and Luxembourg (7.82%) shared similar T2DM prevalence, with a predominance of men having T2DM. Malta exhibited a higher prevalence of obesity among the individuals having T2DM. Multivariable analysis showed no significant association between living in Malta or Luxembourg and diabetes. However, being male (OR: 1.49, CI 95%: 1.07–2.08, p = 0.02), an occasional smoker (OR: 2.49, CI 95%: 1.54–4.03, p < 0.01), increasing age (OR: 1.05, CI 95%: 1.03–1.67), and larger waist circumference (OR: 1.02, CI 95%: 1.01–1.04, p = 0.01) were positively associated with diabetes.

Conclusions

Understanding similarities and differences in T2DM between Malta and Luxembourg is crucial for identifying common challenges to formulate effective prevention and management strategies. Despite similar T2DM prevalence rates, notable differences in obesity rates and socioeconomic factors may contribute to disparities in disease burden. The complex interplay of numerous population characteristics underscores the importance of tailored public health interventions. This study accentuates the need for interventions and evidence-based policies to address modifiable risk factors, and advocate for cross-national cooperation to reduce the T2DM epidemic, especially in the context of post-COVID public health planning and resource allocation.

Key messages

• Malta and Luxembourg share similar T2DM prevalence despite differences in other factors, hypothesised to be attributed to differences in risk factor profiles and health care infrastructure.

• This study underscores the necessity for tailored interventions and cross-national cooperation to address common challenges in T2DM management in the two small countries.
Impact of time and COVID-19 pandemic on GP mental health consultations in deprived neighborhoods
Authors: Sana S , Magnée T , van Pelt S , Kocken P L , Bindels P J , Denktas S , de Schepper EIT
Published: October 2024

Background

The stringent lockdown measures and limited physical access to GP care at the start of COVID-19 pandemic resulted into a decrease of mental health consultations. It raised concerns about the access of patients with mental health problems. The aim of this study is to investigate the mental health GP consultations amongst patients from deprived neighborhoods before and during COVID-19 pandemic, especially after the stringent lockdown in the Netherlands.

Methods

In an observational study (2018-2022), medical data of 360,645 patients were analyzed for the proportions of mental health consultations (segmented per month) by comparing the lockdown phase (March 2020-May 2020) and post-lockdown phase (June 2020-June 2022) with the pre-pandemic period the patients living in deprived and non-deprived neighborhoods.

Results

Analyzing a total of 759,863 mental health consultations showed that during the lockdown phase of COVID-19, less mental health problem consultations were observed than pre-pandemic. This decrease was not significant for patients from deprived neighborhoods, but the decrease was significant for patients from non-deprived neighborhoods, RR = 0.990; 95%CI=0.934-1.051 and RR = 0.918; 95%CI=0.885-0.953 respectively. Conversely, the number of post-lockdown phase consultations for patients in deprived neighborhoods was significantly increased compared to pre-pandemic levels (RR = 1.074;95%CI=1.002-1.152), but not for patients in non-deprived neighborhoods (RR = 1.000; 95%CI=0.959-1.043). This increase in post-lockdown phase consultations in deprived neighborhoods can be explained by the higher frequency of consultations per patient.

Conclusions

Consistently over time, demand for GP mental health care was and remains higher among patients from deprived neighborhoods, with an increase in post-lockdown consultations. Sufficient access to primary health care should be guaranteed to ensure treatment of mental health problems for social-economic disadvantaged groups.

Key messages

• Socioeconomic status has a negative sustainable impact on demand for mental health consultations in deprived neighbourhoods.

• To ensure the treatment of mental health problems for social-economic disadvantaged groups, sufficient access to the primary health care should be guaranteed at all times.
Strengthening Equity, Diversity, and Inclusion in medical education via an intersectional approach
Authors: Hunting G , Hankivsky O
Published: October 2024

Background

In the wake of COVID-19, equity, diversity, and inclusion (EDI) policies have been taken up in the health field, yet the actual impact of these initiatives, particularly for multiply marginalized individuals, is debated. Despite progress in areas such as diversity promotion, EDI has been critiqued as superficial and as failing to challenge the drivers of health inequity. This presentation discusses how an intersectionality-informed approach can help harness the transformative potential of EDI.

Methods

This research is informed by a literature review of EDI initiatives in the health field, and is an offshoot of a 4.5 year international project funded by the Canadian Institutes for Health Research focused on evaluating and strengthening intersectionality-informed policy guidance.

Results

There is a disconnect between EDI commitments and substantive action on health inequities and an intersectional approach can help bridge this divide. We demonstrate this with a case example which brings an intersectional approach to EDI initiatives in medical education - including bias trainings, courses on the social determinants of health, and the engagement of community groups. Drawing on promising equity promoting work across these areas, we show how intersectionality can harness the potential of EDI by bringing to the fore what has often been missing, including the promotion of health stakeholder reflexivity, attention to interacting systems and structures shaping health, and meaningful engagement with underrepresented communities.

Conclusions

An intersectionality-informed approach to EDI has the potential to enhance the health equity impacts of initiatives within medical education and the broader health field.

Key messages

• EDI initiatives in health often have limited impact on health inequities.

• An intersectionality-informed approach to EDI can help health stakeholders drive transformative action on health inequities.
Determining the trauma levels of individuals living in temporary housing after an earthquake
Authors: Baran A , Sülü M , Kekilli C , Boz G , Özer A
Published: October 2024

Background

Earthquakes cause many deaths and injuries in the region in which they occur. In addition, earthquakes can lead to significant mental health among survivors living in affected areas. The aim of this study is to determine the trauma levels of people living in temporary housing after an earthquake.

Methods

This descriptive cross-sectional study was conducted between September and December 2023. The target population consisted of people living in temporary housing, with a sample size of 260 people. Data were collected from a questionnairerelated to sociodemographic and earthquake experience status as well as the Post-Earthquake Trauma Level Determining Scale (PETS). The dependent variable in this study was the total PETS score, and the independent variables included age, being trapped under debris, and experiencing the loss of a loved one. The Student’s t-test and a one-way ANOVA were used in the statistical analyses.

Results

In the research group, 35.4% of the participants reported a job loss and 34.2% reported the loss of relatives. The mean total PETS score was 56.13±16.87. The total scores of individuals who were trapped under debris, lost first-degree relatives, and lost their jobs were significantly higher than others (p < 0.05). In addition, individuals whose houses were destroyed due to the earthquake had significantly higher total PETS scores (p < 0.05). Of the individuals who participated in the study, 88.8% stated that they did not receive psychosocial support after the earthquake.

Conclusions

In the study group, trauma levels were higher among individuals who experienced the loss of a home, job, family members, and relatives due to the earthquake. Alarmingly, more than three-quarters of the participants did not receive psychosocial support after the earthquake.

Key messages

• All individuals housed in temporary settlements after an earthquake should be evaluated in terms of trauma, and psychosocial support should be provided according to risk groups.

• The trauma experienced by individuals who lost their homes and jobs after the earthquake should be reduced by making plans such as providing shelter and job opportunities as soon as possible.
Implementing mental health quality practices for vulnerable populations in five EU countries
Authors: Bempi V , Karnaki P , Zota D , Jarke H , Kulish T , Kusnierkiewicz A , Purvēna G , Enache A , Del Savio E
Published: October 2024

Issue

Mental ill-health has been a leading cause of disability in Europe for many years, with the COVID-19 pandemic increasing incidences of both poor mental health and mental disorders. Vulnerable groups such as children, migrants, individuals with existing mental health issues, and healthcare workers are particularly affected but often lack tailored mental health support.

Description of the problem

The MENTALITY project aims to alleviate mental health distress worsened by the COVID-19 pandemic focusing on vulnerable groups. It also involves developing capacity-building tools and disseminating research results to increase awareness and knowledge sharing. Five EU countries are currently piloting four distinct good practices to address mental health issues among vulnerable populations. Specifically, Poland is aiming to support migrants (including Ukrainian and Spanish-speaking populations), Latvia is focusing on the healthcare workforce, and Romania and Slovakia are concentrating on users and community services. Meanwhile, Greece and Slovakia are implementing initiatives for children. The implementation phase began in January 2024 with a duration of 6 months.

Results

By consulting with relevant stakeholders, a Situation Analysis and Needs Assessment framework has been conducted, allowing for informed decisions regarding the elements to be pilot. Partners have developed country specific piloting plans and external evaluators are leading a common framework for monitoring and evaluation, ensuring regular assessment of the project’s progress.

Lessons

The innovative MENTALITY project aspires to enhance community-based mental health systems and promote improved mental health services across EU Member States during crises by adopting a preventative approach. Preliminary results show that the initiatives within the project were much needed and have already begun to demonstrate promising outcomes in addressing mental health challenges at both individual and community levels.

Key messages

• The MENTALITY project aims to address mental health distress of vulnerable populations in times of crisis.

• The project seeks to advance equality in health and social rights for all individuals living in the EU.
Needs assessment to design a multidisciplinary training programme within the EU-PROMENS project
Authors: De Zeeuw J , Rupppa F , Klymchuk V , Königstein H F , Shields-Zeeman L , Bolinski F , Marinetti C , Sanna L , Zuljevic-Salamon T
Published: October 2024

Background

Mental health as a public health issue warrants a comprehensive prevention-oriented approach whereby capacity building as well as a multisectoral and life-course approach are crucial. The ‘Capacity-building on mental health: multidisciplinary training programme and exchange programme for health professionals,’ project enhances and improves the capacity of professionals across Europe in the field of mental health. Various professionals are targeted 1) health professionals working in the mental health sector, 2) teachers and educators working in the educational setting, 3) social workers working in various community settings and 4) prison staff.

Objectives

To understand the needs, gaps, obstacles in capacities, competencies, and to build upon existing programmes a mixed methods study, adopting a convergent parallel design is conducted to design and develop the programme. First, a literature review is conducted complemented with interviews, focus group discussions and a survey among various stakeholders to enrich the data. The training will be piloted in The Netherlands, Spain, Czech Republic, Croatia, Finland and Austria. Thereafter it will be rolled out in the 21 remaining EU countries as well as in Norway, Iceland and Ukraine.

Results

Various gaps and competencies identified from different perspectives build a solid fundament for a comprehensive multidisciplinary training programme tailored to the needs of various professionals within the mental health arena. Preliminary results show that 98 multidisciplinary training programmes exist, with about half containing training materials and limited reports on evaluation.

Conclusions

The comprehensive needs assessment will assure a multidisciplinary training programme is suitable and relevant for various professionals to ensure a well-designed capacity-building programme.

Key messages

• Various gaps and needs among various professionals exist.

• A comprehensive study strengthens alignment of training to needs and gaps among various professionals.
Exploring the association between cyberchondria and attention to negative information
Authors: Xu R , Lin Y , Sun R
Published: October 2024

Objectives

This study aimed to preliminarily evaluate the relationship between cyberchondria and attention to negative information.

Methods

The data utilized for this analysis was obtained from a cross-sectional and web-based survey conducted in China between March and April, 2024. All participants were recruited from an online panel belonging to a survey company. Cyberchondria was assessed using the Chinese version of the Cyberchondria Severity Scale - 12 item (CSS-12). Attention to negative information was measured using the negative subscale of the Attention to Positive and Negative Information Scale (APNIS). A multivariable linear regression model was employed to evaluate the relationship between cyberchondria and attention to negative information.

Results

Out of 344 participants, 315 (91.6% response rate) completed the questionnaire and provided valid responses. Approximately 51.7% (n = 163) were female, 83.8% (n = 264) had completed tertiary or higher education, and 52.7% (n = 166) were urban residents. The average age was 32.6 years (SD = 6.0). The mean score for CSS-12 was 40.6 (SD = 7.8, range: 18-59). The mean scores for the different dimensions of the CSS-12 were: excessiveness, 10.6 (SD = 2.4); distress, 10.3 (SD = 2.7); reassurance, 10.6 (SD = 2.5); and compulsion, 9.1 (SD = 2.7). The mean score for the negative subscale of APNIS was 31.9 (SD = 8.6, range = 12-52). Multivariable linear regression models revealed a statistically significant relationship between cyberchondria and attention to negative information (beta = 0.42, p < 0.001), after adjusting for background characteristics.

Conclusions

Our findings showed individuals with a higher level of cyberchondria tend to pay more attention to negative information. Therefore, it’s beneficial to develop strategies and interventions that provide accurate, balanced online health information and educate individuals about the risks of excessive online health searches.

Key messages

• Our findings showed individuals with a higher level of cyberchondria tend to pay more attention to negative information.

• It is beneficial to develop strategies and interventions that provide accurate, balanced online health information.
WeCare – Mental healthcare for health professionals
Authors: Sturm N , Goldberg J , Djokic G , Dagnino F , Klapa L , Kretschy S
Published: October 2024

Issue/Problem

Health professionals face physical and mental stressors (risk factors) due to challenging working conditions.

Description of the Problem

Despite high levels of health literacy among healthcare workers, maintaining healthy habits is challenging due to variable shifts, including nights, high workloads, and intense emotional and mental demands. Adopting a healthier lifestyle requires personal changes that can be difficult to implement, particularly in nursing and caregiving. This is critical, as retaining and attracting new staff in these fields is essential for the healthcare sector.

Results/Effects/Changes

To address these challenges, it’s crucial to boost intrinsic motivation and provide healthcare workers with practical tools to support their well-being and encourage them to remain in the sector. The WeCare project offers a mobile app designed as a ‘pocket coach,’ accessible at any time. Healthcare professionals can use the app to assess their current mental well-being through self-evaluation. With built-in assessments and predefined thresholds, the app tracks stress levels and quality of life. Depending on the outcomes, users are automatically guided to appropriate information, gamified activities, and exercises tailored to their specific needs. The project, running from 2022 to 2024, is co-funded by the European Union’s Erasmus+ programme.

Lessons

The app is beta-tested during 2024 in five countries: Germany, Austria, Serbia, Poland, and Italy, with local language support. The test group will consist of healthcare professionals and related professions. The results, including user engagement and motivational factors are analyzed. As the project concludes in autumn, comprehensive recommendations and lessons learned will be compiled and presented at the European Public Health (EPH) Conference. This will also include sharing the app and its solution with the broader healthcare community.

Key messages

• The WeCare app supports healthcare workers’ mental health with a mobile “pocket coach” that provides personalized exercises. Through gamification, it promotes healthy habits and boosts job motivation.

• It is critical to support healthcare workers, as retaining and attracting new persons is essential for the healthcare sector.
“Ajudar” – a practice with people with mental disorders treated with long-acting injectables
Authors: Cabral Ferreira M , Magalhaes C M , Silva F , Basto F
Published: October 2024

Issue

Mental Health problems are one of the main causes of disability and morbidity. We think it is pertinent to intervene, providing special care for people with mental disorders and their families. We developed the project “Ajudar” (“To Help”), in a municipality in Northern Portugal.

Description of the problem

“Ajudar” started in 2013. Its main goal is to contribute to reducing the impact of mental disorders. Its objectives are to identify people with mental disorders treated with long-acting injectables (LAI) and to promote treatment adherence. We identified the Health Units (HU) where these patients take the medication and verified their compliance. An informatic alert was issued when there was non-compliance and we participated in home visits when patients did not show up. We also checked the situation if there was involuntary treatment. We wanted to know if this practice contributed to treatment compliance and to reduce involuntary treatment.

Results

We gradually identified more people, from 47 in 2013 to 108 in 2024. In 2013, 7 people with mental disorders treated with LAI had an involuntary treatment, whereas in 2019 it was 4. We didn’t analyze data from 2020 to 2022, due to the COVID-19 pandemic. We don’t have the complete data from 2023 yet.

Lessons

Within the years of “Ajudar”, there was a more than twofold increase in the identified patients and a reduction of almost fourfold of the patients that had an involuntary treatment. Analyzing these data one must be careful due to small numbers bias. We think that a similar project is feasible in other settings. In our response to this Public Mental Health issue, we collaborated with everyone involved with these patients, from health profissionals to resources in the community (social services, community leaders, etc).

Key messages

• There was a decrease to almost ¾ in the number of patients that had an involuntary treatment.

• Involvement with the community is key.
“Do not forget about us.” A systematic review of needs and unmet needs in dementia care in Europe
Authors: Mercogliano M , Sorrentino M , Fiorilla C , Esposito F , Stilo I , Triassi M , Palladino R
Published: October 2024

Background

In Europe, the prevalence and costs of dementia, including Alzheimer’s disease, are rising due to demographic changes. The care provided does not adequately address the needs of stakeholders involved. This systematic review aims to identify the needs, and unmet needs in European dementia care, thus providing a comprehensive framework to improve dementia care services.

Methods

Our inclusion criteria, adhering to PRISMA guidelines, include studies published from 2013 to 2023, and addressing needs and unmet needs of persons living with dementia, caregivers, and dementia care professionals. Risk of bias was evaluated using the Mixed Methods Appraisal Tool.

Results

From an initial pool of 3738 articles, 48 studies meet inclusion criteria. Caregivers express need for support, notably in psychological and logistical assistance, in managing daily errands and healthcare tasks, and to navigate healthcare system, exacerbated by the stress and isolation during the COVID-19 pandemic. Persons living with dementia face challenges in social inclusion due to the lack of public understanding and community-based care. Dementia care professionals emphasise need for more training and resources to manage dementia effectively, with a recent shift towards the necessity for telehealth competencies. Furthermore, caregivers from ethnic minorities highlight the importance of culturally sensitive healthcare access to overcome cultural and language barriers.

Conclusions

Educational resources, broaden community support, clear information about available care services, and public understanding of dementia were the most commonly expressed unmet needs. Addressing these needs within the dementia care network is crucial for better service integration and improving the quality of life for all stakeholders involved. Future research should focus on developing strategies to address the unmet needs, ensuring robust support for the increasing number of individuals affected by dementia.

Key messages

• Care dementia effectively needs more resources, training, and a culturally sensitive healthcare access to ethnic minorities.

• People living with dementia and caregivers need psychological and community-based support, social inclusion, clear information about available care services, and public understanding of dementia.
Abstract Strengths and difficulties Lithuania
Authors: Balukonytė A E , Stankevičiūtė E , Jakubauskienė M
Published: October 2024

Background

Most mental health disorders begin before the age of 18, peaking at 14.5 years (Solmi, 2022) and manifest as emotional and behavioural difficulties that are more frequent in institutional social care (ISC): former foster care recipients have higher rates of depression and PTSD than the general population (Pecora, 2009). The rate of children living in residential care facilities in Europe and Central Asia is double the global average (UNICEF, 2024). This study aims to assess and compare the mental health of children in ISC centers and regular high schools.

Methods

A cross-sectional study was conducted in ISC centres and high schools in 2022-2023. The sample size consisted of children aged 11-17 living in ISC (n = 49) or in families (n = 193). Online anonymous survey was applied to assess the prevalence of endured violence, substance use and measure mental health outcomes using the Strengths and Difficulties Questionnaire (SDQ-25).

Results

A total of 242 respondents (age mean 14.6, SD = 2.12) in ISC and families showed similar poor mental health rates (42% and 44%, respectively). Prosocial behaviour problems were exhibited more by boys (p < 0.05), whereas emotional symptoms were more common in families (p < 0.001): 90% normal SDQ-25 scores in ISC vs 60% in families. Enduring psychological (38% vs 60.2%) violence was more prevalent among children in families (p < 0.05); smoking - in ISC, alcohol use - in families (p < 0.05). In both groups enduring physical violence was associated with smoking and alcohol use (p < 0.05), and overall poor SDQ-25 results strongly correlated (p < 0.001, r = 0.815, r = 0.610, respectively) with hyperactivity.

Conclusions

A significant part of study participants reported poor mental health outcomes with most problems in relationships with peers. Mental health risk factors such as violence or substance abuse are associated with poor emotional wellbeing while being more common among children living with families.

Key messages

• Children living in ISC and in families demonstrate similar level of mental health problems.

• Varying prevalence of substance abuse among children living in different settings highlights the importance of environmental factors when addressing the issue.
Sense of community, life satisfaction and psychological distress among seniors – HUNT4 study, Norway
Authors: Haugan T , Bojanic I
Published: October 2024

Background

Strong sense of community with one’s neighbors may benefit psychosocial well-being. Moreover, local communities with high level of belonging and social cohesion can have a positive impact on public mental health. This study aims to investigate associations between sense of community and life satisfaction - at both an individual and local community level in a Norwegian county.

Methods

Data from Trøndelag Health Study 4 (HUNT4: 2017-2019) on 22 939 participants were linked to geographic data of residence from Statistics Norway. The basic statistical unit in Norwegian, known as “grunnkrets,” serves to identify participants’ local communities. These units are subdivisions of municipalities, covering geographically contiguous areas that typically include a few hundred inhabitants. This population-based study enables investigation of variation in sense of community, trust, life satisfaction and psychological distress on individual and community level.

Results

Seniors (median age 70.3 years) with strong sense of community with their neighbors had more than three times higher odds (95%CI 3.08-3.93) of high level of life satisfaction and less than 0.3 times lower odds (95%CI 0.26-0.33) of psychological distress symptoms vs those with low sense of community, adjusted to sociodemographic variables. The average sense of community varied between local communities (N = 284). At this local geographical unit, strong sense of community was associated with high level of trust, enjoying the neighborhood and high life satisfaction.

Conclusions

The study can inform public health policy to consider development of social infrastructures that bolster sense of community among seniors within neighborhoods. Policy and action plans targeting to increase the overall sense of community in neighborhoods may contribute to create mental health-promoting and age-friendly local communities in Norway.

Key messages

• At individual level, sense of community with neighbors are associated with life satisfaction and psychological distress among Norwegian seniors.

• The average sense of community varies between geographic local areas and are associated with level of trust, enjoying the neighborhood, average life satisfaction, and psychological distress.
Focus on residents’ mental health: the Public Health Residents’ Anonymous Survey in Italy (PHRASI)
Authors: Caminiti M , Cedrone F , Stacchini L , Gianfredi V , Minutolo G , Berselli N , Sabato M , De Nicolò V , Ancona A , Catalini A
Published: October 2024

The ‘Public Health Residents’ Anonymous Survey in Italy” (PHRASI) represented the first study to specifically investigate mental health and its determinants among Italian public health residents (PHRs). Using a voluntary, anonymous, electronic, 88-item questionnaire, the PHRASI study generated evidence on well-being, eating disorders, sleep disorders, alcohol abuse, depressive symptoms, and anxious symptoms among PHRs. This highlights the correlation with sociodemographic, lifestyle, and work-related characteristics during COVID-19 pandemic. The data was collected in a nationally representative sample of PHRs enrolled in any of the four course years of Italian Public Health schools. The recruitment took place through the communication channels of the Medical Residents’ Council of the Italian Society of Hygiene and Preventive Medicine in the summer 2022. The key findings reveal prevalence rates of mental health conditions comparable to those seen in other healthcare workers during the COVID-19 pandemic: 61% of residents report depressive symptoms and 36% report anxious symptoms. The study also highlights a negative correlation of these symptoms with characteristics of the training and working environment, such as the level of supervision and peer-to-peer support. A stronger social network and higher levels of physical activity emerged to be positively associated with well-being and depression. These and other findings will be available in the final report of the survey that will be presented during the congress. PHRASI led the way to the Residents’ Mental health Investigation, a Dynamic longitudinal study in Italy (ReMInDIt), that aims to explore potential cause-effect relationships between risk/protective factors and mental health outcomes. This evidence could guide the scientific community, school directors, universities, and policymakers in the continuous process of improving the educational quality and working conditions of PHRs.

Key messages

• Residency training and work environment impact the mental health of the PHR workforce.

• It is important to deploy concrete efforts into building healthy work environments and guarantee adequate training for PHRs.
Population trends and demographic disparities in sexual identity in Stockholm County, 2010 to 2021
Authors: Zhang G , Tynelius P , Mathur M B , Brandén G , Liljeros F , Kosidou K
Published: October 2024

Background

Sexual identity, linked to experiences of disadvantage and discrimination, is crucial in equality monitoring. Sweden’s gender-neutral marriage laws, introduced in 2009, provide a unique context. This study examines the population trends and demographic disparities in sexual identity over time.

Methods

We analyzed three population surveys (2010, 2014, 2021) from the Stockholm Public Health Cohort, including around 50,000 individuals per survey. Sexual identity was assessed via self-administered questionnaires. Demographic data were sourced from Swedish national registers. Weighted multivariate Poisson regression with robust variance estimators was used to identify demographic disparities in sexual identity. Results were presented as proportion ratio (PR) with 95% confidence interval (CI).

Results

Overall, 29,607 (2010), 20,249 (2014), and 22,558 (2021) individuals reported sexual identity. Heterosexual identity decreased from 95.7% (95% CI 95.4-96.0%) in 2010 to 89.0% (88.5-89.4%) in 2021, while bisexual identity increased from 1.4% (1.2-1.6%) in 2010 to 2.0% (1.8-2.3%) in 2014, and further up to 2.7% (2.4-2.9%) in 2021. Homosexual identity increased slightly from 1.5% (1.4-1.7%) in 2010 to 1.8% (1.6-2.0%) in 2021. Multivariate analyses showed that female, older age, and lower education were inversely associated, while never-married status and living alone were positively associated, with homosexual identity. In contrast, female, younger age, lower income (100 SEK/year) ( < =2,500 vs > 4,500: 2010: PR 3.32 [95% CI 1.92-5.75]; 2014: 1.83 [1.28-2.60]; 2021: 1.51 [1.14-2.01]), and never-married status (never vs currently married: 2010: 2.03 [1.47-2.80]; 2014: 1.92 [1.39-2.65]; 2021: 1.50 [1.15-1.95]) were positively associated with bisexual identity.

Conclusions

Heterosexual identity decreased while homosexual/bisexual identities increased in Stockholm County during 2010-2021. Socioeconomic disparities persist in sexual minorities and vary by sexual identity.

Key messages

• Marked socioeconomic disparities persist in sexual minorities and vary by sexual identity in Stockholm County, although income and marital status disparities in bisexual group seem narrowing.

• Future studies are warranted to investigate the social dynamics that continue to produce sexual minority disadvantages.
Alcohol consumption and risky sexual behaviours: consistent patterns in France and South Korea
Authors: Jeong J , Simmat-Durand L
Published: October 2024

Background

Despite the concurrent increase in harmful alcohol use and risky sexual behaviours associated with STIs and HIV/AIDS among young adults, their relationship remains inconsistent due to the inherent influence of sociodemographic and cultural factors on drinking and sexual practices. This study aims to examine the relationship between alcohol consumption and risky sexual behaviours and cross-validate this relationship in France and South Korea.

Methods

We conducted a cross-sectional survey among young adults aged 18 to 30 in France and in South Korea in 2023-2024 (n = 998; 489 in France, 509 in Korea). A spearman partial correlation and a z-test on Fisher-transformed correlation coefficients were used to determine the relationship between alcohol use and risky sexual behaviours, as well as the consistency of this relationship across both samples.

Results

After controlling for age, gender, occupation, education, and perceived socioeconomic status, a positive correlation was found between the age of alcohol initiation and the age at first sexual intercourse in both samples (r=.17 in France, r=.28 in Korea; p < 0.001). Alcohol Use Disorder Identification Test (AUDIT) score and the frequency of drunkenness showed positive correlations with the number of sexual partners (r=.19, r=.26 in France; r=.19, r=.23 in Korea; p < 0.001). These two alcohol use indicators were also correlated with the frequency of inconsistent condom use (r=.15, r=.12 in France; r=.06, r=.14 in Korea; p < 0.001). The Z test confirmed that there is no significant difference in all correlation coefficients between the French and Korean samples. (p > 0.05, 95% CI).

Conclusions

An integrated health intervention aimed at simultaneously addressing harmful alcohol use and risky sexual behaviours is warranted to prevent high prevalence of sexually transmitted infections among young adults.

Key messages

• Recent data support that alcohol use is associated with risky sexual behaviours among young adults.

• This relationship is consistent regardless of different sociodemographic and cultural settings.
Integrated care in the Baltic states over a 5-year period: progress, challenges and future directions
Authors: Scarpetti G , Shuftan N , Polin K , Struckmann V
Published: October 2024

Person-centered, multidisciplinary care is key to addressing evolving complex health needs. In Estonia, Latvia, and Lithuania, this pursuit of integrated care has gained momentum as an innovative approach to allocate resources more efficiently and improve patient outcomes. This study investigates the progress of integrating care in the Baltic countries from 2019 to 2024. It details key learnings, particularly for small European countries with limited resources. The Health Systems and Policy Monitor Network of the European Observatory on Health Systems and Policies undertook a cross-country study to better understand the progress in care integration in the Baltics. The Network’s Baltic country experts completed a 21-item questionnaire on the adoption of integrated care reforms. Responses were analyzed to capture reform characteristics and commonalities, countries’ political environments and their conduciveness to the uptake of integrated care. Country-specific experiences with the implementation of integrated care were further explored via case studies of pilot programs over the five years. The pace of implementing integrating care reforms varied in each country. Existing regulatory barriers, workforce challenges and payment schemes have impeded integration efforts across health and social care. Despite these obstacles, the political commitment to new and innovative service delivery and collaboration for chronic care management underscores an important prerequisite toward achieving more integrated and person-centered healthcare. The three case studies illustrate the hurdles that come with shifting care settings and expanding roles for some workers. Findings stress the role for integrated care to address organisational challenges in the Baltics. This study highlights innovative approaches and long-running efforts to provide multidisciplinary care for complex-needs patients and the implications of their results for broader health system adoption.

Key messages

• Small countries like the Baltics face structural challenges in integrating care to improve outcomes and efficiency.

• Investment and innovative care approaches are key to further advancements.
HPV vaccination in Croatia (2016-2023): Increased vaccine uptake and declining sex disparities
Authors: Raic L , Pavic Simetin I , Bradasevic E , Jezidzic A , Nemeth Blazic T , Poljicanin T
Published: October 2024

Background

The Human papillomavirus (HPV) is a known cause of cervical cancer, and is associated with the development of vaginal, vulvar, anal, penile, and head and neck cancer. The availability of the HPV vaccine has enabled generations of young people to be protected from HPV-related cancers. In 2016, a national immunization program targeting 14-year-old girls and boys has been initiated in Croatia. To date, systematic data on HPV vaccination coverage (VC) in Croatia is lacking. This study aims to determine HPV VC, examine trends in HPV vaccination in Croatia from 2016 to 2023 in the context of the national vaccination program, and assess differences between sexes.

Methods

The study is designed as a retrospective analysis covering the data from 2016 to 2023, collected from primary healthcare providers. HPV VC within 2000-2008 birth cohorts (BC) are analyzed for all vaccinated with at least one dose and assessed by sex. The trend in HPV vaccination is shown using joinpoint regression. The chi-square for trend is used to compare the vaccination coverage of females (FVC) and males (MVC). The rate ratio between FVC and MVC is calculated.

Results

HPV VR increased significantly among observed BCs from 6,44 % in 2000 BC to 44,22 % in 2008 BC (FVC rose from 10,67 % to 52,78 %, and males MVC from 2,47 % to 36,05 %). Joinpoint analysis revealed a statistically significant increase in all birth cohorts, while the steeper increase is seen in 2000-2006 BCs (APC = 35,47, P < 0,05) than in 2006-2008 BCs (APC = 13,93, P < 0,05). FVC is significantly higher than MVC in all birth cohorts (Extended Mantel-Haenszel chi-square for linear trend = 809.23, P < 0,001). The highest FVC/MVC rate ratio was observed in the initial 2000 BC (4,31), and the lowest in the last 2008 BC (1,46).

Conclusions

In Croatia, HPV VC continuously increases among observed BCs. The positive trend is present in both sexes, and the rate ratio between female and male cohorts is decreasing.

Key messages

• The study presents a systematical overview of HPV vaccination coverage in Croatia from the beginning of the national immunization program, which is crucial for monitoring progress.

• In the following years, if the revealed trends persist or advance, Croatia could be closer to reaching Europe’s Beating Cancer Plan concerning eliminating HPV-related diseases.