bluuebunny/crossref_metadata_2025 huggingface dataset:
Potential Health Effects of Loneliness in the Pandemic Era
Authors: Banerjee S , Burkholder G , Szirony G , Sana B
Published: October 2021

Background

COVID-19 has posed a public health problem leading to considerably higher healthcare costs in the U.S. population. Additionally, social connectedness has been demonstrated to be directly correlated with improved disease management and outcome of treatment. The purpose of the current study was to explore 10-year mortality outcomes of loneliness.

Methods

We assessed data from the 1999-2008 National Health and Nutrition Examination Survey, with mortality data obtained through 2015. All individuals from this nationally representative study were 20 years and older. Hazard ratios with 95% confidence intervals (CIs) for all-cause and cardiovascular disease (CVD) mortality were estimated using Cox Regression models.

Results

Out of 994 participants (54% females vs. 46% males) with loneliness, 324 deaths were reported (including 71 CVD deaths) during an average of 10-year follow-up. The hazard ratio for mortality among those experiencing social isolation was 1.28 (95% CI = 1.17-1.39). The adjusted HR for all-cause mortality [1.24 (CI 1.12-1.38, p < 0.05)] and CVD mortality [1.31 (CI 1.09-2.56, p < 0.05)] were significant, after additional adjustment for demographic and health risk factors. There was also an increase in COVID-19 related loneliness search behavior.

Conclusions

Individuals who experience loneliness have a significantly higher likelihood of overall and CVD-mortality than those who are socially connected. Consequently, addressing loneliness in the face of social distancing and isolation may contribute to lower premature death risk and improve CVD-mortality in this vulnerable population.

Key messages

Loneliness may longitudinally lead to increased mortality from cardiovascular disease. Future public health interventions should incorporate active efforts to address loneliness.
Data Stewardship. A new health profession for findable, accessible, interoperable and re-usable data
Authors: Döhla C , Dierkes J , Zeeb H
Published: October 2021

Issue

In longstanding tradition of Public Health exists a tension between different stakeholders. Consensus about policies and practices is required to cope with the challenging transformation that results from digitalisation. For health systems, this means a new ‘way of digital thinking', especially in research data management (RDM). In Germany, NFDI4Health, an upcoming national research data infrastructure has the potential to shape this process. Its aim is making personal and health-related research data more findable, accessible, interoperable, and re-usable (FAIR). This vision is inspired by the German Council for Scientific Information Infrastructures.

Description of the problem

Health-related research data are sensitive and related to several legal restrictions. Therefore, it is particularly necessary to accompany these ‘living data bodies' during their entire life cycle. Due to various opt-in or opt-out models, access and re-use may change during and after the studies. This could only be circumvented by an unlimited, irrevocable and non-purposive approval by the data donor. The consequence is a tension between individual needs and the requirements of research.

Results

“Data Stewards” (DS) operate within a Task Area of NFDI4Health. In this context, they act as ‘agents of change' and as ‘boundary spanners' in a complex intervention; they tare individual and societal, legal and technical aspects in the field of research. A preliminary success of NFDI4Health is the integration of a DS in selected projects of a centre for clinical trials. The first milestones were to sensitize the study directors to the benefits of this intervention and to formally involve the DS.

Lessons

The concept of DS embedded in NFDI4Health is innovative and could serve as a model for Public Health worldwide. Clinical trials require tailored RDM, which can be provided by DS. They have the potential to integrate individual and social aspects to make “health-related big data” FAIR.

Key messages

Data Stewardship is an up-coming supporting profession for Public Health, which can help to create a “Big Picture” for more health in all policies. Data Stewardship is facing the task to handle health-related big data and to guide researchers in this field to adapt their techno-ethical work practices in the context of the digital transformation.
Exploring age-sex-specific all-cause mortality in Russia using the RLMS-HSE cohort study data
Authors: Egorova A , Soshnikov S , Otstavnov S
Published: October 2021

Background

Russian Longitudinal Monitoring Survey of the Higher School of Economics (RLMS-HSE) presents a series of annual representative surveys that include questionnaires and a particular module relating to observed individual mortality over 1994-2019.

Methods

All calculations were made in statistical software ‘R-studio'. The analysis includes the descriptive statistics, corresponding figures, and Kaplan-Meier survival analysis, and plots.

Results

Four thousand nine hundred forty-two death cases (1372 females, 1978 males) in 32023 households and 150335 individuals who participated in the RLMS survey over 1994-2019 explored. Most deaths were observed after age 66, while the number of deaths before age 75 among men was prevalent around twice that among women. The mean death age 66.4±18.7 (SD) years, while among females, 73.8 ±17.1 (SD) and 60.8±17.8 years for males. The median time to death among females was 89 years (95% CI: 89-89) and for males 85 years (95% CI: 85-86).

Conclusions

Death numbers because of stroke are around the same among males and females. Deaths due to cardiac and neoplasms prevailed in males. Fatal cases due to injuries/accidents among males were more than twice that among females, same for murder/self-murders. The mean death age for cause-related to neoplasm, cardiac, and stroke was around as general population - 66, 69, and 72 years old, and was more than 80 years in senility/old age cause.

Key messages

The official statistics of mortality by Federal State Statistics Service and results getting from surveys are compatible with each other, therefore adequately reflecting the rate of deaths in Russia. Using RLMS-HSE cohort study data can help identify new yet unexplored risk factors, measure and assess their effects on the leading causes of death in Russia.
The national framework for the integrated prevention and management of chronic disease
Authors: O'Brien S , O'Reilly O
Published: October 2021

Due to an ageing population and improvements in healthcare, the prevalence of chronic disease (CD) is rising in Ireland and internationally. In Ireland, CD care is often characterised by siloed, reactive care, culminating in repeated hospital admissions. This is neither patient-centred nor sustainable. Health services need to evolve to meet changing population need. How can Irish health services meet population need in a sustainable way? The National Clinical Programmes (NCPs) in Ireland draw together healthcare professionals from primary and secondary care to improve specific areas within the health service. Public Health Practitioners (PHPs) have been central to the population health approach taken by the NCPs. Over the past decade, an integrated approach to CD care with an emphasis on prevention and population health has been advocated by PHPs, underpinned by a compelling epidemiological case. The use of a generic model of care for the prevention and management of CD, within an integrated approach to service delivery, is associated with positive health outcomes. The “National framework for the integrated prevention and management of chronic disease in Ireland” is a national clinical model that focuses on shifting the vast majority of CD care into the community. The Framework takes a generic approach to the prevention and management of four major CDs: type 2 diabetes; asthma; COPD; cardiovascular disease. It is now being implemented under PHP leadership. The sustained action of many PHPs over the past decade has resulted in the funding of this seminal programme. This project highlights the importance of working alongside Primary and Secondary Care Clinicians in achieving service reform.

Key messages

This Framework provides an integrated approach to CD care and will transform service delivery. PHPs have a central role in the development and delivery of sustainable, evidence-based health services.
Prevalence of metabolic syndrome and its risk factors among Belgian adults
Authors: Leclercq V , Drieskens S , Van der Heyden J
Published: October 2021

Background

Metabolic syndrome (MetS) is a growing public health concern. It is characterized by the presence of at least three of these five risk factors including abdominal obesity, high triglycerides, hypertension, high blood sugar, and low HDL-cholesterol. Individuals with MetS are at increased risk to develop cardiovascular diseases and type 2 diabetes. A better understanding of this syndrome is essential to implement public health prevention actions. The aim of this study is to investigate the prevalence of MetS and its association with risk factors in the Belgian adult population.

Methods

This study was conducted on the first Belgium Health Examination Survey of 2018 among adults aged 18-90 (n = 1184). MetS was defined based on the Revised-Adult Treatment Panel III (R-ATP III) criteria. Association between risk factors (i.e. socio-demographic and health behavior determinants) and MetS was investigated through a multiple logistic regression (adjusted odds ratio (OR) and 95%CI).

Results

Among the 963 participants with complete data (49 ±15yrs, 51.3% men), we observed an overall prevalence of MetS of 30.9% (95%CI: 27%-35%). MetS is significantly associated with older age (OR 10.2; 95%CI 3.6-28.9), low education (OR 2.6; 95%CI 1.2-5.7), an increasing number of chronic diseases (OR 1.3; 95%CI 1.1-1.5) and BMI. ORs for overweight (BMI > 25 kg/m2), obesity (BMI > 30 kg/m2), and severe obesity (BMI > 35 kg/m2) are respectively 3.8 (95%CI 1.9-7.3), 22.6 (95%CI 9.3-54.8) and 65.9 (95%CI 15.9-271.9). No significant associations were found with gender, region, smoking status, alcohol consumption and physical activity.

Conclusions

Our results showed a high prevalence of MetS in the Belgian population. Identifying MetS high risk groups based on the socio-demographic and behavioral determinants is of major importance to establish preventive measures for cardiovascular diseases and diabetes of the Belgian population.

Key messages

The overall prevalence of MetS is almost 31% in the Belgian population. Age, education, overweight, obesity and chronic diseases are factors associated with the presence of MetS.
Comparative analysis of trends in HTA for new INNs in Bulgaria and France
Authors: Serbezova A , Yanakieva A , Zaykova K , Nancheva V
Published: October 2021

Background

Decisions on pricing and reimbursement of medicines are made at national in the context of the country's health system. Although there has been significant progress towards partial harmonization in health technology assessment (HTA) approach in EU member-states, currently HTA process is still country-specific. This fact does not prevent countries to exercise significant efforts for regular improvement/upgrade of their HTA systems, based on health policy's goals, budget, existing good practices in other countries etc. The aim of the current publications is to perform a comparative analysis of the reimbursement systems for medicines in Bulgaria and France.

Methods

The methodology includes comparative analysis based on the assessment of the health technologies in both countries for the period from April.2019 until Sep.2020; sociological

Methods

documentary method and statistical

Methods

graphical analysis.

Results

The number of the HTA reports reviewed in both countries is similar as well as the ratio of approved/non-approved therapies. In both countries the largest share of new medicinal products approved for reimbursement were cancer products and the number of orphan medicines was significant. The main difference is that in Bulgaria there is only one evaluation needed for inclusion in the reimbursement system, while in France two evaluations form the reimbursement level. Some differences regarding reimbursement of hospital use medicines were also found.

Conclusions

The efficacy of systems in both countries is similar as far as the number of approved therapies is concerned. Slight difference in the methods applied was observed.

Key messages

The Haute Autorité de Sante (HAS) is amongst the few HTA decisions recognized and reviewed in Bulgaria which obviously impacted the Bulgarian system and resulted in the observed similarities. Sharing best practices and assessment reports amongst countries facilitate future harmonization of HTA on EU level.
Association between different outcomes of students’ health status, health behavior & health literacy
Authors: Lange M , Loewe A , Schaller A
Published: October 2021

Background

Next to classic full-time studies, a significant part of students of universities of applied (UAS) chooses part-time or dual study formats leading to double burden and higher stress levels. Up to now, the impact of different study formats on student's health status (HS) and health behavior (HB) has not been analysed in the context of UAS comprehensively. Also, the role of health literacy (HL) is not sufficiently investigated (Bai et al., 2019; Krüsmann, 2019; Plotnikoff et al., 2019). The primary aim of the study is to collect associated data on various aspects of HS, HB and HL of UAS students.

Methods

The prospective cohort study collects data on HS, HB and HL every semester from winter semester 20/21 to 22/23. HS is operationalized with stress level (SL), sleep quality (SQ) and life-study-satisfaction (LSS). HB included physical activity (PA), screen-time (ST) nutrition (NU), smoking, drinking and drug-use behavior (SDB); HL was assessed with the HLS-EU-Q16. At t1 n = 295 students (n: ♂=213; ♀=82; age∅=28,8 (SD = 8,49) could be included.

Results

Analysis revealed that all HS-domains correlated significantly with all HL (Range: r=.14** to .31**) and most HB-scores (NU: r=.22** to .35**; ST: r=.15** to .28**). PA correlated significantly with most HS-scores (r=.13** to .29**), but not with HL. Also, no correlations could be found between SQ, SDB and HS, HB and HL. With regard to gender difference, female students show significantly lower SDB (t = 4,38***), higher SL (t=-3,92***) and ST (t = 3,99***). Also, NU (R2 =, 30***; F = 27,21; f2 =, 32) and PA (R2 =, 34***; F = 17.9; f2 =, 37) reveal a strong explanation of variance of HS.

Conclusions

HS, HB and HL are complex dimension of students' health. The results indicate that HL AS a major impact on overall HS, but not necessarily on all HB-scores such as PA. Health promoting interventions should consider these findings on HS, HB and HL and target specific groups with individualized interventions.

Key messages

Health literacy plays an important role in students’ health, but is not linked to physical activity as a health behavior. Student health promotion should be target group specific and focus on different aspects of health behaviours.
Long-term research impact: the case of adolescents having ‘good places to spend free time’ in Ireland
Authors: Nic Gabhainn S , Gavin A , Kelly C , Hanafin S
Published: October 2021

Background

Demonstrating long-term impacts of research can be fraught with methodological challenges, especially when approached retrospectively. Potential accusations of bias or over-interpretation, and a lack of clear and specific causal data, can be real obstacles. This paper presents a case study of research impact, including enablers and context to aid interpretation. To develop a national set of child wellbeing indicators in line with UNCRC commitments, a participative study of children's understandings of wellbeing was undertaken to accompany a Delphi study with experts. The children contributed a number of unique indicators, including having ‘good places to spend free time'.

Methods

Public actions which aimed to meet Irish commitments to child wellbeing were documented. Collected evidence comprised the development of, and reporting on, a national set of wellbeing indictors for children, the development and implementation of two national policies and cyclical monitoring data, collected through the nationally representative data sets of the Health Behaviour in School-aged Children (HBSC) study in Ireland, 2002-2018.

Results

Measurement of stakeholder-informed indicators helped stimulate national policies on play (2004) and recreation (2007). Partnership-based policy implementation led to increases in spaces for play and recreation. Trends data from the HBSC study revealed significant and meaningful increases in ‘good places to go spend free time' for children aged 10-17 from 45.1% in 2002 to 63.5% in 2018, and for all socio-demographic sub-groups. Temporal analyses showed that increases followed policy implementation.

Conclusions

This impact case study links an original participative study, though policy development and implementation, to long-term improvements in Irish children reporting having ‘good places to spend free time'. An understanding of the decision-making context at key points is important to aid interpretation of the evidence under investigation.

Key messages

Commitment to child participation influenced national indicator adoption, policy development and implementation, with subsequent improvements to children’s health-related environments. The quality and specificity of data needed to demonstrate long-term research impact is challenging and interpretation requires contextualisation to avoid leaps of faith.
Information needs in relation to childhood vaccinations in Austria
Authors: Sommer I , Titscher V
Published: October 2021

Background

The internet has facilitated access to health information. However, it remains difficult to locate trustworthy and high-quality health information. Access to trustworthy health information is particulary important for topics that arouse emotions and controversy such as vaccinations. Indeed, results of the European Health Literacy Study show that there is uncertainty about vaccinations in Austria. To address this issue, we aimed to identify the information needs of parents regarding childhood vaccinations.

Methods

The method was based on the current guideline for the development of evidence-based health information of the German Network for Evidence-Based Medicine. To identify the information needs of parents of young children, we conducted an umbrella review and interviews with 13 parents of young children (0-2 years). We used the findings of the umbrella review to inform the topic guide for the face-to-face interviews. The interviews were analyzed using thematic analysis and reflected on in a workshop with the participants.

Results

In terms of content, parents sought information on the function of the immune system, characteristics of diseases, composition of vaccines, benefits and harms of vaccinations, the vaccination schedule and legal regulations. They desired information that is easy to understand, well-structured and neutrally presented. The preferred media were app, brochure and website. Dissemination should take place through various channels, but most importantly during pregnancy, through paediatricians, general practitioners, and via the Internet.

Conclusions

Parents of young children have a wide range of information needs regarding childhood vaccination that goes beyond a simple benefit-harm assessment. The preferred media and dissemination channels are also diverse. Different types of evidence need to be drawn upon for the preparation of evidence-based health information.

Key messages

Parents of young children have a wide range of information needs regarding childhood vaccination that goes beyond a simple benefit-harm assessment. Parents of young children display a range of preferences regarding the delivery of information on childhood vaccination.
Comparison of face-to-face and online mindfulness-based public health interventions for older adults
Authors: Juraga D , Vasiljev V , Bilajac L , Marinović Glavić M , Roviš D , Rukavina T
Published: October 2021

Background

Coping with everyday stress, maintaining well-being and building up personal competencies is essential to handle today's way of living. Additionally, the actual COVID-19 pandemic also impacted the overall health of global population because of reduced social contact and other epidemiological measures. The aim of the study is to compare the effectiveness of two different approaches in conducting mindfulness-based public health interventions focused on quality of life and mental health of older adults as well as their ability to self-manage their health.

Methods

In total, 450 participants aged 65 years and older will participate in the study. Participants will be residents living in the city of Rijeka and the wider urban area consisting of six local municipalities. All engaged participants will be divided into three groups: face-to-face intervention group, online intervention group and control group. Older adults engaged in the face-to-face and online mindfulness-based intervention will participate in a seven-week workshop program base on two existing evidence-based programs: Mindfulness-based Living Programme and The Chronic Disease Self-Management Programme. The study is based on a pre-post-test design which will assess the effectiveness of public health interventions on self-efficacy in health management, social support, stress, depression, sleep, fatigue, medication use, and quality of life.

Results

Research results will provide insight into the difference in effectiveness between two forms of implementation of public health interventions, which can be important in defining health policies regarding quality of life, mental health and health self-management of older adults.

Conclusions

This study will enable policy makers in defining future public health interventions and their adaptation to various epidemiological situations such as the one caused by the COVID-19 pandemic.

Key messages

Mindfulness is known as an efficient tool in maintaining personal well-being. Mindfulness can be an effective tool for improving mental health and resilience even during the COVID-19 pandemic.
Childbearing intentions after a very preterm delivery: a study among Portuguese mothers and fathers
Authors: Alves E , Amorim M , Nogueira C , Silva S
Published: October 2021

Background

Adjustments to intended family size are strongly affected by life-course events, but data on childbearing plans after a very preterm delivery are lacking. This study intends to assess the childbearing intentions of mothers and fathers of very preterm infants, regarding the desired and intended number of children, the factors associated with the intention to have more children and the main reasons for not wanting to have more children.

Methods

Between May and July 2017, mothers and fathers of very preterm infants were invited to participate in a structured online questionnaire through the Portuguese association of parents for support to the premature baby, and 231 mothers and 21 fathers were included. The discrepancy between the ideal and intended number of children was assessed by the McNemar-Bowker test. To assess the main factors associated with the plan to have more children in the future, unconditional logistic regression models were fitted to compute odds ratios (OR) and 95% confidence intervals (95%CI), adjusted for age, number of children and time after the very preterm delivery.

Results

Participants intend to have fewer children than they ideally desired (p < 0.001). Although 69.8% of parents would like to have more children, only 25% actually plan to conceive. After adjustment, participants aged above 34 years (OR = 0.27; 95%CI:0.08-0.86), with more than one offspring (OR = 0.34; 95%CI:0.14-0.69) and who experienced a very preterm delivery 5 or more years ago (OR = 0.28; 95%CI:0.09-0.90) were less likely to report the intention to have more children. The main reasons reported for not wanting to have more children were “having the desired number of children” (38.5%), “financial unavailability” (24.2%) and “being too old to have more children” (20.5%).

Conclusions

This study provides a comprehensive assessment of childbearing intentions after a very preterm delivery, advocating for reproductive counselling policies supportive of family planning.

Key messages

Discrepancy between the ideal and actual childbearing intentions support the enhancement of reproductive healthcare services for family planning. Socioeconomic and age-related constraints were the main motives presented by mothers and fathers of very preterm infants for not wanting to have more children.
Performance-enhancing drugs attitudes among young amateur Croatian athletes
Authors: Miskulin I , Stimac Grbic D , Domacinovic T , Nujic D , Kovacevic J , Miskulin M
Published: October 2021

Background

Recent studies revealed that amateur athletes, especially young ones, have an increasing tendency of performance-enhancing drugs (PEDs) usage. The aim of this study was to explore PEDs attitudes among young, amateur Croatian athletes.

Methods

This cross-sectional questionnaire study was done in convenient sample of young amateur Croatian athletes during the August 2019 to January 2020 at the occupational and sports medicine office in Eastern Croatia. Performance Enhancement Attitudes Scale (PEAS) was used for evaluation of athletes' attitudes towards doping.

Results

There were 306 athletes median age 18.0 (interquartile range (IR) 15.0 - 21.0) years; 62.7% females and 37.3% males. According to the age there were 52.9% of adolescents (aged 13 to 18 years) and 47.1% of young adults (aged 19 to 24 years). Regarding the type of sport there were 19.6% of subjects who played individual sports and 80.4% of them who played team sports. Considering the length of sport engagement 49.7% of subjects were engaged in their sport for 1 to 5 years and 50.3% of them were engaged in their sport for 6 or more years. The prevalence of current PEDs usage was 1.3%, while past PEDs usage prevalence was 3.3%. Current PEDs usage was more frequent among young adults (P = 0.048) and athletes playing individual sports (P = 0.001). Athletes who were engaged in sports for 1 to 5 years had more permissive attitudes toward PEDs (P < 0.001) as measured by the PEAS. The study did not establish any correlation between current or past PEDs usage and attitudes toward PEDs.

Conclusions

PEDs usage is present among young Croatian amateur athletes. There is a need for interventions directed toward the prevention of PEDs usage in an observed subgroup of athletes.

Key messages

In order to be more effective doping prevention strategies should take into account athletes’ attitudes towards doping. Public awareness and knowledge about doping in sports should be increased in order to achieve more efficient anti-doping programs.
Occupational Risk Perception and occupational and work-related diseases prevention
Authors: Madaleno P , Sousa-Uva A
Published: October 2021

Background

It is estimated 6500 daily deaths by occupational diseases with a high social and economic impact. Several studies show that the perception of occupational risks acts as a precursor to preventive attitudes and behaviors of workers. Nevertheless, attention paid to the perception of occupational risks is scarce and even controversial. This study focuses on a model used by behavioral safety programs associating it with the psychometric paradigm, to understand the worker's risk perception of a Portuguese Health Education and Research Institution (Portugal).

Methods

This cross-sectional study covered a total of 84 workers. Of these,73% had a very differentiated academic background (doctorate, and post-doctorate degrees). Workers can carry out their activities in more than one work area.60% work in Research, 49% in the Education, 42% in Laboratories and 47,6% in the General and Administrative Services. Risk perception (cognitive and emotional) was assessed using an online questionnaire that also included sociodemographic and occupational information and perception of exposure to occupational hazards.

Results

95% of participants reported exposure to at least one occupational risk factor, but only 22% perceived the risk (probability of accidents and illnesses associated with the work performed). There was a positive correlation between the perception of exposure to occupational hazards and risk perception (p < 0,001) and that, the greater the perceived risk, the lower the tolerance to it (p < 0,001).While teaching, research and laboratory work is associated with low perception and high-risk tolerance, individual variables such as gender, age, educational qualifications, and professional category did not influence the perception of risk.

Conclusions

Understanding how risk is perceived by workers is determinant for the effective occupational risk management.

Key messages

Occupational risk perception is necessary to prevention of occupational and work-related diseases. Occupational risk perception is determinant for the complementarity of the on-site diagnosis of real work situations and relevant for dynamization of Occupational Health services.
Basic training in “participatory practice” to foster municipal health equity in Germany
Authors: Bär G , Kasberg A , Markert C , Speltz Z , Griebel F , Schaefer I
Published: October 2021

Participation is a key strategy in municipal health promotion and health equity. Short-term trainings for professionals and activists are missing in Germany. Therefore, a curriculum was developed together with experienced health promotion professionals and Public Health scientists.

The course aims at the development of competencies as well as at practical training. Essentials to the curriculum are main principles of participatory approaches, academic and practice-based knowledge on methods of community-based research. The evaluation asked: -Which amount of in-class time and field training is needed?

How can elements of ‘participatory training' be implemented? What support is given to transfer the course contents into practice?

Two pilot series with in sum 25 participants were conducted. This led after evaluation to a five days' curriculum of training, divided on two workshops plus a midterm online-meeting. Training material on participatory approaches and step-by-step-descriptions on six methods were developed. An own practice project is embedded in the program. Experienced trainers introduced the methods and led seminar sessions. Elements of ‘participatory training' were implemented as follows: in the application as teams of two, in telling project stories to introduce new methods, supporting peer-to-peer-reflection and learning from each other. Support was provided through a virtual course platform for the group exchange and individual consulting. After evaluation informal meet-ups and monthly tasks were added to the course. In the pre-pandemic series all teams designed and started own projects.

There is a high need in the field of municipal health promotion to implement community-based participation in Germany. Thus, classes were quickly booked out and evaluation showed a high motivation in working more participatory after the course. The curriculum is going to be published open access. Several health promotion associations are interested in offering the program.

Key messages

There is a high need in the field of municipal health promotion to implement community-based participation in Germany. The curriculum is going to be published open access. Several health promotion associations are interested in offering the program.
Assessment of the level of anti-corruption culture in medical colleges of the Republic of Kazakhstan
Authors: Koikov VV , Derbissalina GA , Akanov AB , Baigozhina ZA , Kabdullina GB , Mergentai A
Published: October 2021

Background

The relevance of the topic lies in the fact that anti-corruption measures in educational institutions today are an acute problem in the education system of the Republic of Kazakhstan. The facts of corruption in the field of education have a destructive effect on the process of training health professionals.

Methods

The study of the level of anti-corruption culture was carried out on the basis of a survey of 13,110 students, 825 teachers and 199 administrators. We have developed 3 types of questionnaires for each category of respondents. The survey was conducted on the SurveyMonkey platform in May-June 2020.

Results

An analysis of the level of anti-corruption culture indicates that the greatest risk of situations in which elements of corruption in college are most common occurs when entering college, passing midterm exams (ratings), and passing final exams and tests. As the main reasons for corruption in college, most respondents point to the low level of teacher salaries, low interest in learning among students. Teachers and administrators give much higher satisfaction with the level of response of the college administration to complaints about corruption and unethical attitudes than the students themselves.

Conclusions

In order to ensure a timely response to the facts of corruption and the formation of an anti-corruption culture, it is necessary to ensure regular feedback from students, questioning of teachers and administrators. Activities aimed at identifying, suppressing and preventing corrupt practices should primarily relate to the process of entering college, passing midterm and final exams.

Key messages

The discrepancy in the assessments of certain categories of respondents indicates the need for regular feedback from students, conducting a survey of college staff. Anti-corruption measures should relate primarily to the process of entering college, passing midterm and final exams.
Sexually Transmitted Infections surveillance among the patient population in Belgian general practice
Authors: Bensemmane S , Vanden Berghe W , De Schreye R
Published: October 2021

Background

In Europe, prevalence of Sexually Transmitted Infections (STI) is continuously increasing. The Belgian public health institute ensures STI surveillance in general practices through the Sentinel General Practitioners (SGP) network. Between 2015 and 2020, the SGP reported cases for 5 STIs: chlamydia, gonorrhoea, syphilis herpes and genital warts. The objective is the surveillance of STI in primary care.

Methods

General practitioners (GPs) report STI cases through the SGP network on a voluntary basis, using an online questionnaire. This questionnaire is developed in cooperation with STI experts, as well as a steering committee group composed of GPs and representatives of regional health agencies.

Results

In total 1009 cases were registered from 2015 until 2020 within the SGP network. 59.8% of patients consulting for STIs were men, of which 63.5% had exclusively heterosexual contacts and 24.8% are Men who have sex with Men (MSM). 91.8% of women had exclusively heterosexual contacts. Chlamydia was the most common STI (57.4%). Women are more likely to be diagnosed with chlamydia (OR 1.6; 95% CI 1.1-2.2) and herpes (OR 1.7; 95% CI 1.0-2.9) than men. Men represented most of the gonorrhoea (79.77%) and syphilis (86.7%) cases. Having bi- or homosexual contacts increases the likelihood of getting gonorrhoea (OR 3.3; 95% CI 2.1-5.1) and syphilis (OR 13.7; 95% CI 7.4-25.3). Incidence of Chlamydia is estimated at 68.81/100000, and incidence of gonorrhoea at 21.11/100000 over 6 years.

Conclusions

We observe a slight increase in chlamydia and gonorrhoea incidence in the Belgian population over the study period. MSM are at higher risk of STI and represent an overwhelming proportion of syphilis cases. Being a woman is associated with higher risk of acquiring chlamydia and herpes infection. We recommend continuing prevention and awareness campaigns targeting high risk groups.

Key messages

MSM and women remain high-risk populations regarding STIs among the patient population of general practitioners. Continuous STI surveillance is necessary to monitor STI related healthcare needs and adapt prevention programs.
Modelling public health policies for influenza vaccination campaigns
Authors: Lopes H
Published: October 2021

Issue/problem

Public health policies (PHP) are crucial for controlling infectious diseases. Namely, those focused on influenza stand out for the permanent threat of seasonal and the risk of pandemic flu. The COVID-19 pandemic revealed many frailties in PHP, part of which may be lessons to improving responses to future flu epidemics and pandemics. Among the tools available to control influenza, vaccination stands out, a matter where much remains to be improved regarding PHP and communication with the public, among others. The Kassianos model (2021) seeks to create a qualitative conceptual tool to optimizing influenza vaccination campaigns, being organized into 5 pillars with 42 categories.

Description of the problem

We seek to take a step forward based on the Kassianos model, making it quantitative. This project is the mathematical modelling and the testing in a country (Sweden). It started in January 2021 and will be completed towards the end of the year.

Results

This work will allow health authorities and similar partners to have a tool to support the optimization of influenza vaccination campaigns in effectiveness and efficiency. The work is expected to be pre-completed in October 2021. The international presentation of results is intended to be simultaneous at the European Parliament and, if possible, at the 14th European Public Health Conference 2021. The results will cover the dimensions of vaccination and relations to VCR:

Campaign accountability Access to vaccination HCP engagement Burden of Disease Awareness Communication with the public

Lessons

It is possible to increase the effectiveness and efficiency of vaccination campaigns through the quantitative modelling of aspects related to influenza vaccination, usually worked as qualitative.

Key messages

It is essential to have PHP as rigorous for supporting public health action. The need for really effective influenza vaccination is critical and must be achieved in the shortest time.
Teacher-rated school leadership and adolescent gambling: a study of schools in Stockholm, Sweden
Authors: Olsson G , Brolin Låftman S , Modin B
Published: October 2021

Background

So-called “effective schools” are characterised by features such as a strong and purposeful school leadership and a favourable school ethos. A prior study showed that a school's degree of teacher-rated ethos was inversely associated with student gambling and risk gambling. Building on these findings, the current study aims to examine the associations that teachers' ratings of the school leadership share with gambling and risk gambling among students in the second grade of upper secondary school in Stockholm (ages 17-18 years).

Methods

Data were drawn from two separate surveys performed in 2016: the Stockholm School Survey (SSS) and the Stockholm Teacher Survey (STS), with information collected amongst 5,191 students and 1,061 teachers in 46 upper secondary schools. Gambling and risk gambling was measured by student self-reports in the STS. School leadership was assessed by teachers' responses to ten items in the STS, which were added to an index and aggregated to the school level. School-level information from administrative registers was also linked to the data. The statistical method was two-level binary logistic regression analysis.

Results

Teachers' average ratings of the school leadership were inversely associated with both gambling (OR 0.96, 95% CI 0.93-0.998, p = 0.039) and risk gambling (OR 0.94, 95% CI 0.89-0.99, p = 0.031) among upper secondary students, whilst adjusting for sociodemographic characteristics at the student and the school level.

Conclusions

The findings lend further support to the assumption that characteristics of effective schools at different levels of the school organisation may reduce students' inclination to engage in health risk behaviours.

Key messages

Teachers’ ratings of the school leadership were inversely associated with student gambling and risk gambling, whilst adjusting for student- and school-level sociodemographic characteristics. The findings indicate that a strong school leadership, being one key feature of effective schools, may reduce students’ inclination to engage in health risk behaviours.
Social media and experiences of maternity care during the Covid-19 pandemic
Authors: Miani C , Leisse A , Wandschneider L , Batram-Zantvoort S
Published: October 2021

Background

Social media offer expecting and new mothers a space to discuss birth-related fears, hopes and experiences. This is particularly the case during the Covid-19 pandemic, which has altered delivery of maternity care. Measures to reduce transmission risk in birth facilities and changes in birth plans are likely to have had an impact on new mothers' experiences of birth and birth care. From a feminist epidemiology perspective, seeking to incorporate more the views of the “researched”, we explored themes discussed by (expecting) mothers on social media, hoping that those real-life concerns would find echo in the design of future research instruments for data collection.

Methods

Using content analysis, we identified key themes in 200+ comments posted on a social media public page as a reaction to the dissemination of a research survey on maternity care during the Covid-19 pandemic in Germany.

Results

In the comments, the most mentioned topics were own mask wearing, having a companion of choice during birth, visiting hours, and the possibility to welcome visitors (e.g. siblings of the newborn, other relatives and friends). Those topics also generated the most reactions, revealing compassion from other women and mixed feeling about health measures (from acceptance to anger). Concerns about quality or appropriateness of care were almost absent from the data.

Conclusions

Social media content analysis shows clearly that women giving birth during the pandemic are most concerned with a specific set of disrupting and potentially upsetting measures. These spontaneous testimonies differ content-wise from what research surveys tend to ask women about (e.g. care standards). Those discrepancies are to some extent inevitable, but integrating more bottom-up generated topics from social media into research instruments could help move forward toward better care.

Key messages

On social media, women were most concerned with own mask wearing, presence of a birth companion and visits from the newborn’s siblings. Social media analysis brings valuable insights into what matters the most to women who give birth during the pandemic and could inform future research developments.
Early diagnosis and management of learning disabilities in children living in rural communities
Authors: Papadakaki M , Lioliou S , Pedioti N , Bitsakos N , Bufachrentin N , Kounali V , Milathianakis G , Papaiosif M , Pisiota S , Servou E
Published: October 2021

Children with learning disabilities have been shown to experience complex emotional and conduct difficulties, poor self-esteem and school refusal due to late diagnosis and inappropriate management. The current project has been conceived in light of the unique circumstances found in Greece, with a tremendous shortage of diagnostic services for learning difficulties in children attending primary schools and a total lack of family support services for the management of these difficulties at home. A university mobil unit was set in mid 2020 with funds raised by the Region of Crete, aiming at diagnosing learning difficulties in children living in remote areas as well as offering tailor-made biopsychosocial counselling to their families, at no cost. Diagnosis is made on the basis of reliable tools (e.g. WISC VGR, etc) by a range of specialised professionals (e.g. child psychologists, speech therapists, nurses, social workers). Children diagnosed with a learning disability receive a personalised intervention plan and a package of educational and counselling services ranging from 8-12 one-to-one tutoring sessions. Preliminary analysis of 68 records indicates 54 children being diagnosed with some type of learning disability. Nearly 40.0% of them were older than 10 years (implying delayed treatment seeking) and 46.3% lived in rural areas (implying service accessibility). Prevalence was higher among males as compared with females (61.1% vs 38.9%). A high prevalence of emotional difficulties was identified in children with learning disabilities (32.4%). Out of 54 children assessed for intelligence level, 8(14.8%) scored very low (70-79units) and 4 (7.4%) scored extremely low (below 69units). Out of the 12 who scored low, 11 were males. Family-centred and community-oriented interventions are necessary for early diagnosis and holistic management of learning disabilities. The project bears useful insight for health policy and health services planning.

Key messages

Early diagnosis and targeted interventions can help children overcome their difficulties. Family-centred interventions are necessary for efficient management of learning disabilities.
Anxiety and depression levels in Malta: A year into Covid-19 pandemic
Authors: Cuschieri S
Published: October 2021

Background

Covid-19 pandemic resulted in a number of lifestyle changes and restrictive measures. The aim was to assess for the impact of Covid-19 on anxiety- depression levels and associated behavioural attitudes among the adult population of Malta.

Methods

An anonymous survey using Google Forms was disseminated on social media (1st to 26th of February), targeting the adult residents of Malta. The survey's questions assessed for socio-demographic characteristics, changes in physical activity levels, and body weight. The Generalised Anxiety Disorder assessment tool was used to evaluate the level of anxiety and the Patient Health Questionnaire-9 assessment tool was used to evaluate the level of depression among the participants during the pandemic. Quantitative and qualitative analyses were performed.

Results

A total of 1,034 participants responded. Mild anxiety levels (41.20% CI95%:38.24 - 44.23) and minimal depression levels (54.23% CI95%:51.17-57.25) were generally reported. On stratification by employment status, students reported severe anxiety levels (p = <0.01). Indeed, a participant reported, “COVID-19 made me very anxious…not knowing if I will be finishing my degree”. Covid-19 also impacted on behavioural attitudes, “I am eating more, I put on weight…resulting in feeling a bit depressed and have nothing to look forward to”. Indeed, a proportional increase in body weight was reported among those with mild to severe anxiety levels (p = <0.01). An inverse trend with an increase in anxiety and depression scores and decrease physical activity levels was observed (p = <0.01 respectively).

Conclusions

The population's mental health has been impacted differently, with some societal groups more susceptible than others. An increase in body weight and a decrease in physical activity appears to be linked with both anxiety and depression levels.

Key messages

Increase in mental health burden and obesity prevalence is anticipated as a resultant effect of Covid-19. Enhanced psychological support and prevention strategies targeting mental health and obesity are recommended.