bluuebunny/crossref_metadata_2025 huggingface dataset:
Learning from calorie posting/traffic light systems introduction in a University hospital canteen
Authors: Fitzpatrick P , Flood C , Cuniffe E , Doherty K , Lyons A , Stynes S , Pilkington A , Barnes L , Peare T , Kelleher C C
Published: November 2019

Calorie posting is now policy in hospitals in Ireland and restaurants will be required to display calorie counts on menus by end of 2019. The Health Promotion, Dietetics and Catering teams worked together to introduce calorie posting and a traffic light system (TLS) for all foodstuffs available in the staff canteen of a large University teaching hospital in Dublin, Ireland. A calorie posting launch took place in September 2018. The aim of this study was to determine staff perception of calorie posting and TLS.

One month after the launch, 343 staff members were surveyed using a short pre-designed Sphynx-software questionnaire at 3 time points daily over one week, at breakfast, lunch and evening mealtimes. SPSS was used for analysis.

Of the 353 respondents (65.3% female; 18-44 years 65.3%, 45+ 32.1%, unknown 2.6%), more staff found calorie posting helpful compared to TLS (66.5% vs 43.7%; p = 0.001). Staff stated they made themselves aware of calorie count always/mostly (46%) and sometimes (26.2%). More females than men found both calorie posting (72.3% vs 53.3%; p = 0.001) and TLS (49.1% vs 31.8%; p = 0.001) helpful. More respondents identified calorie posting than TLS as influencing food choice at least sometimes (60.3% vs 36%; p = 0.0001). Females were more likely to make a food choice change based on TLS (39.7 vs 20.6%; p = 0.01). Age and frequency of canteen use were not associated with either.

The results suggest calorie posting is used rather than TLS by all hospital staff and female hospital staff are likelier to use both. Learning from this study, the positioning of TLS in relation to individual foodstuffs has been reviewed, further promotion of TLS/calorie posting has taken place in the hospital and a regular audit has been established. Notwithstanding the challenges, important moves towards healthier choices were seen.

Key messages

Introduction of traffic light system and calorie posting needs evaluation. Females appear more likely to avail of traffic light systems and calorie posting in relation to food choices.
MRSA contamination in ambulances: a systematic review
Authors: Fattorini M , Quercioli C , Messina G , Nante N
Published: November 2019

Background

Methicillin-resistant Staphylococcus aureus (MRSA) is a multidrug resistant organism (MDRO) frequently involved in skin, soft tissue and bone infections. Moreover, it is one of the most frequently isolated pathogen in bloodstream infections in European countries. Because of its capacity to survive on inanimate surfaces, this microorganism could be detected not only on hospital environment, but also in other healthcare settings such as ambulances. We performed a systematic review in order to study the level of MRSA contamination in ambulances (vehicle surfaces and medical equipment).

Methods

In March 2019 we searched studies in PubMed using the key search terms “MRSA, ambulance”. We included different designs of studies in English.

Results

The research yielded 18 publications: after title, abstract and full text’s analysis, 9 manuscripts were included in this review. Studies were conducted from 2007 to 2018 in USA, Egypt, Poland, Germany and South Korea. Overall, the number of ambulances sampled for MRSA was 511 (min. 3-max. 150), and 64 (12.5%) resulted contaminated by MRSA. Sampling points examined for each vehicle varied from 5 to 33, for a total of 5872 (min. 39-max. 2136) samplings performed. The amount of MRSA positive samplings was 145/5872 (2.5%) (min. 1-max. 43). Stretcher resulted the most frequently contaminated fomite (29 of the 145 MRSA positive samplings, 20%).

Conclusions

Despite MRSA prevalence is decreasing in Europe, recent studies showed how this MDRO could still be responsible of a remarkable burden in terms of attributable deaths and costs. Implementing effective sanitation procedures with a continuative monitoring of the processes is highly recommended in all the healthcare settings, including ambulances. Automated terminal disinfection of these vehicles, adopting technologies such as ultraviolet germicidal irradiation or hydrogen peroxide aerosol, could reduce bacterial contamination hosted on surfaces and medical equipment.

Key messages

Although the percentage of isolates of MRSA in European countries is decreasing, the burden this multidrug resistant organism in terms of mortality and costs remains remarkable. Ambulances must be considered as a potential reservoir of MRSA because of its ability to survive on inanimate surfaces, and adequate sanitation procedures should be frequently performed.
Increasing awareness about psittacosis among bird owners
Authors: Overmars-Marx T
Published: November 2019

Background

Visitors of bird fairs and bird owners in general are at risk of becoming infected by Chlamydia psittaci bacterium. This bacterium is mainly found in birds and can be transmitted to humans. The knowledge about psittacosis is limited among the general public, bird owners and even among doctors.

Awareness to health problems regarding psittacosis, is important. By increasing this awareness among bird owners we encourage them to report these health problems and bird contact to the general practitioner. Experience shows that it is difficult to reach this particular group. The aim of this study was to gain more insight in the characteristics of bird owners to develop methods for providing appropriate information. This information aims to increase awareness regarding psittacosis.

Methods

The research adopted a qualitative approach and in depth interviews were held with sixteen bird owners using a semi-structured interview guide. The data collected was analysed using thematic analysis.

Results

Four themes were identified: social network related to birds, relationship with birds, awareness of risks and symptoms of psittacosis, information channels.

Conclusions

Most of the study participants were hobby breeders. They experience a strong connection with their birds and are experts in this field. In general they feel healthy. The bird owners are unaware of the fact they risk a disease as a consequence of their favourite hobby. However, they seem to be open for advice related to their health. It is recommendable to provide information from a near-by environment (e.g. through internet or at the local bird club) and use credible ambassadors. Increased awareness on the symptoms of psittacosis can be reached if appropriate information is received by bird owners. This might lead to more reports at the general practitioner and therefore prevents severe cases of psittacosis.

Key messages

Most bird owners were unaware of the health risks related to their birds. To prevent severe cases of psittacosis it is important to provide information from a near-by environment and to use credible ambassadors.
Vaccine hesitancy among parents in the general population in Sicily (South Italy): A survey study
Authors: Ferrante M , Cristaldi A , Cormaci L , Falla M G , Zuccarello P , Oliveri Conti G , Fiore M
Published: November 2019

Background

Vaccine hesitancy (VH) has become the focus of growing attention because of decreased vaccination rates and increased emergency department use, morbidity, and mortality. VH has not been deeply studied in Sicily. The aim of this study was to estimate the prevalence of VH among parents and to investigate the potential determinants.

Methods

We performed a survey from 1 March to 1 June 2018, using a random sample of parents who reported on median 10 year-old children. The parents were recruited in pediatrician’s offices and elementary schools. Information pertaining to socio-demographic characteristics, sources of information regarding vaccination and VH was collected. VH was calculated using the Parents Attitudes about Childhood Vaccines (PACV) questionnaire. Associations between VH and predictors were tested using Multivariable Logistic Regression.

Results

In total 471 questionnaires were collected, 77.7% of respondents were mothers. Based on the PACV 100-point scale, 73.2% (95% CI: 69.0-77.2) of parents had a 0 to <49 score (low level of VH); and 26.8% (95% CI: 22.8-31.0) had a score of 50 and higher (high level of VH). Internet (66.9%, 95% CI: 62.4-71.1) was the main source of information on vaccination followed by television (29.1%, 95% CI: 25.0-33.4). In the bivariate analyses, VH was associated with education, marital status and occupation, but not with gender and age of parents. In multivariate analyses, highly educated (ORadj = 0.297, 95% CI = 0.141-0.626) and married (ORadj = 0.457, 95% CI = 0.213-0.977) parents were more prone to be nonhesitant, but not so unemployed parents (ORadj = 1.787, 95% CI = 1.083-2.956).

Conclusions

The prevalence of VH among the Sicilian parents was comparable with other populations. These results could be an important starting point to support the implementation of effective vaccination strategies.

Key messages

Implement interventions and strategies to further understand the issue of VH, to restore trust in authorities and vaccines. Suggest strategies that could improve childhood vaccination rates.
Prevalence survey of healthcare associated infections in a large teaching hospital
Authors: Castellani F , Barbato D , Angelozzi A , Isonne C , Baccolini V , Migliara G , Marzuillo C , De Vito C , De Giusti M , Villari P
Published: November 2019

Background

Healthcare Associated Infection (HAI) is the most frequent adverse event in healthcare settings. It is associated with an increased mortality and antimicrobial resistance, prolonged hospital stays and consistent financial loss for the healthcare systems. The objective of this study was to estimate the burden of HAIs and antimicrobial use in the Teaching Hospital Policlinico Umberto I (THPUI) of Rome to identify the most critical areas for interventions.

Methods

Data were collected according to the most recent ECDC Point Prevalence Survey protocol in November 2018. Descriptive statistics for all variables were calculated. Univariate analysis was used to assess possible associations between variables and HAIs. Variables with a significance level of p < 0.25 were included in a multiple logistic regression model.

Results

A total of 799 patients were included in the analysis; of these, 13.3% presented at least one HAI. Bloodstream infection was the most common, accounting for 30.9% of the total infections. Globally, 125 microorganisms were isolated, with Enterobacteriaceae being the most frequent (32%). At the time of the survey, 49.1% patients were receiving antimicrobial therapy. The multivariate analysis showed a significant association between HAI and use of medical devices (OR = 34.30,IC95%:3.69-318.66), length of stay (OR = 1.01, IC95%:1.00-1.02) and the exposure to prophylactic antimicrobial therapy (OR = 0.23, IC95%:0.11 -0.47).

Conclusions

Our HAI prevalence was higher than the European standard (6.7%). This highlights the need of implementing targeted measures to prevent and control HAIs and a continuous monitoring to evaluate the effectiveness of such interventions. Another step could be the elaboration of a survey to investigate the knowledge, attitudes and practices of healthcare workers towards HAIs in order to raise awareness, enhance surveillance strategies and promote educational interventions.

Key messages

It was important to quantify the burden of HAIs in the THPUI in order to identify the main areas for interventions. Several activities will be implemented to contain this problem.
MenACWY vaccination decisions in the Netherlands: the role of risk perceptions
Authors: de Vries M , Claassen L , te Wierik M , Coban F , Timmermans D , Timen A
Published: November 2019

Background

The Netherlands experiences an unprecedented increase in meningococcal W infections. A national catch-up menACWY vaccination campaign started in October 2018, covering birth cohorts 2001-2005. To understand menACWY vaccination decisions, our study reports on perceptions of risks and their influence on menACWY vaccination intentions during an ongoing outbreak of meningococcal infections.

Methods

Online surveys were administered in September 2018 among adolescents (AD) targeted for menACWY vaccination (N = 3036) and parents (PA) of these adolescents (N = 3002). Following a mental models approach, survey items addressed knowledge and beliefs of meningococcal disease, the menACWY vaccination and vaccinations in general, and menACWY vaccination intention. Random Forest Analyses were conducted to identify those knowledge and beliefs that strongest predict vaccination intention.

Results

The response was 52.8% (N = 1603) in AD and 57.1% (N = 1784) in PA. 71% Of AD and 83% of PA indicated a positive vaccination intention. Most respondents perceived meningococcal disease as a severe disease with possible deathly consequences and were aware of transmission routes. Some misbeliefs of vaccines were rather strongly represented, with respectively 35% of AD and 45% of PA thinking that each year a number of children dies due to vaccination side effects. Preliminary results indicate that perceptions of vaccines in general, especially concerning the need for and the effectiveness, were the strongest predictors of vaccination intention in both AD and PA.

Conclusions

Adolescents and their parents seemed well informed about meningococcal disease, but less about vaccinations. The belief that vaccines are needed and effective in preventing infectious diseases seems to be of more importance in vaccination decisions than other beliefs of disease and vaccination. Future communications need to address the identified misbeliefs and emphasize the need for and effectiveness of vaccines.

Key messages

MenACWY vaccination intentions are more dependent on beliefs about vaccines in general than on beliefs about meningococcal disease and the menACWY vaccination. The belief that vaccines are needed and effective in preventing infectious diseases is of major importance in menACWY vaccination decisions.
Legionella control in a tertiary care hospital in Italy: adapting solutions to changing scenarios
Authors: Noberasco G , Battaglini A , Grammatico F , Zacconi M , Battistini A , Daturi V , De Florentis D , Borneto A , Morando A , Orsi A
Published: November 2019

Background

Legionella contamination of hospital water distribution system still remains a critical issue in healthcare settings, despite the disputed relationship between environmental legionella and hospital-acquired legionellosis. We report the experience of our 1200-beds hospital, where a new water safety plan (WSP) has been applied since 2017, and the results obtained with the application of different methods to control Legionella water contamination, especially in critical areas.

Methods

Policlinico San Martino is the referral tertiary acute-care university hospital in Liguria region, North-West Italy. It’s made of 21 buildings of different dimensions, 7 of which host high risk patients, according to Italian Guidelines for legionellosis prevention and control. A sampling plan for Legionella detection was implemented in 2017, focusing on the water network critical points. Different secondary disinfection procedures were used, including systemic (chlorine dioxide, monochloramine), focal (point-of-use filtration) and short-term methods (hyperchlorination), the last in case of contamination higher than 10^4 CFU/l.

Results

Respectively, during 2017 and 2018 a total of 201 and 119 hot water samples were collected, distributed among the 7 critical buildings of the hospital. Negative samples raised from 69.7% to 74.8%, while positive samples >10^3 CFU/l (recommended cut-off for acute disinfection according to Italian guidelines) lowered from 21.9% to 9.2% of total samples. Out of 55 positive samples, Legionella sg 3 accounted for 98.2% of the total.

Conclusions

The new WSP determined a significant reduction of Legionella contamination of water distribution networks in our hospital critical buildings. The continuous surveillance of critical water system points provided evidence to elaborate an effective protocol for routine and extraordinary disinfection interventions, as result of a close collaboration between hospital hygiene unit and engineering and technical services.

Key messages

The implementation of an effective water safety plan and different disinfection procedures in hospital critical areas allow us to reduce and control the risk of hospital-acquired Legionella infection. Continuous surveillance cultures of drinking water to detect Legionella are necessary to adapt disinfection methods to local results.
Pediatric vaccination appointment scheduling: experience from an Italian clinic
Authors: Toscano F , Cuccaro C , Ceriale E , Mercone A , Rossi S , Nante N , Messina G , Bagnoli A
Published: November 2019

Issue/problem

Since 2012 pediatric vaccination coverages in Italy have been decreasing. Negative trends have been recorded especially for hexavalent and MMR vaccines. In mid-2017 the Italian government passed an act making ten vaccines compulsory. Most recent data show the act is working, however other aspects of the process should be improved.

Description of the problem

Parents are invited to bring their children to the clinic through letters or telephone calls. Vaccination appointments are scheduled during weekdays, either in the morning, the afternoon, or both. Each session is carried out by a physician and a nurse, with a new patient scheduled every ten minutes. Appointments and vaccinations are registered on the vaccine-specific electronic health record (SISPC).

Results

In March 2019, the vaccination clinic worked 21 days for a total of 29 sessions. 823 appointments were available, 797 of them (96.8%) had a patient scheduled before the session started. 547 (68.6%) attended the vaccination appointment, 98.4% of them were vaccinated (538, 67.5% of the total patients scheduled). Among those who did not attend the scheduled appointment, only 108 (43.2%) agreed to reschedule. Eventually, only 58.3% of these patients attended the rescheduled appointment. No statistically significant differences among those who attended and those who did not attend the appointment were found among the variables retrieved from SISPC: day, time, vaccination planned (type, and if mandatory or not), sex, age.

Lessons

A third of available vaccination appointments in our clinic were lost. Despite the ease through which patients can reschedule an appointment, many choose not to and left their appointments unattended. Although missing a vaccination appointment can be appropriate - e.g. when the child is sick - and great effort should be put to achieve the goal of improving coverages, policymakers should also consider provisions to discourage such behaviors for a better use of resources.

Key messages

A third of available vaccination appointments in our clinic were lost in a month. Keeping in mind the goal of improving coverages, policymakers should aim for the best possible use of resources.
Improving the operational skills of the health personnel working in the emergency departments
Authors: Arnone R , Romano G , Skinner J , Watt S , Poenicke C , Hoestergard D , Chiaramonte G
Published: November 2019

In December 2013 the European Commission approved the project promoted by CEFPAS, The Centre for Training and Research in Public Health within the programme PROGRESS, “Improving the operational skills of health personnel working in the emergency departments. A useful tool to give concrete answers to EU policies on patients’ safety and to create new working opportunities”.

This project aimed to combine the need to find innovative solutions in the field of healthcare with the objective of increasing the safety of patients in emergency departments, while also covering the need to promote worker mobility within the European Union. The key tool for implementing this goal is the exchange of experience and best practices.

The project partners included: the Edinburgh University of Medicine, the Napier University (again in Edinburgh), the Dresden University of Technology, the Herlev Hospital (in Copenhagen) through the DIMS or the Danish Institute for Medical Simulation at the University of Copenhagen, as well as ISMETT and CREAM (the Research Centre of the University of Medicine) in Palermo.

Every partner, during the planning, has provided the know how developed in the area of emergency. Specifically it has been analyzed the possibility to compare and visit the simulation Centres of Edinburgh, Dresden and Palermo, and to study the use, in each country, of innovative methodology during the training of the health personnel.

The partner, during the planning of the project, studied also how to help people to find easier jobs opportunities in the health sector (so they thought to create a specific data base of the emergency departments operating in Italy, Scotland and Germany where to find a job or a chance for an internship).

The project has lasted for one year and has provided research activities and the exchange of experience and best practices.

Key messages

There is a huge difference regarding the way in which the emergency system is organized within single countries around Europe. Comparing high-level organisations we have benefited in terms of ideas, projects and potential objectives to be set in order to improve our work and to improve results for patients.
Recording educational information in medical record: the experience of a Rehabilitation Hospital
Authors: Scarpis E , Poletto M , Guardini I , Londero C , Maestra M R , Tea G P , Zampa A , Lattuada L , Castriotta L , Brusaferro S
Published: November 2019

Issue/Problem

Healthcare organizations have the responsibility to provide education to patients and families so that they have the knowledge to participate in the care process and make decisions. Rehabilitative organizations, on account of the long hospitalization period and the specific care plans, have to organize education resources in the most effective manner, ensuring the registration of what has been done in the medical record (MR).

Description of the problem

During the accreditation process, IMFR (Medical and Physical Rehabilitation Institute - an hospital part of the Udine Healthcare Trust) launched a MR-quality program. A dedicated team of 3 doctors, 4 nurses and 4 therapists changed the way in recording educational information in MR, introducing in April 2018 a specific, independent form, part of the MR, where documenting the achievement of two educational phases: assessment and delivery. The aim of this project is to determine if the introduction of this specific educational form and its sharing process, included in the wider MR-quality program, would improve the recording behavior. Twenty MRs were quarterly analyzed from December 2017 to December 2018, assessing educational forms completeness. Significance (p < 0.01) was assessed by Cochran-Armitage test for trends.

Results

The recording behavior improved significantly from 53% (21/40; Dec-17) to 88% (30/34) in June 2018, after the introduction of the specific education form and remained high also in Sept.2018 (90%, 34/38) and in Dec.2018 (82%, 31/38), with an overall trend of + 29%.

Lessons

Sharing elements in the creation of the specific educational form with a multidisciplinary approach, within a wider MR-quality program, allows to improve the recording behavior of educational information in it. Hopefully this method would help healthcare professionals and organizations to ensure the education needed to patients and families.

Key messages

A multidisciplinary approach is a good model to deal with specific aspects of quality programs. A specific form, part of the MR, allows to improve behavior in recording educational information.
Roma health mediators in Serbia – good example of multisectoral cooperation in health promotion
Authors: Kilibarda B , Vasic M , Knjeginjic V
Published: November 2019

Issue

Within the framework of the JA CHRODIS plus participants of the WP5 worked on identification of factors that contribute to collaboration within healthcare and between the broader health system and other sectors, as well as their enablers and barriers. In Serbia, practice that was identified and elaborated was aimed at improvement of health of Roma population.

Description of the problem

Based on available data, health indicators among Roma population in Serbia were two to three times worse than national averages. In order to tackle this issue, government of the Republic of Serbia, started with implementation of the project of education and inclusion of Roma health mediators in the health system. This project has been implemented in Serbia since 2009. Roma Health mediators (Roma ethical minority females) were trained for fast and efficient provision of support to Roma families.

Results

As a result of the project there was increased number of visits to health institutions and preventive check-ups of target population. Established cooperation between Roma health mediators and other health professionals in centers for primary health care, social care, and local self-government helped them in fulfilling their tasks, but also built capacity of other service providers to work in Roma communities. Through trainings they increase knowledge on various health, social and child care topics.

Lessons

Capacity building and inclusion of memebrs of vulnerable population into health promotion of the own to this population in terms of better acceptance of specific population population is useful to access groups as they can better understand and adapt to the needs of groups they want to reach. They should have opportunity to share their experience and lessons learned with experts involved in planning interventions for other vulberable groups.

Key messages

Building capacity of Roma mediators empowers them for integration into society beyond the scope of the Project. Lessons learned should be used for planning further actions for vulnerable groups.
Early recognition of mental health problems in Croatia
Authors: Stimac D , Pavic Simetin I , Istvanovic A
Published: November 2019

Issue/problem

Mental disorders account for the largest and fastest growing categories of the burden of disease in Croatia. Around 30% of the population has experienced some form of mental illness in the past year. 32% of them had more than one mental health problem. 50% of mental disorders arise by the age of 14. School medical doctors in Croatia are in the position to do early recognition of mental disorders during regular check-ups of school children. It is very important that the health care system helps people to be aware of early signs of mental health problems and enable people to get the timely treatment. According to those facts, Croatian Institute of Public Health starts the preparation for implementing screening for mental health risks of school children. The screening will be implemented by the school medical teams for all students as part of regular yearly check-ups in the 5th and 8th grade of elementary school and 1st grade of secondary school. The screening will be carried out using the YP-CORE questionnaire, which measures the degree of general mental distress. Students at increased risk will be referred to Mental Health Departments in County Public Health Institutes. Mental Health Department’s team of experts, which includes psychiatrist, nurse and psychologist, will carry out further diagnostic and treatment. Education of school staff, which includes teachers, school psychologists, special educators, social workers, nurses who are in direct contact with the children will also take place. Parents also should be educated on early recognition of mental disorders and should be recognized as partners in diagnostics and therapy throughout the child’s life.

Lessons

Early recognition of mental disorders leads to a reduction of psychological distress and increased feelings of control over one’s health.

Key messages

Early recognition of mental disorders leads to a reduction of psychological distress and increased feelings of control over one’s health. School staff and parents should be partners in earliy recognition and treatment of mental disorders of school childrens.
Verbal victimisation and mental health of sexual minority adults in France
Authors: El-Khoury F , Marr K , Melchior M , Héron M ,   Equipe Baromètre Santé 2017
Published: November 2019

Objectives

Sexual minority individuals face minority stress, and specific discrimination and abuse that might increase their risk of having mental health problems. We examine associations between sexual orientation, experienced violence in the past year, and mental health outcomes in a representative sample of French adults aged 18 to 75 years.

Methods

Analyses were based on the “Health Barometer” (Baromètre Santé) a nationally representative, cross-sectional survey which recruited 25,198 adults in 2017. Data were weighted to be representative of the French adult population. Four mental health outcomes occurring in the preceding year or currently were examined: a) current depressive symptoms, b) having experienced a major depressive episode, c) suicidal ideation, and d) suicide attempt. We conducted mediation analysis using the counterfactual approach to evaluate the contribution that verbal violence victimisation experience in the preceding year has in the association between sexual orientation and mental health outcomes.

Results

Sexual minority adults were more likely to experience verbal violence in the last year compared to heterosexual individuals (22% vs 11.4%). They were also more likely to have experienced each of the four mental health outcomes. Verbal victimisation in the preceding was found to significantly mediate the association between sexual orientation and mental health outcome with mediated proportions varying between 15 to 22%.

Discussion

Initiatives that aim to structurally reduce stigma and victimisation against sexual minority individuals, but also improve social support and resilience, could have a significant impact on their mental health and well-being.

Key messages

Sexual minority adults are more likely to experience verbal violence, and mental health problems. Verbal victimisation partly explains the increased risk of having mental health problems among sexual minority individuals.
The EMMY Project: Promoting mental wellbeing among the oldest old – The Finnish Case
Authors: Forsman A K , Nordmyr J
Published: November 2019

Background

The European Welfare Models and Mental Wellbeing in Final Years of Life (EMMY, 2017-19) project covers interdisciplinary and mixed method studies on mental wellbeing among the oldest old in Finland, Italy, Norway and Spain. The overarching aim is to strengthen the understanding of how welfare models and related policies could be adapted to support mental wellbeing in the oldest old. Project results will be incorporated in a new tool for assessing the mental wellbeing impact of welfare policies.

Methods

23 focus group interviews were conducted, including 117 participants aged 80 years or older. Six of these were conducted in Finland (N = 28) and the data was analysed using qualitative content analysis. In a policy analysis, relevant national legislation, plans and programmes were identified from the four countries. Five key stakeholders in each country validated the identified policies in interviews. The policy items were systematically coded (N = 42 in Finland), focusing on their correspondence with older adults’ own views on their mental wellbeing and its protective factors.

Results

The findings highlight that although functional status undeniably plays an important role for experienced wellbeing in general, it is not the principal component of the experienced mental wellbeing among the oldest-old. The Finnish policy case pinpoints both promising policy examples, but also development needs such as the inclusion of issues related to e.g. digitalization and social challenges including loneliness.

Conclusions

These findings have significant multi-level implications, showcasing the importance of coordinated actions at societal and individual levels alike. Actions to enhance social participation, especially for individuals with reduced social networks are needed, as well as a more holistic approach in general considering the multi-dimensional nature of experienced mental wellbeing in later life.

Key messages

Results support the exchange of good policies between EU Member States to incorporate a change of focus from mental disorders to mental wellbeing among older people and its protective factors. Country-specific case studies highlight the relevance of context,pinpointing the various pathways to increased mental wellbeing that could be translated into policy.
Determination of mental status of the university students and related risk factors
Authors: Erden Cengiz C , Topuzoğlu A
Published: November 2019

University time is one of the most challenging periods of a person’s life. It’s also peak period of many mental illnesses. Mental disorders are the most important cause of disability in people aged 10-24 and contribute to 45% of the disease burden. The aim of this study is to determine the frequency of mental illness of university students in the research population and to assess the possible risk factors.

This study is a cross-sectional study. 345 students systematically selected by population weighting method were included in the study. Dependent variable of the study is depression, generalized anxiety, bipolar disorder and presence of psychotic symptoms. Mental disorders were evaluated using the CIDI and the DSM-5 Oriented Diagnostic Interview Form. 30.1% of the students had depression, 25.2% had generalized anxiety disorder, 9% had bipolar disorder and 2.9% had psychotic symptoms. The mean age of the participants is 20.4 ± 1.6. According to the binary logistic regression analysis, mother with mental problems, sexual abuse, person with special needs in family, pessimistic personality were found as risk factors for depression. Female gender, stay in a dormitory, poor economic condition of the family, mother with mental problems, alcohol/substance use of parent, pessimistic personality, lack of confidence were risk factors for generalized anxiety disorder. Alcohol use was risk factor for bipolar disorder. Poor academic achievement, having the family excluded by society were risk factors for psychotic symptoms. Average income level was a protective factor for bipolar disorder. Approximately one out of every 3 students use alcohol, and one out of every 20 students found to be at risk by using drugs.

The incidence of mental disorders in university students is high. Many factors play a role in the emergence of mental problems. Early recognition of mental disorders, effective control and intervention studies are highly valuable in universities.

Key messages

The social negative attitude developed against psychiatric diseases and patients has a direct effect on the prevention, early recognition and treatment of mental disorders. University students should be seen as a risky group for substance use, policies should be developed to prevent substance use at universities immediately.
Mental health problems and support needs of PhD students: bottle necks of the phD trajectory
Authors: Van Der Heijde C M , Douwes L , Vonk P
Published: November 2019

Background

A substantial part of PhD students is struggling with mental health problems. These complaints can lead to dropping out and societal costs. Various bottlenecks that students may face during the PhD process can undermine mental health. We aim to test what bottlenecks are predictive of mental health problems. Furthermore, we aim to address the responsibility of the University.

Methods

In a cross-sectional survey design (N = 427), both mental health status, and possible bottlenecks of the PhD trajectory were studied amongst PhD students at the University of Amsterdam. Mean age was 29 years; 29% was male; 71% female. Participants were recruited through emails and newsletters (response rate 14%). Regression analysis’ were performed with depression and anxiety as dependents (k6, ek10). We controlled for gender, age, international PhD student yes/no.

Results

PhD students that score higher on anxiety, are more often international students (β=.09; p<.05), score significantly higher on negative work home interference (β=.46; p<.001), and on negative home work interference (β=.12; p<.01), score significantly lower on social support (β=.19; p<.001) and on self-efficacy (β=-.18; p<.001). [F(15, 413) = 20.00; p = .000].

PhD students that score higher on depression score significantly higher on negative work home interference (β=-.54; p<.001), and on negative home work interference (β=-.07; p<.05), score significantly lower on social support (β=-.23; p<.001) and on self-efficacy (β=.03; p<.001). [F(15, 416) = 41.68; p = .000].

Conclusions

The bottlenecks that we found to be predictive of a worse mental health status can be addressed in the university context through providing information to PhD students, PhD supervisors and PhD student counselors. Extra attention needs to be paid to international PhD students. The University could offer interventions such as coaching, career guidance, relaxation training, time management, intervision, and sports to meet support needs.

Key messages

Work home interference, home work interference, social support and self-efficacy are important aspects of mental health in PhD students. Extra attention needs to be paid to international PhD students. The University has a responsibility and an interest regarding its PhD students’ mental health and wellbeing: appropriate interventions can be deployed for the support needs of PhD students.
Childhood adversities and related mental health among children in socialization centers
Authors: Peciukaityte A , Jakubauskiene M
Published: November 2019

Background

Life course paradigm provides a comprehensive overview of different determinants and mental health outcomes during the life course. Childhood adversities experienced in early adulthood are related to poor mental and physical health in the future. The aim of the study was to identify relations between experienced childhood adversities and mental health outcomes among children in socialization centers and regional high schools (HS) in Lithuania.

Methods

A prevalence study was conducted in all 3 socialization centers (SC) in Lithuania (n = 35) and two regional high schools (n = 96) among 13-18 year old’s. Anonymous individual interviews were conducted in 2018. Descriptive statistics using SPSS was applied for assessment of adverse life events, mental health risk factors and outcomes (%). Pearson chi square, Fisher test, Kruskal - Wallis H were applied for comparison and statistical significance (p ≤ 0,05).

Results

Prevalence of bullying among children in SC was 77.1% (47.9% among HS children), parental divorce - 60% (27% HS), parental criminal behavior - 40 % (2.1% HS), family violence - 48.6% (16.7% HS), physical abuse - 62.9% (9.4% HS), parental alcohol use - 40% (13.5% HS). 74.3% among children in SC experienced neglect, physical traumas (39.6% HS), prevalence of suicidal behavior was 25.7% and 6.25% accordingly. Criminal behavior, alcohol, substance abuse and smoking were much more prevalent among children in socialization centers than among high school children (p < 0.01).

Conclusions

Children in socialization centers had higher exposure of childhood adversities and poorer mental health outcomes. High prevalence of adversities was related to poor parenting skills as well as toxic family and social environment.

Key messages

Childhood adversities experienced in early adulthood are related to poor mental and physical health as well as deprivation of social performance in later life. Childhood adversities are more prevalent among children in socialization centres than in regional high schools.
Sleep and Mental Health Among Older Adults in the Canadian Longitudinal Study on Aging
Authors: Rodrigues R , Nicholson K , Wilk P , Guaiana G , Stranges S , Anderson K K
Published: November 2019

Background

Global studies have demonstrated consistent associations between sleep problems and mental health and well-being in older adults, however Canadian data are lacking. We investigated associations between sleep quantity and quality with both mental illness symptoms and well-being among older adults in Canada.

Methods

We used cross-sectional baseline data from the Canadian Longitudinal Study on Aging, a national survey of 30,097 community-dwelling adults aged 45 years and older. Self-reported sleep measures included average past-week sleep duration (short [<6h], normal [6-8h], long [>8h]), and sleep quality (satisfied or dissatisfied vs neutral). Mental illness outcomes included depressive symptoms and psychological distress. Mental well-being outcomes included self-rated mental health and satisfaction with life. We used modified Poisson regression models with adjustment for sociodemographic, behavioural, and clinical factors, and stratification by sex and age to explore effect modification.

Results

In the unadjusted analysis, short and long sleep duration and sleep dissatisfaction were associated with higher mental illness symptoms and lower well-being across all outcomes. Sleep satisfaction was associated with a lower likelihood of mental illness symptoms and better well-being. Short sleep duration was associated with the largest effects on mental health outcomes. Self-rated mental health and depressive symptoms had the largest associations with sleep measures. Effects were larger in males and the 45 to 54 year age group.

Conclusions

Preliminary evidence suggests sleep duration and quality are associated with symptoms of depression, psychological distress, and poor mental well-being among older adults. We are unable to determine whether sleep problems are a cause or consequence of poor mental health. Nonetheless, sleep may be an important target for public health initiatives to improve mental health and well-being among older adults.

Key messages

Our findings contribute further evidence that sleep difficulties are associated with adverse health outcomes including higher mental illness symptoms and lower well-being among older adults. Sleep disturbances are an unmet public health problem, and may be an important target for public health initiatives to improve mental health and well-being among older adults.
What can dietary patterns tell us about the Caribbean nutrition transition?
Authors: Colombet Z , Allès B , Perignon M , Landais E , Martin-Prével Y , Amiot-Carlin M-J , Darmon N , Méjean C
Published: November 2019

Background

Given the public health urgency facing the increasing rates of obesity and chronic diseases in the Caribbean, characterization of the nutrition transition and population groups at higher nutritional risk is needed. We identified dietary patterns in the French West Indies (FWI) and their association with individual characteristics.

Methods

This cross-sectional analysis included 1,144 Guadeloupeans and Martinicans from a representative survey. To identify dietary patterns, principal component analysis was performed using 25 food groups, followed by a clustering procedure classifying subjects in independent clusters. Their associations with health status, Diet Quality Index-International (DQI-I), food supply behaviors, sociodemographic and economic characteristics were studied using multivariable models.

Results

Four dietary patterns were identified, representing 25%, 24%, 31% and 20% of the sample: (1) a “healthy” cluster characterised by a high DQI-I, composed of high educated individuals; (2) a “traditional” cluster with a high DQI-I and high intakes of traditional dishes, formed mostly by women and older persons, with a high obesity prevalence (26%); (3) a “western” cluster with a low DQI-I, high intakes of sweetened beverages, snacks and fast foods, composed mainly of young subjects, buying their fruits, vegetables and tubers only or mainly in supermarkets; and (4) a “transitional” cluster with high intakes of bread, processed meat, sauces, alcoholic and sweetened beverages but conversely high intakes of tubers, legumes, fish and low intakes of biscuits and cakes, formed mainly by middle age men, self-employed or manual workers, and 35% had metabolic syndrome.

Conclusions

The dietary patterns identified reflect different steps of dietary change as described by Popkin, suggesting an ongoing nutrition transition in the FWI. This characterization provides useful information for public health actions regarding population groups at higher nutritional risk.

Key messages

Four diversified dietary patterns were identified suggesting an ongoing nutrition transition in the French West Indies. Demographic and socioeconomic characteristics associated with dietary patterns, especially age, reflecting a generational contrast, provided needed information to guide future public health measures.
Factors associated with mechanical and systemic adverse events after colonoscopy (France, 2010-2015)
Authors: Laanani M , Weill A , Blotière P O , Pouchot J , Carbonnel F , Coste J
Published: November 2019

Background

More than one million colonoscopies are performed every year in France. They are associated with risks of mechanical and systemic serious adverse events (SAEs) which can be associated with patient, procedure, endoscopist, and facility characteristics. We tried to identify the factors associated with colonic perforation, gastrointestinal bleeding, splenic injury, shock, myocardial infarction, stroke, pulmonary embolism, acute renal failure, and urolithiasis after colonoscopy.

Methods

We analysed data from the French national claims databases (SNDS). A total of 4,088,799 patients, 30 years or older, undergoing a first screening or diagnostic colonoscopy between 2010 and 2015 were identified. SAE rates were estimated, and risk factors associated with SAEs were identified using multilevel logistic regression models, adjusted for patient, colonoscopy, endoscopist, and facility characteristics.

Results

Increasing age was associated with an increasing incidence of mechanical and systemic SAEs. Cancer and cardiovascular comorbidities were associated with mechanical SAEs, and a higher number of pre-existing conditions was associated with shock and acute renal failure. Polypectomy, especially of polyps larger than 1 cm, was associated with an increased risk of perforation (OR = 4.1; 95% CI, 3.4-5.0) and bleeding (OR = 13.3; 95% CI, 11.7-15.1). Mechanical SAEs were associated with the endoscopist’s experience, while systemic SAEs were more frequent in public hospitals than in private clinics.

Conclusions

SAEs related to colonoscopy were more frequent in older patients and in those with comorbidities. Mechanical SAEs were more frequent when colonoscopy was performed by less experienced endoscopists. Systemic SAEs were more frequent in public hospitals, reflecting patient selection processes. The risk of both mechanical and systemic SAEs should be taken into account when deciding to perform colonoscopy, particularly in older patients with multiple pre-existing conditions.

Key messages

Systemic SAEs are not uncommon after colonoscopy and, together with intestinal SAEs, should be considered when considering the need for colonoscopy. Patients at risk of SAEs should be identified and colonoscopy should be performed by experienced endoscopists in these patients. Less invasive alternatives should also be considered in these patients.