bluuebunny/crossref_metadata_2025 huggingface dataset:
Awareness and knowledge about Female Genital Schistosomiasis among European healthcare workers
Authors: Marchese V , Remkes A , Kislaya I , Rausche P , Brito A , Hey J , Rasamoelina T , Rakotoarivelo R , May J , Fusco D
Published: October 2024

Background

Female Genital Schistosomiasis (FGS) is a gynaecological manifestation of persistent infection with Schistosoma haematobium, which can lead to severe consequences, such as miscarriage and infertility. It is estimated to affect 56 million women globally, mostly in sub-Saharan Africa (SSA). Most migrants in Europe are female, often from SSA and therefore at risk of FGS, hence healthcare workers (HCWs) knowledge of FGS is essential for the provision of adequate care. This study aims to assess awareness and knowledge of FGS among European HCWs to inform strategies to improve the management of migrant health.

Methods

In June 2023 - January 2024 we conducted a cross-sectional online survey targeting medical doctors (MDs), nurses and midwives (NMs) working in fields of infectiology, gynaecology, urology, family, travel, internal or occupational medicine. The prevalence of FGS awareness and knowledge was estimated, Poisson regression was used to identify factors associated with MDs’ awareness of FGS.

Results

Among 922 surveyed HCWs, 43.7% (CI95%: 39.6-47.9) of MDs and 12.0% (CI95%: 8.8-16.0) NMs have heard about FGS. FGS awareness among MDs was associated with work in clinics for migrants (prevalence ratio (PR)=1.33, CI95%: 1.10-1.59) and specialization, being lower for gynaecology (PR = 0.67; CI95%:0.51-0.88), and family medicine (PR = 0.42, CI95%:0.30-0.59). Among MDs, 7.1% (CI95%: 5.1- 9.5) had medium knowledge, while 25.3% (CI95%: 21.8-29.0) had low, and 67.6% (CI95%: 63.7-71.4) no knowledge on symptoms, complications or diagnostic tools for FGS. FGS knowledge was mostly acquired through academic curricula (34.7%), scientific literature (28.4%) and conferences (25.6%).

Conclusions

The study shows limited awareness of FGS among European MDs and NMs, and highlights that European HCWs may not be adequately prepared to deal with diseases that are gaining relevance on the European continent due to the global connectivity and the dynamic nature of our societies.

Key messages

• In Europe, the health specialities that are the first point of patient access to the health system show a low level of awareness and knowledge of Female Genital Schistosomiasis.

• Rising knowledge of FGS among European HCWs through academic curricula and continuous medical education is important to ensure adequate diagnosis and management of disease in migrant populations.
Reflecting (on) power?Critical reflections by healthworkers in Germany on racial power and privilege
Authors: Tezcan-Güntekin H , Papadopoulou S , Stüwe E , Meshkova K , Merz S
Published: October 2024

Background

Healthcare users have increasingly reported on experiences of racial discrimination in healthcare encounters in Germany (Aikins et al. 2020). While research on the experiences of racialised users predominates, examining the perspectives of white professionals, especially those holding positions of authority, regarding their internalised stereotypes and discriminatory practices is also crucial. This study therefore investigated the prevalence of conscious or unconscious biases related to critical whiteness and anti-racism among healthcare workers (doctors, nurses and therapists) and how these attitudes shaped their professional practice.

Methods

Problem-centred expert interviews (Döringer 2021) with 20 healthcare professionals from medicine, nursing, and therapeutic professions working in hospitals or rehabilitation facilities across three German federal states. Data were analysed using documentary method (Bohnsack 2002).

Results

Respondents exhibited varying degrees of reflective abilities, and there are limited opportunities for structured self-reflection focused on recognizing and addressing racism. The research interview constituted a much-needed space for such reflection. Those who are sensitised about their own positions of privilege often are so due to external influences and personal trajectories (teenaged children, trade union activism) rather than through the values or structures of their institutions. Unconscious racism nonetheless still manifests, demonstrating the need to create more inclusive environments where critical self-reflection on racism is encouraged.

Conclusions

To effectively combat racism, German healthcare institutions must systematically implement anti-racist and intersectional interventions. This also entails creating spaces for reflection where staff can openly examine and acknowledge their own biases, fostering an environment conducive to collective action for promoting anti-racist workplace practices.

Key messages

• Opportunities for self-reflection critical of racism should also be offered across institutions in order to ensure trusting, non-hierarchical spaces.

• Reflections on one’s own social positioning and privileges are not common in all circles, so the necessity of this attitude should be communicated in an error-friendly manner.
Productivity loss due to acute COVID-19 and post COVID-19 condition in the Northern Netherlands
Authors: Monteiro Sanchez G , van Ooijen R , Rosmalen JGM , Fens T , van Asselt T , Brouwer S , van Zon SKR
Published: October 2024

Introduction

The COVID-19 pandemic caused significant socioeconomic and health shocks worldwide. Yet, research is still scarce on how acute COVID-19 and post COVID-19 condition (PCC) have impacted workers productivity in terms of absenteeism, presenteeism and reduced unpaid work. This study examines the effect of acute COVID-19 and PCC on Dutch workers’ loss of work productivity in standardized hourly costs compared to those with neither disease.

Methods

This study included data from 31 waves (March 2020 - October 2022) of the Lifelines COVID-19 cohort, a populational cohort from the Netherlands. Productivity was measured in 7 waves in terms of absenteeism, presenteeism, and loss of unpaid work using the Medical Technology Assessment Productivity Costs Questionnaire. We selected workers aged 18 to 64 in the first wave (n = 10,950). Using administrative data, average hourly costs of productivity were calculated as 38.67€ for absenteeism and presenteeism and 15.94€ for unpaid work. The friction cost method was used. To compare group differences, a Kruskal-Wallis rank sum test with Holms-Bonferroni p-value adjustment was performed.

Results

In total, 33.4% of participants had acute COVID-19, 5.7% had PCC, and 60.9% had neither disease. The mean total combined productivity loss per person of those with PCC was 7,118€, compared to 3,410€ for those with acute COVID-19, and 3,076€ for those with neither. When comparing groups, significant differences in costs were found for all aspects of productivity, except for unpaid work loss between acute COVID-19 and those with neither disease.

Discussion

Although the number of people with acute COVID-19 represents a large societal cost in terms of accumulated loss, those with PCC incurred on average twice as much productivity losses per person across all domains. This study highlights the high costs associated with PCC, which continues to chronically burden workers. Policies should be aimed at lessening this burden.

Key messages

• Post COVID-19 condition is associated with significantly higher average productivity costs per person than acute COVID-19, which highlights the individual burden of this chronic disease.

• Acute COVID-19, despite relatively lower average productivity costs, represents a large societal cost in terms of accumulated loss.
The Norwegian Counties Public Health Survey (NCPHS)
Authors: Aarø L E , Nilsen T S , Knapstad M , Skogen J C , Nes R B , Vedaa Ø , Klepp K I
Published: October 2024

Effective public health initiatives should be based upon a thorough understanding of important health-related factors. The purpose of The Norwegian Counties Public Health Survey (NCPHS) is to gain insights from the adult population on topics relevant for planning of public health policy, interventions, and action at the county and municipality levels. The survey includes a core questionnaire on public health-related topics such as health behaviour, subjective quality of life, distress, subjective health, social support, social capital, community contexts, and demographics, including indicators of socio-economy, with additional optional questions and scales varying across data collections. Samples are drawn from the Norwegian National Population Register. NCPHS was piloted in three counties in 2015 and in one county in 2018. After some revision of instruments and sampling procedures, surveys have been carried out in most Norwegian counties since 2019. The total number of participants has now passed 400 000. Expedient data analysis and reporting has enabled the Norwegian Institute of Public Health to present comprehensive reports within six weeks after completed data collections. In these, outcome variables are analysed against district (within counties), gender, age, educational attainment, and assessment of household economy. Tables are also made available at the municipality level. The NCPHS represent a valuable addition to existing health registries and regional health surveys, providing critical information for planning purposes for local and regional public health authorities, for assessing trends over time, comparisons across counties and regions, and for evaluation of policies and interventions. The value of such a system during times of crises was demonstrated during the COVID-19 pandemic. At the Lisbon 2024 European Public Health conference, a few selected examples of use of data from the NCPHS system will be presented.

Key messages

• Large-scale community surveys provide important insights for planning of public health policies and action.

• Strong involvement and collaboration with regional and local public health personnell as well as with media and local people is a prerequisite for succeeding.
Monitoring the level of health and inequality over time using the Population Health Performance Index
Authors: Grün A , Bozorgmehr K , Nowak A
Published: October 2024

Background

The Population Health Performance Index (PHPI) is a composite measure that combines average health outcomes and their distribution within a population, thereby allowing for a comprehensive assessment of population health and inequality. The aim of this study is to examine the extent to which the PHPI adds value to monitoring of health and inequality over time in comparison to absolute and relative inequality.

Methods

Data from the WHO Equity Monitor database on under-5 mortality disaggregated by wealth quintiles for Nepal, Ethiopia, Peru, Rwanda, and Zimbabwe were analysed using different years between 1994 and 2020. Descriptive comparative statistics were employed to assess trends in the PHPI and conventional pairwise measures of absolute and relative inequalities, with consideration of different weights for inequality aversion.

Results

PHPI trends correspond to the trend of absolute inequality in all five countries, although they exhibit less volatility over time. Relative inequality follows the trend of the PHPI in only two of the five countries (Ethiopia and Zimbabwe), reflecting the methodology utilised for the PHPI. PHPI scores vary based on different inequality aversion weights, highlighting the sensitivity of the index to methodological adjustments.

Conclusions

The PHPI demonstrates notable convergence of trends with conventional methods, thereby substantiating its utility as a comprehensive tool for the simultaneous measurement of health and inequality. As it is able to consider both absolute and relative inequality within its own calculations, the PHPI allows for independent analysis of its two key components. The PHPI facilitates a more nuanced understanding of population health and may be more easily understood by policymakers and other stakeholders. As it does not address the underlying causes of changes in health inequalities, further research is necessary to supplement monitoring activities.

Key messages

• PHPI is a valuable tool for health and inequality monitoring by integrating both average health and disparity in a single index, facilitating communication of trends over time.

• The dual focus complements conventional methods with its multidimensionality and may enable stakeholders to assess health and inequalities in alignment with broader health policy objectives.
Individual level risk factors associated with episodes of heat as recorded within primary care records: a time-stratified case-cross over study
Authors: Thompson R , Kovats S , Hajat S , O’Connell E
Published: October 2024

Background

A key recommended action outlined in Heat-Health Action Plans is to identify individuals at risk and deploy targeted interventions, however this is not routinely undertaken. A major contributing factor is a lack of understanding of individual-level risk factors to support an evidence-based approach to targeted prevention.

Aim

To use electronic health data to identify individual level characteristics associated with increased risk of mortality during heatwaves in England.

Methods

A time-stratified case-crossover analysis was undertaken of individual-level clinical and socio-environmental (SE) risk factors. Conditional logistic regression was used to characterise associations between temperature and the risk of death on hot days, with analysis stratified by potential risk modifying factors.

Results

Heat mortality risk was modified by a large range of chronic conditions, with cardio-respiratory, mental health and cognitive function conditions, diabetes and Parkinson’s, all increasing risk. Prescribed medications also increased odds of death during heatwaves. Heat mortality risk was modified by a range of SE determinants of health investigated, with ORs increasing with age; OR differences by sex, ethnicity and living arrangement; an increasing trend in ORs by alcohol intake and body mass index, excluding the obese-3 group. Results suggest the least deprived have the lowest OR and the most deprived have the highest.

Conclusions

This study has important implications for patient medication management during heat events, incorporating heat-risk considerations into other health policies. The results also provide important evidence on the role of disadvantage in driving the inequitable distribution of climate impacts, and the need for better socio-economic data sets linked to health records. The findings highlight the importance of incorporating an assessment of individual SE circumstances when prioritising patients at highest risk during heat events.
Dispensing of antibiotics in community pharmacies before, during, and after the COVID-19 pandemic
Authors: Pinto H , Pessoa V
Published: October 2024

Background

Antibiotic resistance threatens our capability to successfully treat bacteriological infections, becoming a major threat to public health. Therefore, measures must be taken to minimize de incidence of multi-drug resistant bacterial infections. Antimicrobial Stewardship is a systemic healthcare approach devised to foster, enhance, oversee, and assess the judicious application of antimicrobials, aiming to safeguard their efficacy in the future, whilst advocating and safeguarding public health. In the initial phase, a correct diagnosis of antimicrobial utilization is pivotal for the proper implementation of an Antimicrobial Stewardship Program.

Methods

A cross-sectional study encompassing the Alentejo region, Portugal, with a specific focus on central Alentejo, was conducted to analyze the dispensing of antimicrobials in community pharmacies, alongside the examination of the prescribing locations, before, during, and after the COVID-19 pandemic, from 2019 to 2023.

Results

The number of antibiotic packages dispensed decreased, as expected, during the COVID-19 pandemic, but returned to pre-pandemic levels after its conclusion. In several prescribing locations, the proportion of cephalosporins and quinolones exceeded the maximum expected value.

Conclusions

The implementation of an appropriate Antimicrobial Stewardship Program in this region is necessary to ensure the correct prescription of antimicrobials, decreasing the risk that antibiotic resistance pose to public health. Emphasis on the application of the Clinical Practice Guidelines issued by the Portuguese Directorate-General of Health regarding the proper approach to bacterial infections should be intensified so that all prescribing locations exhibit proportions of cephalosporins and quinolones below the maximum expected value.

Key messages

• Antimicrobial resistance poses a threat to public health.

• Stewardship is crucial for appropriately safeguarding public health by reducing antimicrobial resistance emergence.
Assessing contextual factors influencing scale-up: a interactive approach involving stakeholders
Authors: Carboni C , Lambert Y , Plessis L , Bardon T , Vreden S , Suarez-Mutis M , Sanna A , Douine M
Published: October 2024

Issue

Pilot interventions are not always put into practice at scale. When they are, effectiveness is often highly reduced in the field due to contextual factors. To effectively implement a scale-up, stakeholders’ involvement is crucial. Curema is an international research evaluating an intervention aiming to reduce malaria transmission by distributing RDTs and treatments in mobile hard-to-reach populations. This intervention might be scaled-up in Brazil, Suriname, and French Guiana as a tool of national malaria programs for specific areas and populations.

Description of the problem

An interactive pre-planning assessment was conducted involving key stakeholders -implementers, decision-makers, and researchers - in working sessions, semi-structured interviews, and formal meetings. Mendelow’s Power/Interest Matrix was used to map stakeholders and a SWOT analysis was conducted using ExpandNet/WHO Framework to evaluate contextual factors and identify levers and obstacles influencing the scale-up.

Results

A total of 23 participants were involved. Health authorities had high power and generally high interest, while implementers and recipients had lower power and different interest levels. National engagement for WHO E2025 or E2030 enhanced scalability and represented a main opportunity in the three countries. Nevertheless, several regulatory and administrative aspects were identified as potential obstacles to be addressed to make scale-up realistic. Funding was also a major concern for sustainability. The need for regional cooperation was emphasized to achieve malaria elimination.

Lessons

Despite financial and regulatory challenges, a window of opportunity is open to scale-up Curema. Identifying and involving stakeholders in a pre-planning assessment and advocating for foster regional cooperation are crucial steps to support the scale-up. Stakeholder analysis should be refined during the scaling-up to capture further changes in factors that might influence the process.

Key messages

• Engagements with WHO represent windows of opportunity to enhance Curema scale-up.

• Stakeholder involvement and regional cooperation are crucial for scaling up Curema in Brazil, French Guiana and Suriname.
The HEROES (HEalth woRkfOrcE to meet health challengeS) Joint Action
Authors: Diedenhofen G , Baldini L , Menin G , Di Marco M
Published: October 2024

Background

The HEROES (HEalth woRkfOrcE to meet health challengeS) Joint Action aims to advance health workforce planning across the EU, addressing the pressing need for a resilient, sustainable, and accessible health service systems. Given the evident strain on health systems demonstrated during the COVID-19 pandemic, this initiative seeks to address the critical need for strategic HWF planning. Building on previous projects, HEROES will foster the capacity of EU states in workforce planning, preparing the health systems to meet future challenges.

Methods

The study adopts a collaborative framework involving 19 EU countries, segmented into clusters based on health system characteristics. A stepwise approach (‘AS IS,’ ‘TO BE,’ ‘TO DO’) characterizes the methodology, incorporating extensive data collection, stakeholder engagement, and scenario forecasting. Country-level information on HWF Data and Planning will be compared both across countries in clusters and across clusters.

Results

Initial findings indicate significant disparities in health workforce data quality, availability, and planning methodologies among the states. Identified methodologies also involve real-world data applications and predictive analytics to refine health workforce planning. Efforts are underway to define an Advanced Minimum Dataset (AMDS) to synchronize health workforce data and define planning tools across the clusters, as country-level AS IS reports have been finalized and cross-country comparisons are ongoing.

Conclusions

Collaborative, data-driven health workforce planning can significantly enhance health system resilience and responsiveness. Recommended public health actions include enhancing HWF data integration, forecasting capabilities, and stakeholder participation, with the aim of shaping national health policies and practices. The public health impact is profound, as it allows to improve health service delivery and workforce adaptability in response to dynamic health demands.

Key messages

• The HEROES Joint Action advances EU health workforce planning, with the aim of enhancing the resilience and responsiveness of health systems.

• Strategic data-driven approaches in health workforce planning are pivotal for resilient, accessible and sustainable healthcare systems.
Accounting for health equity in policy evaluation: a content analysis of primary research
Authors: Sell K , Rabbani S , Burns J
Published: October 2024

Background

Public Health researchers increasingly make use of sophisticated study designs and methods to evaluate the effects of policies on health and social outcomes. Natural experiment evaluation (NEE) conceptualises policies as ‘natural’ experiments that occur outside of the control of researchers. Often, NEE employs quasi-experimental methods (QEM) which enable researchers to rigorously evaluate the effect of population-level interventions. As for other health-related research, it is unclear to what extent such public health evaluations can and do consider the (health) equity implications of policies. We sought to investigate how health equity is addressed in NEEs and other policy evaluations that employ QEM.

Methods

We identified a random sample of primary research as part of a pre-registered scoping review (https://osf.io/3h6cb/). Studies that employed methods labelled as interrupted time series, difference-in-differences, controlled before and after, regression discontinuity, and synthetic control were included. Through content analysis, we examined how health equity was considered in data analysis and discussion sections.

Results

We analysed 59 studies, of which 25 were stratified for one or more socially-stratifying factors. Results were mainly stratified by sex (n = 15, 25.4%), age (n = 13, 22%), and diverse measures of socioeconomic status (n = 14, 23.7%), i.e. income, employment, education, or other factors. Of these, 21 studies included a discussion of health equity-related results, ranging from a few sentences to a holistic discussion including recommendations for decision-makers. Most commonly, researchers recommended monitoring of policy effects in different sub-populations, and careful policy design that conceptualises complex policy effects, including unintended and unequitable effects.

Conclusions

Policy evaluations have great potential for informing public health decision-making but health equity aspects were under-examined in these studies.

Key messages

• Health equity is assessed by evaluating policy effects in relevant sub-populations. Only 25 of 59 studies included results that were stratified for one or more socially stratifying factors.

• Studies that were focused on disadvantaged populations commonly included recommendations for policymakers, calling for better policy design and improved monitoring of policy effects.
Covid-19 and mental health hospitalizations in Italy. Results from a multicenter longitudinal cohort
Authors: Petrelli A , Ventura M , Ciampichini R , Di Napoli A , Fano V , Pacifici M , Rosini C , Voller F , Zucchi A , Aragona M
Published: October 2024

Background

The impact of Covid-19 pandemic on mental health (MH) is still being assessed. The aim of this study was to evaluate the impact of Covid-19 on ordinary hospital admissions for psychiatric disorders in Italy.

Methods

The multicenter project “Covid-19 and mental health” (CoMeH), coordinated by the National Institute for Health, Migration and Poverty, enrolled an open cohort of subjects resident in three large areas of Italy (2018-2021) aged 10 + (N = 5,159,363), and followed-up until 2021. The study outcome was the first ordinary admission with a psychiatric disorder as main diagnosis (FMHA). Citizenship and deprivation level (DL) are the socioeconomic factor considered. Different groups of diagnosis were used to characterize the hospitalizations. The impact of Covid-19 on FMHAs was evaluated by interrupted time series (ITS) analysis, pre (until February 2020) and post (from March 2020) the outbreak of pandemic, using a step-change model.

Results

11,171 FMHAs were observed. Patients hospitalized with a MH diagnosis were younger compared to the study population; the distributions by sex, deprivation level and citizenship were similar. A decrease of incidence of FMHAs was found after the outbreak of the pandemic, overall and for all group of diagnoses, except for post-traumatic stress disorders (PTSD). A reduction in adjusted FMHA rates after the onset of Covid-19 (RR 0.80[0.72-0.90]) were observed through multivariate ITS. The oldest patients had the lowest probabilities of FMHAs in pre Covid-19 and experienced the highest reduction in post-Covid19. PTSD presented trend in countertendency compared with the other diagnosis, with an immediate effect of Covid-19 increasing FMHAs (+97%), followed by a post-outbreak return to the pre-pandemic levels, below the counterfactual line.

Conclusions

Covid-19 pandemic determined a general reduction of admissions for psychiatric disorders. A significant impact was observed among the eldest (decrease) and for PTSD (increase).

Key messages

• Covid-19 pandemic determined a reduction of admissions for psychiatric disorders.

• Older people were mostly affected. No significant socioeconomic impact was observed.
Digital services as alternative for in-person visits among clients with long-term illnesses
Authors: Kainiemi E , Virtanen L , Aalto A-M , Heponiemi T
Published: October 2024

Background

For individuals managing long-term illnesses and often requiring complex care across health and social care sectors, the transition to digital platforms holds considerable potential to facilitate management of one’s health. This study examined factors among people with long-term illnesses associated with their perception that digital services had replaced in-person visits in health and social care.

Methods

A total of 11,012 Finnish residents with long-term illnesses necessitating regular care (56% female, mean age 56.9, SE .23) responded to a nationwide population survey between September 2022 and March 2023. The Inverse Probability Weighting method was used to correct for bias. Complex samples binary logistic regression was used to examine whether factors related to self-rated health, distress, digital skills and perceived benefits of digital services were associated with the replacement of in-person visits by digital services. The model was adjusted for age, gender, education, and urbanicity.

Results

Approximately one third (35.8%) of the respondents indicated that the use of digital services had replaced in-person visits within the past 12 months. Respondents in poor or moderate health (OR 1.17, 95% CI 1.02-1.34) had greater odds of reporting the replacement compared to those in good health. Those with proficient digital skills (OR 1.84, 1.57-2.14) and those perceiving more benefits in digital services (OR 1.56, 1.47-1.74) had greater odds of reporting of the replacement compared to their counterparts.

Conclusions

Transition to digital services could facilitate access to care for individuals with long-term illnesses perceiving their health poorer. Promoting digital skills and perceptions of benefits of digital services can significantly increase the use of digital services as substitutes of in-person visits and contribute to more efficient allocation of health and social care resources.

Key messages

• Especially those reporting poorer health seem to use digital services as replacements of in-person visits, offering the potential to optimize resource utilization in health and social services.

• Promotion of digital skills and perceptions of the benefits of digital services could increase the use of digital services as replacements for traditional visits with health and social professionals.
Fear of falling as a psychological consequence of fall in older adults
Authors: Tamulaityte-Morozoviene I , Dadoniene J , Stukas R , Tamulaitiene M , Alekna V , Jakubauskiene M
Published: October 2024

Background

Falls is one of geriatric syndromes that impact active ageing. It is a major public health problem as falls can lead to irreversible health, social, and psychological consequences, and a large economic burden.

Methods

Elderly women, aged 65 years and above, who attended the National Osteoporosis Center for diagnostic or treatment purposes, participated in telephone interviews. These interviews aimed to document the outcomes and healthcare measures associated with any falls they experienced in the preceding 12 months. There was used a specially prepared questionnaire for demographic and falls data, fear of falling questionnaire “Falls Efficacy Scale International” (FES-I) and physical activity questionnaire “Physical Activity Scale for the Elderly” (PASE).

Results

The study population consisted of 339 community-dwelling women (mean age 72.9±5.3 years) all of whom reported experiencing one or more falls. One in three of these women had fallen two or more times. Most of all their fall resulted in an injury, and 79 (23.3%) reported falls led to bone fractures. Fear of falling was reported as a consequence of experienced fall by 251 (74.1%) women. Almost half of fallers restricted their everyday activities. The primary cause for limiting everyday activities was identified as pain.

Conclusions

Fear of falling was reported by 74.1% of women who fell during the previous 12 months. Every woman who experienced hip or vertebral fractures subsequently restricted their daily activities.

Key messages

• Fear of falling is common among elderly women who has fallen once or more.

• The restriction of everyday activities is usually reported by women who feel pain and are afraid to fall again.
Latent class analysis of attitudes towards drug use and well-being among South Korean young adults
Authors: Lee S , Chun J S , Lee J
Published: October 2024

Background

The surge in drug use and lack of awareness about drug-related dangers among young adults have become major public health concerns in South Korea. According to the Theory of Planned Behavior, understanding attitudes towards drugs is crucial, as permissive attitudes may lead to drug use. Thus, the study aims to identify latent classes of drug use attitudes among Korean young adults and evaluate how their well-being influences each class.

Methods

A total of 301 college students in Seoul, South Korea, participated in the study. Latent class analysis (LCA) was employed to identify unique patterns of attitudes towards drug use. Subsequently, we examined the relationships between auxiliary variables (i.e., well-being, including life satisfaction, self-control, quality of life, depression, generalized anxiety disorder, childhood trauma, self-esteem, stress, family strengths, perceived social support, and stigmatization) and latent classes (i.e., attitudes towards drug use subgroups) by conducting multivariate logistic regression analyses.

Results

LCA categorized attitudes towards drug use into three groups: Class 1 (Permissive Drug Attitude Group), Class 2 (Moderate Drug Attitude Group), and Class 3 (Critical Drug Attitude Group). Class 2 showed a particularly permissive view on marijuana legalization. In multivariate logistic regression, higher stigmatization (β = .900, p < .05) was associated with membership in Class 1 compared to Class 3. Furthermore, being male (β = 2.272, p < .001) and having higher self-esteem (β = .989, p < .05) were linked to membership in Class 2 compared to Class 3.

Conclusions

The study enhances understanding of the complex relationship between Korean young adults’ well-being and their drug use attitudes. Effective interventions by frontline social workers aimed at preventing drug use should continuously monitor and address social stigmatization and self-esteem while providing accurate information and education regarding drug use.

Key messages

• Latent Class Analysis sorted drug attitudes into three groups: ‘Permissive,’ ‘Moderate,’ and ‘Critical’ Attitude Groups.

• Individuals experiencing social stigmatization had a higher risk of permissive attitudes, while higher self-esteem increased the likelihood of being in the moderate group over the critical group.
Psychological Capital Promotion in Universities
Authors: Fontes A
Published: October 2024

Background

The rise in student depression and anxiety highlights a crucial intersection between education and public health. Academic pressures intensify mental health issues, necessitating comprehensive strategies to address them.

Objectives

This study assessed the effectiveness of a Psychological Capital (PsyCap) intervention in enhancing university students’ PsyCap and reducing anxiety, aligning with broader public health education goals.

Methods

A randomized controlled trial was conducted, where students either received a PsyCap intervention or were placed on a wait-list. The intervention, based on Luthans et al.’s guidelines, was delivered online and included self-reflection, goal-setting, and resource assessment.

Results

Post-intervention, the PsyCap of students in the intervention group significantly increased (M = 1.098, SD = 0.24, CI [0.98, 1.21], t(17) = 19.72, p < .001). There was also a significant reduction in GAD scores (M = -0.24, SD = 0.46, CI [-0.47, -0.01], t(17) = -2.19, p = .043). No significant changes were observed in the control group.

Conclusions

Short-term PsyCap interventions can significantly improve students’ mental resilience and decrease anxiety, suggesting their integration into educational curricula. This study underlines the need for educational and public health sectors to collaborate in mitigating mental health issues among students, particularly in response to crises like COVID-19. Addressing the rising anxiety among students through brief, online PsyCap interventions shows promise. This approach not only enhances PsyCap but also lowers anxiety, advocating for their regular inclusion in educational settings to support student mental health.

Key messages

• Results from a controlled trial revealed increases in PsyCap and decreases in anxiety.Findings advocate integrating such interventions into educational curricula promoting student mental health.

• Recent trends indicate a rise in anxiety among students, challenging both educational and public health. Addressing this, the study evaluated the impact of a brief online (PsyCap) intervention.
Effect of moderate wine consumption on men’s sexual potential
Authors: Varga L , Oláh C S , Molnár P , Oláh Z S , Oláh B , Kiss I , Hajzer EZS , Tóth M , Czabajszki M , Váradi C S
Published: October 2024

Background

Drinking large amounts of alcohol has a negative effect on men’s sexual activity and reproductive potential. High alcohol intake can interfere with hormone production in the hypothalamus. The connection between low alcohol consumption and sexual activity is not yet clear from previous research.

Methods

In the course of a prospective study with ethical approval, we examined how the consumption of 1 deciliter of white wine per day for 5 weeks affects the parameters of men’s sexual life. In the course of strict inclusion and exclusion criteria, 45 healthy male volunteers were included in the study. 25 men in the active arm drank wine, while 20 men in the control arm drank apple juice instead of wine for 5 weeks. On day 0 and week 6, we examined the serum testosterone level, liver enzymes, inflammatory parameters, anxiety level, sleep quality and sexual activity of the participating men using objective tests.

Results

As a result of consuming moderate white wine for 5 weeks, the men’s testosterone level increased significantly, inflammatory parameters and liver enzyme values decreased, the sleep quality of the participants in the active arm improved, their pain decreased, and their quality of life improved. The sexual performance of 85% of participants in the active arm improved, none of them deteriorated. No similar improvement occurred in the control arm.

Conclusions

Moderate wine consumption improves the sexual performance, quality of life and several laboratory parameters of healthy men.

Key messages

• Based on our pilot prospective clinical study, men do not need to fear that a small amount of wine will negatively affect their sexual performance.

• Moderate wine consumption had a positive effect on men’s testosterone levels, quality of life and also improved sleep quality.
Results from the Swiss Cohort of Healthcare Professionals: Intention to stay and well-being
Authors: Peytremann-Bridevaux I , Jubin J , Le Saux C , Roth L , Zuercher E , Oulevey Bachmann A , Gilles I
Published: October 2024

Background

In the context of personnel shortages and high turnover rates in the healthcare sector, the Swiss COhort of Healthcare Professionals and Informal CAregivers (SCOHPICA) seeks to understand which factors act as determinants of professionals’ intent to stay in their profession and well-being, and to monitor their trajectories.

Methods

This cross-sectional study used baseline data from a prospective open cohort including any type of healthcare professionals practicing in Switzerland. They were invited to complete an online questionnaire measuring their intent to stay in their profession and well-being, several determinants of these, sociodemographic and socioprofessional characteristics, and they were able provide open comments. Standard statistical and thematic analyses were performed where appropriate.

Results

5927 participants completed the 2022 (n = 1707) or 2023 (n = 4220) questionnaire, and 1811 left open comments. Preliminary results revealed that the main determinants of intention to stay and well-being were work-life balance, opportunities for development, and meaning of work. Moreover, nine sub-themes were identified in open comments, grouped under three main themes: 1) working hours and private life; 2) working conditions, relating to administrative work, salary, health and staffing issues, participants with a low intent to stay being overrepresented in the last two; 3) career paths, exploring employer changes or training recongnition.

Conclusions

Finding a balance between constraints inherent to the healthcare professions and professionals’ social life as well as reintroducing sense at work are key aspects that policymakers should take into account to brake turnover, retain healthcare professionals and make health professions attractive again.

Key messages

• Work-life balance, opportunities for development, and meaning of work appeared to be reasons to stay in healthcare professions.

• People thinking of leaving commented on staffing and their own health.
Catching-Up in Islamabad, Pakistan: Identifying and Reaching Zero-Dose Children Following the COVID-19
Authors: Baig R
Published: October 2024

Background

Routine Immunisation (RI) is critical in mitigating child morbidity and mortality while preventing the spread of infectious diseases. Nevertheless, the COVID-19 pandemic has resulted in considerable disruptions, which have given rise to an unprecedented number of zero-dose (ZD) infants. It has presented formidable obstacles for healthcare systems on an international scale.

Methods

The study employed a retrospective analysis of data obtained from thirteen Supplementary Immunisation Activities (SIAs) that were carried out from 2019 to 2021 to investigate the fluctuations in the documented number of children with ZD. Health authority stakeholder interviews yielded valuable insights about vaccination strategies and obstacles.

Results

An enormous increase in the number of documented ZD minors were identified during the study period. The number of documented ZD minors rose from 3,827 in 2019 to 4,271 in 2020, and then again to 9,620 in 2021. Notwithstanding diligent attempts to immunise ZD children, the vaccination rate persisted at a less-than-ideal 81.24% of documented ZD children in 2021.

Conclusions

As a result of the COVID-19 pandemic, pre-existing obstacles to accessing ZD infants in Islamabad were further intensified. The lessons learned emphasise the significance of community engagement, improved outreach strategies, and fortified healthcare infrastructure in guaranteeing comprehensive immunisation coverage. It is imperative to confront these challenges to reduce the likelihood of subsequent epidemics and protect children’s health.

Key messages

• The spread of COVID-19 among ZD neonates in Islamabad accelerated, prompting calls for improved vaccination programmes.

• The suboptimal ZD vaccination rate in 2021, despite concerted efforts, underscores the criticality for enhanced strategies.
Body mass index change and risk of poor oral health in Norwegian adults: the HUNT longitudinal study
Authors: Myhr A , Jiang L , Stangvaltaite-Mouhat L , Skudutyte-Rysstad R , Sen A
Published: October 2024

Background

Oral diseases and obesity share common risk factors and are highly prevalent. However, the relationships between body mass index (BMI), BMI change and oral health conditions in adults are less studied. In this study, we investigate the associations of long-term obesity and BMI change with risk of poor self-rated oral health among adults.

Methods

This study include individuals aged 29-90 years (57.8 % women, mean age at baseline, HUNT3, was 54.9 years) who participated in the first (HUNT1, 1984-86), second (HUNT2, 1995-97), third (HUNT3, 2006-08) and fourth (HUNT4, 2017-19) survey of the Trondelag Health Study (HUNT). Weight and height were measured at each survey. We estimated average BMI values and BMI change over a 10-year (HUNT2- HUNT3, N = 19,729) and 20-year (HUNT1- HUNT3, N = 14,276) period and linked to their information on oral health status at HUNT4. We employed logistic regression models with adjustment for confounders and computed odds ratio (OR) with 95 % Confidence Interval (CI).

Results

At HUNT4, 1812 (9.2 %) participants rated their oral health as poor or very poor. The multivariable-adjusted ORs for average BMI over 30 kg/m2 were 1.3 (95 % CI: 1.1-1.5) and 1.2 (95 % CI: 1.0-1.5) over a 10-year and 20-year period, respectively, when compared to normal weight. After adjustment for most recent BMI (HUNT4), the associations of long-term obesity with poor self-rated oral health weakened. Compared with stable BMI, both loss and gain in BMI over a 10-year period were associated with increased risk of poor oral health. In the adjusted analysis, we found that a BMI loss of more than 2.5 kg/m2 and a BMI gain of more than 5 kg/m2 was associated with 1.5 times (OR = 1.5, 95 % CI: 1.1-1.9) and 1.3 times (OR = 1.3, 95 % CI: 1.1-1.6) greater risk of poor oral health.

Conclusions

Our findings suggest that individuals with long-term obesity and BMI change have a markedly higher risk of poor self-rated oral health.

Key messages

• Long-term obesity was associated with increased risk of poor self-rated oral health.

• Compared with stable body mass index (BMI), loss- and gain in BMI were associated with increased risk of poor self-rated oral health.
Dementia risk factors and cognitive function in a nationwide population-based sample aged 65+
Authors: Gaertner B , Fuchs J , Kuhnert R , Neuhauser H
Published: October 2024

Background

Cognitive function is fundamental to healthy aging and independent living. As there is no cure for dementia, prevention of risk factors (e. g. physical inactivity, obesity, hypertension, diabetes, social isolation, depression) is crucial. The aim of our study was to analyze selected dementia risk factors and their association with cognitive function in people aged 65 years and older.

Methods

Cross-sectional data from the nationally representative examination Study on Health of Older People in Germany (Gesundheit 65+) conducted between 2022-2023 by the Robert Koch Institute (n = 1.493; 48% women; mean age 78.8 years). Cognitive function was assessed by the Letter Digit Substitution Test (LDST), a measure of general speed of information processing, and of the Consortium to Establish a Registry for Alzheimer’s Disease (CERAD) 10-word list delayed recall (WLR), a measure of memory. Weighted associations between age, sex, education, dementia risk scores and z-standardized test scores were examined using linear regression analysis.

Results

Higher age, male sex and lower level of education were significantly associated with lower z-scores in both tests (all p < 0.001). In separate models, all adjusted for age, sex and education, social isolation was associated with lower performance on both LDST (ß=-0.22; 95% confidence interval -0.42, -0.01) and CERAD WLR (ß=-0.21; -0.41, -0.01); depressive symptoms were associated with lower LDST z-scores (ß=-0.40; -0.67, -0.13), and physical inactivity with lower CERAD WLR z-scores (ß=-0.12; -0.24, -0.01). Obesity, hypertension, and diabetes were not significantly associated with any test.

Conclusions

Our findings from this nationwide general population study of old and very old adults show a clustering of reduced cognitive function with social isolation, symptoms of mental health impairments, and physical inactivity in old age which call for coordinated intersectoral health promotion and prevention activities.

Key messages

• The clustering of reduced cognition with dementia risk factors calls for intersectoral health actions.

• Limitations in cognition should only be defined by age-, sex-, and education-specific norms.