bluuebunny/crossref_metadata_2025 huggingface dataset:
Integrated health and social care evaluation framework for mental health and drug addiction care
Authors: Barbaglia G , Robles N , Hilarión P , Torres M , Gotsens M , Colell E , Puigdomènech E , de la Torre J Arias , Espallargues M
Published: October 2022

Background

Guiding the decision-making process in mental health investments is advisable. The objective of the study is to develop a framework for evaluating the quality of integrated health and social care in Mental Health and Drug Addiction (MH&DA)

Methods

A literature review helped to establish a definition of integrated care specific to MH&DA and to identify potential indicators for its evaluation. The quality of integrated care was assessed through focus groups (FGs) and interviews (INs) with three different profiles: professionals (2FGs & 2 INs), patients (3 FGs & 2 INs) and families/carers (2FGs & 2 INs). Additional indicators were also obtained from them.

Results

Out of 2,226 publications identified, 87 (4%) were reviewed in full. According to the literature, integrated care in MH&DA is based on four main components: case management, comprehensive assessment, individualised care plan and care coordination among different providers. Based on these components, an operational definition of integrated care was developed and validated in the FGs and INs. Positive aspects identified were a respectful approach and positive experiences of coordination between social and community network. Regarding indicators about 400 were identified, after screening were reduced to 60: 25% corresponded to accessibility, 20% person-centred care, 16% each to care coordination and to effectiveness. In general, the main threats to the quality of care, identified in FGs and INs, matched the dimensions with the highest proportion of indicators (i.e., limited care resources, poor coordination and communication among professionals and services, and barriers in accessing specialized treatment).

Conclusions

According to literature, integrated care in MH&DA seems to be mainly evaluated in terms of accessibility and person-centred care. In a following phase, a large group of experts will be key to select the most relevant dimensions and indicators for the evaluation in a Delphi study.

Key messages
Determinants of Homelessness (SODH) in North West England in 2020
Authors: Mabhala M
Published: October 2022

Background

Poverty creates social conditions that increase the likelihood of homelessness. These include exposure to traumatic life experiences; social disadvantages such as poor educational experiences; being raised in a broken family, care homes or foster care; physical, emotional, and sexual abuse; and neglect at an early age. These conditions reduce people's ability to negotiate through life challenges.

Methods

This cross-sectional study documents the clustering and frequency of adverse social conditions among 152 homeless people from four cities in North West England between January and August 2020.

Results

Two-step cluster analysis showed that having parents with a criminal record, care history, and child neglect/abuse history was predictive of homelessness. The cluster of indicator variables among homeless people included sexual abuse (χ2 (N = 152) = 220.684, p < 0.001, Cramer's V = 0.7), inappropriate sexual behaviour (χ2 (N = 152) = 207.737, p < 0.001, Cramer's V = 0.7), emotional neglect (χ2 (N = 152) = 181.671, p < 0.001, Cramer's V = 0.7), physical abuse by step-parent (χ2 (N = 152) = 195.882, p < 0.001, Cramer's V = 0.8), and physical neglect (χ2 (N = 152) = 205.632, p < 0.001, Cramer's V = 0.8).

Conclusions

Poverty and homelessness are intertwined because of the high prevalence of poverty among the homeless. Poverty sets up a chain of interactions between social conditions that increase the likelihood of unfavourable outcomes: homelessness is at the end of the interaction chain. Interventions supporting families to rise out of poverty may also reduce entry into homelessness.

Key messages
Sickness absence and disability pension in white-collar workers in the trade and retail industry
Authors: Farrants K , Alexanderson K
Published: October 2022

Background

Very little is known about sickness absence among white-collars workers in the trade and retail industry, despite being a large and important group on the labour market. The aim was to investigate future sickness absence (SA) and disability pension (DP) in a cohort of privately employed white-collar employees in the trade and retail industry.

Methods

A prospective population-based cohort study of all 192,077 such white-collar workers (44% women) in Sweden in 2012, using linked microdata from three nationwide registers covering 2012-2016. Prevalence and mean number of SA and/or DP net days/year in general and by diagnoses categories were calculated for all and also stratified by sex. Logistic regression was used to calculate odds ratios (OR) and 95% confidence intervals (CI) between sociodemographic and work-related factors and future SA/DP.

Results

The proportion who had SA and/or DP was higher in women (10-13%, depending on year) than men (4-6%) each year. Each studied year, women had more mean SA/DP net days than men in the entire cohort, however, among those who had SA and/or DP, there were no gender differences regarding the mean number of net days. The mean number of SA/DP net days increased for both women and men each year, especially SA due to mental diagnoses. SA in 2012 was the strongest factor associated with SA/DP in 2016 (OR women 3.28, 95% CI 3.09-3.47; men 4.10, 95% CI 3.76-4.48). Work-related factors were only weakly or insignificantly associated with future SA/DP. The ORs for most factors were stronger for men than for women.

Conclusions

More knowledge about the mechanisms behind these results are needed. Some SA/DP measures showed large sex-differences, others not - it is important to use different measures to show the complexity of these phenomena. Several factors were more strongly associated with SA/DP among men than among women, indicating that there are other factors of importance for women.

Key messages
Prior sick leave with mental or somatic diagnoses and being in work in ages 66–71; a Swedish cohort
Authors: Martikainen A , Alavi A Svensson , Alexanderson K , Farrants K
Published: October 2022

Background

As longevity and retirement ages are increasing, knowledge is needed on factors hindering extended working lives. The aim of this study was to explore how sickness absence (SA) and disability pension (DP) due to mental and/or somatic diagnoses before age 65 were associated with being in paid work when aged 66-71.

Methods

A 6-year prospective population-based cohort study of all 98,551 people (48% women) in Sweden who turned 65 years in 2010 (baseline year) and had been in paid work at any point when aged 60-64. Microdata from nationwide registers were used. Exposure variables were SA (spells >14 days) and/or DP in 2005-2009, and the outcome variable was paid work at any point in 2011-2016. Logistic regression was used to calculate odds ratios (OR) with 95% confidence intervals (CI) for associations between exposures and outcome, controlling for sociodemographic factors in 2010, stratified by sex.

Results

Most women (56.0%) and men (66.3%) had no SA or DP when aged 60-64. Of the women, 42.7% and of the men 53.3% were in paid work after the age of 65. Those with SA due to mental diagnoses had lower OR of being in paid work (women 0.76; 95% CI: 0.69-0.84; men 0.74; 0.65-0.84). This association was weaker for SA due to somatic diagnoses (women 0.87; 0.84-0.91; men 0.92; 0.89-0.96). Having had SA due to both mental and somatic diagnoses was associated with lower OR for men (0.77; 0.65-0.91) but not women (0.98; 0.88-1.09). Full- or part-time DP had the strongest association with not being in paid work regardless of diagnosis group and sex (e.g., women mental DP 0.39; 0.34-0.45; women somatic DP 0.38; 0.35-0.41; men mental DP 0.36; 0.29-0.43; men somatic DP 0.35; 0.32-0.38).

Conclusions

SA due to mental diagnoses had a stronger association with not being in paid work after age 65 than SA due to somatic diagnoses. The results highlight the importance of identifying factors that hinder older workers with mental disorders to extend their working lives.

Key messages
Impact of COVID-19 on psychosocial work factors and emotional exhaustion among healthcare workers
Authors: van Elk F , Robroek SJW , Burdorf A , Hengel KM Oude
Published: October 2022

Background

Healthcare workers are at risk to develop mental health problems and to experience adverse psychosocial working conditions during the COVID-19 pandemic. This study aims to investigate across subgroups of healthcare workers i) differences in psychosocial working conditions and emotional exhaustion, ii) changes in psychosocial working conditions and emotional exhaustion during the pandemic compared to the situation before, and iii) impact of different stages of the COVID-19 pandemic in terms of hospital pressure on psychosocial working conditions and emotional exhaustion.

Methods

Data on psychosocial working conditions and emotional exhaustion of five measurements from 1,915 healthcare workers participating in the longitudinal study ‘the Netherlands Working Conditions Survey- COVID-19’ were used. Three subgroups were defined: working with COVID-19 patients, working with other patients, and not working with patients. For each measurement, hospital pressure was determined. Linear mixed models were fitted to analyze the differences across subgroups of healthcare workers.

Results

Healthcare workers working with patients, in particular COVID-19 patients, had more unfavorable psychosocial working conditions than those not working with patients. Psychosocial working conditions deteriorated among those working with patients compared to pre-COVID-19, but no changes were found for emotional exhaustion. An increasing hospital pressure resulted in improved job autonomy and emotional demands among healthcare workers working with COVID-19 patients, but did not result in differences in other working conditions and emotional exhaustion.

Conclusions

Psychosocial working conditions deteriorated for healthcare workers working with (COVID-19) patients during the pandemic compared to the situation before the pandemic, while emotional exhaustion did not change in these subgroups. This shows the importance of interventions to improve working conditions of healthcare workers.

Key messages
Predictors of physical activity and smoking among German teachers during the SARS-CoV-2 pandemic
Authors: Eggert V , Koestner C , Beutel T , Kalo K , Dicks T , Zaehme C , Letzel S , Dietz P
Published: October 2022

Background

The SARS-CoV-2 pandemic has influenced the social and health-related behavior due to significant changes and constraints in the professional and private life. Especially in the school context, there were considerable changes, which may have promoted positive and negative health behaviors. Therefore, the aim of our study was to identify the predictors of physical activity and smoking of teachers during the SARS-CoV-2 pandemic.

Methods

In March 2021, a nation-wide online survey was conducted among teachers in Germany. A total number of 31,089 participants entered analysis. Data on smoking and physical activity as well as sociodemographic, workplace-related, psychological, SARS-CoV-2-related, and health-related items were collected using established instruments and if necessary self-developed items. Two binary logistic regressions with block wise inclusion of the different variable groups were performed to predict physical activity and smoking.

Results

Among all surveyed teachers, 70.1% did not comply with the WHO recommendation of being physically active for at least 150 minutes per week and 13.9% reported to smoke. The regression analyses revealed significant predictors for physical activity (e.g., time requirement) and smoking (e.g., work schedule).

Conclusions

Recommendations to improve teachers’ health can be derived from the predictors for physical activity and smoking that were identified in our study. Given the alarming result that more than two thirds of the teachers did not comply with the WHO recommendations, a special focus should be placed on improving physical activity, as this is a crucial factor for somatic and mental health.

Key messages
General paediatrics: motives and concerns of medical students on the career pathway
Authors: Šlegerová L , Michenka P , Kočí M
Published: October 2022

Child public health is dependent on preventive care provided by primary care physicians for children and adolescents. Nevertheless, their accessibility in Czechia is exceedingly endangered by their ageing (the average increased by 1.5 years to 57.5 in eight years). This study aims to (1) identify medical students who opt for paediatric residency and explore the effect of undergraduate training on their decision, (2) detect factors that would persuade them to become practitioners, and (3) factors influencing their choice of a medical facility. The analysis builds on our survey's unique data exploring students’ views on training and occupational preferences. Students in the fourth to the sixth year of all medical faculties in Czechia were addressed in two waves (2020 and 2021) of this cross-sectional study, resulting in 2,283 complete questionnaires (response and coverage rate of 25.3%). Out of these, 306 respondents have already decided on or shortlisted paediatrics as a residency speciality, with a strong over-representation of women (85.3%). The evaluation of undergraduate paediatric training's quality (in terms of its organisation, number of students and teachers’ feedback) is mildly correlated with considering the paediatric residency (Cramer's V < 0.1). Fewer administrative obligations represent the most frequent factor necessary to lean towards primary care, reported by 54% of respondents preferring hospital paediatrics (or yet undecided); a financial entry bonus is less convincing (only 27% of them). To attract graduates, medical facilities need to provide favourable conditions for residency (good supervisor, employer's support in the training); financial offers might not be an adequate decoy in less-attractive areas. This survey sheds light on medical students’ views and decision-making processes, which are essential to consider in the public discussion on the future accessibility of primary care for children and adolescents.

Key messages
Nurse understaffing and short work experience as predictors of healthcare-associated infections
Authors: Peutere L , Terho K , Pentti J , Ropponen A , Kivimäki M , Härmä M , Krutova O , Ervasti J , Koskinen A , Virtanen M
Published: October 2022

Background

Healthcare-associated infections (HAIs) are a serious risk factor for hospital patients leading to more than 90 000 deaths each year in European countries. It has been evaluated that 7% of patients in European acute care hospitals acquire an HAI, and that a large part of cases could be prevented. Good hand hygiene is central in preventing HAIs, which may be compromised under high work pressure. The aim of this study was to analyse the associations between nurse understaffing and short work experience with the risk of HAIs at patient-level. Prior evidence on this topic remains inconclusive due to a reliance on imprecise measurement of these exposures.

Methods

We utilized administrative data on employees’ working hours and patient records from one hospital district in Finland from years 2013-2019. The data included in total 281,672 inpatient periods. We used mixed-effects survival analyses to predict the overall risk of HAIs, and four types of HAIs: bloodstream, Clostridium difficile, surgical-site and pneumonia. To consider the incubation time, exposure to nurse understaffing and short work experience were measured in preceding days in moving time windows when the patients were in the hospital.

Results

Preliminary results showed that exposure to nurse understaffing within two days, measured as low nursing hours relative to planned hours, was associated with increased risk of HAIs (hazard ratio was 1.23, 95% CI 1.05-1.45). Additional analyses showed that this risk was especially pronounced in surgical-site infections, which were also carefully monitored in the hospital district. We did not find associations between exposure to short work experience among nurses and HAI risk.

Conclusions

This study showed that nurse staffing below planned levels was associated with an increased overall risk of HAIs, particularly surgical-site infections, among patients. Adequate levels of nursing staff in hospitals may be important for preventing HAIs.

Key messages
The role of ‘satellite crash training’ in capacity building for migration health out of Europe
Authors: Szilárd I , Emődy L , Hárdy L , Marek E , Katz Z , Jaksa C , Kiss I
Published: October 2022

Background

In spite of the significant shortage of migration health professionals in and out of Europe, higher education institutions are not really likely to accept WHO repeated calls for developing/ strengthening ‘migrant sensitive’ health care. Following the Syrian crisis in 2015/16, and now in Ukraine, millions of refugees have left their home country.

Objectives

University of Pécs Medical School (UPMS) - based on its broad experience in migration health training -, has developed a ‘crash training’ package, easy to implement in other higher education institututions.

Results

Within the frame of the program of the Hungarian Ministry of Foreign Affairs aiming to increase the migration health capacity in the Jordanian Kingdom, UPMS has established a bilateral cooperation with the Jordanian University in Amman and has offered to implement and monitor a seven-day satellite crash training on migration health.

- The program was developed in a form of ‘problem-based learning’, aiming to strengthen the self-activity of the students, while solving the task: how to establish a refugee camp addressing the challenge of high and rapid influx of migrants from the region.

- The necessary theoretical background provided by the expert team was set up around the territories as follows: international guidelines and experiences, epidemiological and public health challenges, the role of cultural competence, mental health aspects including the need for ‘helping the helpers’ as well.

Conclusions

The program included a pre- and post-test component, aiming to monitor the change in knowledge, attitude, and commitment. Detailed results will be introduced during the presentation.

Key messages
Determinants of cigarette and e-cigarette use among youth and young adults-PolNicoYouth study results
Authors: Wężyk-Caba I , Znyk M , Zajdel R , Balwicki L , Tyrańska-Fobke A , Juszczyk G , Świątkowska B , Zajdel K , Kaleta D
Published: October 2022

Identifying predictors of e-cigarette use initiation is important for preventing young persons from becoming smokers. Because of the addictiveness, harmful effects but on the other hand attractiveness and fashion for e-cigarettes among young people, teen use of tobacco related products is a significant public health concern. This study evaluated the determinants of susceptibility to e-cigarette use to both e-cigarettes use and traditional cigarettes in secondary school students in Poland. This study examined a sample of Polish youths aged 13-19 (n = 19241) attending 192 schools, 12 on average in each voivodship. Logistic regression and multivariable logistic regression models were used to calculate crude and adjusted odds ratios. The profile of susceptibility to e-cigarettes use among never e-cigarette users included: pocket money available per month (more than 150 PLN) (OR = 1.7; p = 0.001), 16-17 years old (OR = 1.9; p = 0.001), parental tobacco smoking and e-cigarette usage (OR = 2.0; p = 0.01 and OR = 1.7; p = 0.001 respectively), maternal secondary education (OR = 1.1; p = 0.04) and living in big cities >500 thou. inhabitants (OR = 1.4; p = 0.04). E-cigarette susceptible persons among ever users were similar to never cigarette users in their opinion that e-cigarettes use are less harmful than conventional smoking (OR = 1.6; p = 0.0012) and living with both parents smoking cigarettes (OR = 1.3; p = 0.02). Additionally, the determinants were: female gender (OR = 1.5; p = 0.009) in the age group less than 15 years of age (OR = 1.3; p = 0.007). The results revealed that such basic predictors as: parental smoking and opinion of lower harmfulness of e-cigarettes use are the most important determinants of smoking susceptibility among never or ever e-cigarette users. The intervention should be focused on educating the young people and their parents on the addictiveness and harmful effects of e-cigarette use and smoking.

Key messages
Exploring barriers to vaccine delivery in adult migrants: a qualitative study in primary care
Authors: Hargreaves S , Carter J , Mehrotra A , Knights F , Deal A , Crawshaw AF , Wurie F , Ciftci Y , Majeed A
Published: October 2022

Background

The COVID-19 pandemic has highlighted shortfalls in the delivery of vaccine programmes to older migrant groups. Guidelines exist, however, little is known around care pathways and engagement of these older cohorts in routine vaccinations in primary care, including catch-up programmes. We explored the views of primary care professionals around barriers and facilitators to catch-up vaccination in adult migrants (defined as foreign born; 18+ years) with incomplete or uncertain vaccination status.

Methods

We did a qualitative interview study with purposive sampling and thematic analysis in UK primary care (50 practices included nationally; 1 hour qualitative interviews) with 64 primary care professionals (PCPs): 48 clinical staff including GPs, Practice Nurses and healthcare assistants (HCAs); 16 administrative staff including practice managers and receptionists (mean age 45 years; 84.4% female; a range of ethnicities).

Results

Participants highlighted direct and indirect barriers to catch-up vaccines in adult migrants who may have missed vaccines as children, missed boosters, and not be aligned with the UK's vaccine schedule, from both a personal and service-delivery level, with themes including: lack of training and knowledge of guidance around catch-up vaccination among staff; unclear or incomplete vaccine records; and lack of incentivization (including financial reimbursement) and dedicated time and care pathways. Adult migrants were reported as being excluded from many vaccination initiatives, most of which focus exclusively on children. PCPs noted that migrants expressed to them a range of views around vaccines, from positivity to uncertainty, to refusal.

Conclusions

Vaccine uptake in adult migrants could be improved through implementing new financial incentives, strengthening care pathways and training, and working directly with local community groups to improve understanding around the benefits of vaccination at all ages.

Key messages
Change in the financial situation of students during COVID-19 and its impact on depressive symptoms
Authors: Negash S , Horn J , Heumann E , Helmer SM , Busse H , Heinrichs K , Pischke CR , Trümmler J , Niephaus J , Mikolajczyk R
Published: October 2022

Background

Students faced unique challenges during the COVID-19 pandemic that may have affected their financial situation as well as their mental health. This study sought to examine whether changes in financial situation before and during the COVID-19 pandemic were associated with depressive symptoms among German university students.

Methods

The cross-sectional COVID-19 German Student Well-being Study (C19 GSWS; N = 7,267) was implemented at five German universities between 27.10. and 14.11.2021. Students were asked if they had had sufficient financial resources to cover monthly expenses before the pandemic, as well as during the first and third waves of the pandemic. Depressive symptoms were assessed using the CES-D 8 (score ranges 0-24) and the PHQ-2 (0-6); higher scores indicating more severe depressive symptoms. Linear regression models were used to examine associations between variables.

Results

A worsened financial situation between the first and the third wave of the pandemic was associated with a one point (0.95) increase on the CES-D 8 scale (95% CI: 0.61, 1.29) and an improved financial situation with a decrease by 0.81 points (95% CI: -1.20, -0.42). A worsened financial situation was associated with a 0.26-point increase in PHQ-2 (95% CI: 0.14, 0.37) and an improved financial situation with a -0.12-point decrease (95% CI: -0.25, 0.01). Similarly, worsened financial situation in the third wave compared to prior to the pandemic, was also associated with an increase in CES-D 8 score and PHQ-2 and an improved financial situation with a decrease in CES-D 8 and PHQ-2.

Conclusions

Our findings suggest associations between students’ financial situation during the COVID-19 pandemic and their mental health. Due to their instable financial situation, students are a vulnerable group in need of mental and financial support during pandemic crises.

Key messages
COVID-19 impact on familial relationships and mental health in a representative sample of adults
Authors: Vigezzi GP , Zeduri M , Carioli G , Lugo A , Amerio A , Gorini G , Pacifici R , Politi P , Gallus S , Odone A
Published: October 2022

Background

Benefits of the stay-at-home order imposed in Italy to prevent SARS-CoV-2 transmission need to be weighed against its impact on citizens’ health. In a country with a solid familial culture and where welfare relies on households, confinement drastically decreased support provided by elder relatives, which may have worsened mental health.

Methods

A web-based cross-sectional study (LOST in Italy) was conducted on a representative sample of Italian adults during lockdown (27th of April-3rd of May 2020). We asked 3156 subjects to report on reduced help in housework and childcare from retired parents to assess confinement impact on mental health through validated scales before and during the lockdown.

Results

Overall, 1484 (47.0%) subjects reported reduced housework help from parents, and 769 (64.0%, of the 1202 subjects with children) diminished babysitting support. Subjects reporting reduced housework help had worsened sleep quality (multivariate odds ratio, OR 1.74, 95% confidence interval, CI 1.49-2.03) and quantity (OR 1.50, 95%CI 1.28-1.76), depressive (OR 1.32, 95% CI 1.14-1.53) and anxiety symptoms (OR 1.53, 95%CI 1.32-1.78), compared to those reporting unreduced help. Worsening in sleep quality (OR 2.32, 95%CI 1.76-3.05) and quantity (OR 1.80, 95%CI 1.36-2.37), depressive (OR 1.79, 95%CI 1.39-2.31) and anxiety symptoms (OR 1.90, 95%CI 1.48-2.46) was also associated with reduced babysitting help. In subjects with poorer housing and teleworking, mental health outcomes were worse.

Conclusions

Confinement came along with reduced familial support from parents, negatively impacting mental health. Social networks and support within families provided by older relatives act as a resilience factor and a potential vulnerability that affects mental health outcomes. Health and social services response should be designed to address mental health needs and mitigate long-term health costs caused by the pandemic's unprecedented stressfulness and unknown duration.

Key messages
Risk factors for internet addiction among Croatian university students during the COVID-19 pandemic
Authors: Miskulin M , Pavlovic N , Miskulin I , Kovacevic J , Laslo D , Vukoja I
Published: October 2022

Background

Following the increased internet use due to the COVID-19 pandemic there have been concerns regarding an elevated risk of developing internet addiction (IA). University students are especially prone to develop IA and risk factors for its development in this population during pandemics are not fully investigated nor understood. This study aimed to identify possible risk factors of IA in the studied population during the ongoing pandemic and to compare it with risk factors in pre-pandemic time.

Methods

In April 2016 and April 2022 a validated, anonymous questionnaire that contained questions regarding demographic data, as well as Young's Internet Addiction Test, was self-administered to a cross-faculty representative student sample of the University of Osijek, Croatia.

Results

The study included 1602 university students median age of 21 years (interquartile range 20-22), 34.5% males, and 65.5% females. There was no statistically significant difference in the median age between the two student samples (p = 0.234). The main reason for internet use (social networking and entertainment and online gaming) was considered the significant risk factor for IA in a studied population in pre-pandemic time (the year 2016) and pandemic time (the year 2022) (p < 0.001). In pre-pandemic time the IA was more frequent in males (p = 0.046) while the difference in IA prevalence between sexes did not exist during pandemics (p = 0.160). During pandemics, the students who did not work during their study had higher proportions of IA (p = 0.021) while there was no difference in IA prevalence among students regarding their working status during the study in pre-pandemic time (p = 0.251).

Conclusions

During the COVID-19 pandemic working status of students has been recognized as the new risk factor for IA in the Croatian university students population. Further studies are needed to identify other possible risk factors for IA in the studied population during pandemics.

Key messages
Trends and serotype distribution of human Salmonella strains in central Italy (2015-2021)
Authors: Russini V , Lucarelli C , Marrocco MG , Owczarek S , Villa L , De Marchis ML , Bilei S
Published: October 2022

Introduction

Salmonella enterica (S.) is one of the most common agents of foodborne infections and a risk for children, elder people and immunocompromised patients. S. is the first cause of foodborne outbreaks in the EU, the majority being caused by S. Enteritidis. We report S. serovars prevalence and trends in clinical isolates in central Italy from 2015 to 2021.

Methods

S. strains of patients from Lazio and Tuscany regions isolated by hospitals and private laboratories were sent to the Regional Reference Centre for Pathogenic Enterobacteria (CREP) at IZSLT (Rome) for serotyping. All metadata and a selection of isolates were shared with ISS according to the National Surveillance Enter-Net Italia program.

Results

A total of 2395 strains were collected from 2015 to 2021, with a mean value of 342 strains per year. Notably, reported cases did not decrease during the pandemic in 2020. A total of 116 different serovars were identified. The most common ones were S. Typhimurium var. monophasic, which increased from 2015 to 2021, S. Enteritidis, which peaked in 2018 doubling its average, and S. Typhimurium with a reverse trend compared to the monophasic variant, followed by S. Infantis, S. Napoli and S. Derby. Afterwards, S. Brandenburg showed a constant increase (from 2 cases in 2015 to 18 cases in 2021). S. Strathcona showed a significant peak during 2019 with 23 cases, correlated to a European reported outbreak. The average age of patients was stable (mean 28.5, median 12.8), except for an increase in 2021 (mean 35.2, median 27).

Conclusions

The results show a substantial agreement between data collected in central Italy and national trends. The occurrence of cases per year is stable. The serovars prevalence does not agree with the prevalence found in EU, in particular concerning S. Typhimurium var. monophasic frequency. Further investigations are needed to explain the significant increment of patients’ mean age in 2021.

Key messages
Causes of death in Germany: A time series analysis of official statistics from 1990 to 2020
Authors: Montano D
Published: October 2022

Background

The analysis of the temporal patterns of causes of death is one of the most important tasks in population health monitoring and forecasts. In the present study, a detailed time series analysis of official statistics is performed in order to identify major temporal trends in the distribution of health risks in the German population.

Methods

Official statistics on causes of death from 1990 to 2020 are utilised. The causes of death are classified according to the International Classification of Diseases (10th Revision). Temporal trends of death cases per 100,000 population and ten-year forecasts are estimated with integrated autoregressive moving average models (ARIMA).

Results

Cardiovascular diseases, neoplasms and cerebrovascular diseases have accounted for more than 70% of all deaths between 1990-2020. In contrast, urogenital, infectious and muscular-related diseases have been reported for less than 2% of deaths during the same period. Annual deaths per 100,000 population due to cardiovascular and cerebrovascular diseases largely decreased between 1990-2020 (-11.07 95% CI [-15.17; -6.97] and -4.02 95% CI [-6.85; -1.20], respectively). Concerning other causes of deaths, no temporal trends were observed, with the exception of diseases of the nervous and digestive system (0.83 95% CI [0.08; 1.58]). The forecasts for the decade 2020-2030 suggest that cardiovascular diseases and neoplasms are expected to remain the most frequent causes of death in Germany and could account for about 67% of all deaths.

Conclusions

The results indicate that non-communicable diseases, in particular the group of cardiovascular diseases and neoplasms, will remain the major driver of mortality in Germany over the next decade.

Key messages
A German study on the impact of stress on interparental relationship strain after preterm birth
Authors: Reimer A , Mause L , Hoffmann J , Hagemeier A , Scholten N
Published: October 2022

Background

Relationship satisfaction is an important predictor of well-being. Few studies address the effects of stress on interparental relationships of parents with preterm infants. However, the experience of a preterm birth represents an extreme, stressful event and therefore may place a strain on a relationship. Our aim is to examine the impact of postnatal stress on maternal and paternal perceptions of relationship strain.

Methods

As part of the Neo-CamCare project, a retrospective cross-sectional study was conducted targeting parents with infants with a birth weight below 1,500 g. Linear regression was used to analyse the influence of stress on relationship strain.

Results

437 mothers and 301 fathers participated. Data indicate that interparental relationship strain experienced by fathers (M = 2.61, SD = 1.46) is lower than strain experienced by mothers (M = 3.43, SD = 1.7). The stress level due to the infant's behaviour and appearance is lower in fathers (M = 2.53, SD = 0.95) than in mothers (M = 2.98, SD = 1.05). Stress due to parental role change is higher in mothers (M = 3.37, p = 1.04) than in fathers (M = 2.49, SD = 0.99). Regression analyses show that stress due to behaviour and appearance, as well as parental role change, can be associated with relationship strain in mothers. For fathers, only stress experienced due to the behaviour and appearance can be associated with relationship strain, whereas parental role change is not significant.

Conclusions

Our data illustrate that relationship strain can result from stress in mothers and fathers, indicating the need for stress prevention measures for both. Only mothers show relationship strain due to stress in their parental role. Although it is unclear what mechanisms underlie these findings, we assume that the maternal role is still primarily associated with child care. One way to relieve maternal stress could be to increase psychological support and the promotion paternal involvement in the postnatal period.

Key messages
Having mental health problems but not sickness absent: factors of importance among privately employed
Authors: Narusyte J , Alaie I , Ropponen A , Svedberg P
Published: October 2022

Background

Knowledge is scarce on individuals who are experiencing mental health problems but who have low or no sickness absence (SA). The aim of this study was to identify individual-level characteristics, including sociodemographic factors, morbidity, and lifestyle, among privately employed individuals with previous depression/anxiety but no SA during follow-up.

Methods

This prospective cohort study included 750 twin individuals born in Sweden in 1959-1986, employed in the private sector and with a history of depression/anxiety. Depending on the birth year, the twins were invited to participate in two different health-screening surveys in 2005, when study participants were aged 19-20 or 20-30, respectively. Survey data were used to evaluate depression and anxiety, self-rated health, stressful life events, emotional neglect, level of physical activity, and alcohol use. Study participants were prospectively followed regarding SA occurrence between 2006 and 2018. Data on SA, sociodemographic factors, outpatient healthcare use, and use of prescribed antidepressants were obtained from the Swedish national registries. Descriptive statistics will be reported with further analyses for the presentation.

Results

Preliminary results showed that despite previous depression or anxiety, 35% of women and 52% of men were not on SA during the follow-up period. Those who had no SA during follow-up were more likely to have higher education >12 years (49%), experienced fewer stressful life events (43%) and emotional neglect (56%), had better self-rated health (95%), along with a lower use of antidepressants (11%) and outpatient healthcare (88%), as compared with those on SA (33%, 65%, 66%, 90%, 17%, and 98%, respectively).

Conclusions

Higher education, being male, fewer life adversities, good self-rated health and low use of antidepressants and outpatient healthcare were individual-level factors of importance for those with previous depression or anxiety and no incident SA during follow-up.

Key messages
Anticipating & assessing adverse consequences of public health interventions - CONSEQUENT framework
Authors: Stratil J , Biallas RL , Movsisyan A , Oliver K , Rehfuess EA
Published: October 2022

Introduction

Despite the best intentions, public health (PH) interventions can have adverse and other unintended consequences (AUCs). AUCs may arise in novel PH interventions, as well as from known and tested PH interventions implemented in a new context. Despite their importance, this topic has been largely overlooked. Therefore, we used a structured value-guided as well as evidence-based approach, to develop a framework to support researchers, practitioners, and policy-makers in anticipating and assessing AUCs of PH interventions.

Methods

We employed the ‘best-fit’ synthesis approach starting with an a priori framework and iteratively revising this based on systematically identified evidence. The a priori framework was derived from both the WHO-INTEGRATE framework and the Behaviour Change Wheel, to root the framework in global health norms and values, established mechanisms of PH interventions, and a complexity perspective. The a priori framework was advanced based on theoretical and conceptual publications and systematic reviews on the topic of AUCs in PH. Thematic analysis was used to revise the framework and identify new themes. To validate the framework, it was coded against four selected systematic reviews of AUCs of PH interventions.

Results

The CONSEQUENT framework includes two components: the first focuses on AUCs and serves to categorise them; the second component highlights the mechanisms through which AUCs may arise. The first component comprises eight domains of consequences - health-related, health system, human and fundamental rights, acceptability- and adherence-related, equality- and equity-related, social and institutional, economic and resource-related, and environmental.

Conclusions

Both over- and underestimation of AUCs of PH intervention poses risks. The CONSEQUENT framework may facilitate classification and conceptualization of AUCs of PH interventions during their development or evaluation to support evidence-informed decision-making.

Key messages
Swedish local and regional politicians’ views on their role in health promotion
Authors: Svanholm S , Carlerby H , Viitasara E
Published: October 2022

Background

The political context is an important determinant of health. Politicians in municipalities and regions in Sweden are responsible for many of the determinants of health, and their role is therefore important when considering health promotion. The aim of the study was to explore how politicians describe their role in health promotion.

Methods

An electronic questionnaire focused on politicians’ role, responsibility, and possibility to promote health was sent to all politicians in municipalities and regions in the north of Sweden. A total of 667 politicians answered the questionnaire, and out of them, 361 politicians answered the free text question “as a politician I consider my role in health promotion to be ...”. The answers were analyzed using thematic analysis. The four themes discovered were used to sort politicians into groups. All politicians were sorted into the group that was most similar to their answer. Group sizes were shown in percentage of how large part of the politicians belonged to the respective groups.

Results

Preliminary results show that the politicians could be divided into four different groups: 1) No political role, only personal aspects described (such as being a good role model) (25,3%), 2) Promote individuals to take care of their health (for example through information) (19,5%), 3) Support other parts of the organization (municipality or region) to promote health, mainly through financial support and agenda-setting (29,8%), 4) Most (if not all) political decision-making affect health (25,4%).

Conclusions

There is a large variety in how politicians describe their role in promoting health. Only approximately half of the politicians see that their political decision-making can directly affect the health of the population. With the political context being an important determinant of health, this could be considered a missed opportunity for structural health promotion work.

Key messages
Public Health Guideline to prevent and control SARS-CoV-2 in schools: development and evaluation
Authors: Pfadenhauer L , Rueb M , Strahwald B , Wabnitz KJ , Nothacker M , Rehfuess EA
Published: October 2022

Issue/problem

In times of high demand for scientific evidence for decision-making on COVID-19 mitigation measures, guidelines can be useful for translating scientific evidence into policy and practice. While guidelines are widely used in medical decision-making, they are novel to public health in Germany.

Description of the problem

Since December 2020, a guideline group has been working on a living, evidence- and consensus-based public health guideline on preventing and controlling SARS-CoV-2 transmission in schools. The group includes scientists across multiple disciplines as well as a broad range of stakeholders, including from the school family. Key features in the development of recommendations included a Cochrane rapid review and the WHO-INTEGRATE evidence-to-decision framework. The development and usefulness of the guideline for decision-making are being evaluated using a multi-method approach.

Results

The first version of the guideline containing nine recommendations was published in February 2021. The WHO-INTEGRATE framework facilitated the consideration of factors such as health benefits and harms, feasibility, acceptability and financial constraints. Preliminary findings of the evaluation suggest that under time pressure, developing few essential, consensus-based recommendations while assessing their societal implications is warranted. A shared understanding of evidence and of the purpose and limitations of guidelines is critical. To remain relevant, continuous integration of new evidence and updating of the guideline is necessary.

Key messages
Using default opt-out strategies to undercover the unknown HCV infections: a scoping review
Authors: Ceccarelli L , Paparatto G , Tavoschi L
Published: October 2022

Background

Following the advent of directly acting antivirals (DAAs) a global effort is underway to eliminate viral hepatitis C (HCV) by 2030. Yet identification of infected individuals and access to dedicated services may pose a challenge to the achievement elimination targets. A scoping review to synthesize studies that explored the efficacy of opt-out strategies to improve HCV testing capacity was conducted.

Methods

We searched PubMed and Scopus (from 2015 to March 2022) for all English original articles and systematic reviews addressing opt-out strategies for HCV testing in different settings, published in the WHO's European Region Countries. We excluded articles that focused on other testing implementation strategies.

Results

A total of 136 articles were screened at the title and abstract level, of which 41 were also assessed at full text for eligibility after deduplication. In the end, 30 articles met the inclusion criteria. Studies originated from 19 different countries of the WHO's European Region, with the most prevalent being France (26.9%, 11/41). The 43.3% of the articles addressed opt-out testing strategies in emergency departments (EDs), 36.6% into prisons, 13.3% in primary care, and 6.6% among people who use drugs. Opt-out default testing was found to be effective in EDs and prisons, whereas only 2 articles tested the efficacy of opt-out strategies for HCV testing in primary care settings.

Conclusions

Opt-out strategies resulted in increased testing rates and higher cost-effectiveness in different settings, especially EDs and prisons. However, to identify individuals with undiagnosed infections, birth cohorts screening in the general population may be needed. Further research is needed to assess the utility of an opt-out default testing strategy in primary care settings.

Key messages
Dietary factors and risk of SARS-CoV-2 infection in the Moli-sani Study Cohort
Authors: Bonaccio M , Castelnuovo A Di , Costanzo S , Persichillo M , Curtis A De , Gianfagna F , Donati MB , de Gaetano G , Cerletti C , Iacoviello L
Published: October 2022

Background

A healthy diet plays a major role in supporting the immune system which is critical to protect the host from pathogenic organisms. To date, evidence on the relationship between dietary habits and the risk of SARS-CoV-2 infection is still scarce.

Methods

Analyses on 1,096 participants from the Moli-sani Study (2005-2010) who were re-examined in 2017-2020, and in January-September 2021. Food intake was assessed in 2017-2020 using a 188-item FFQ. Adherence to Mediterranean diet (MD) was evaluated using the Mediterranean Diet Score (MDS) ranging from 0 to 9. Multivariable logistic regression models were used to estimate odds ratios (OR) and 95% confidence intervals (95%CI) for incident SARS-CoV-2 infection in association with dietary factors.

Results

Out of 1,096 participants, 90 either reported to have tested positive for COVID-19 or were positive for anti-SARS-CoV-2 antibodies before receiving any COVID-19 vaccine. In a multivariable-adjusted model controlled for known risk factors, a 1-point increase in MDS was associated, though not significantly, with lower risk of SARS-CoV-2 infection (OR = 0.90; 95%CI 0.78-1.04). Among individual dietary components, a high consumption of vegetables or fruits and nuts was associated with lower odds of SARS-CoV-2 infection (OR = 0.57; 0.34-0.96 and OR = 0.61; 0.37-1.00, respectively). High fish intake was otherwise linked to increased risk of infection (OR = 2.05; 1.25-3.36). Nutritional factors associated with reduced risk of infection were dietary fibre (OR = 0.50; 0.27-0.93 for 10 g/d increase), vegetable proteins (OR = 0.56; 0.33-0.94 for 10 g/d increase) and vitamin C (OR = 0.94; 0.89-0.99 for 10 g/d increase).

Conclusions

Adherence to MD was suggestive of a lower risk of SARS-CoV-2 infection. In particular, large amounts of fruit and vegetables were associated with reduced odds of being infected, as well as diets rich in fibre, vegetable proteins and Vitamin C.

Key messages