bluuebunny/crossref_metadata_2025 huggingface dataset:
The isolation room of the future: changing the perspective on isolated care
Authors: Eilers R , Haverkate M , Nijnenhuis J , Timen A
Published: October 2021

Antibiotic resistance is a growing problem worldwide. Several measures are taken when identified carriers of antibiotic resistant bacteria (such as MRSA) are admitted to a hospital: patients stay in an isolation room and healthcare workers have to put on personal protective equipment (PPE) before entering the isolation room. Previous research on experiences of isolated care shows that patients felt lonely, forgotten and stigmatized while healthcare personnel felt guilty for bundling their contact moments. Therefore, an innovation project has been set up to re-design the concept of an isolation room: the isolation room of the future. The isolation room of the future concentrates around providing enhancements for communication and interaction, comfort and accessibility and architecture and interior design, while taking into account the infection prevention regulations for isolation rooms in hospitals. The interior of the isolation room of the future consists of biophilic elements, including photo wallpaper, transparent walls, surfaces that mimic natural materials, and natural and dynamic light; creating a positive healing and working environment for patients, staff and visitors. Transparent walls also allow easy communication between patients and healthcare workers without the need for the PPE. Furthermore, a transfer hatch is installed to easily serve meals and drinks to the patient. A modular furniture set-up will ensure the most optimum use of space in the room. The isolation room of the future does not necessarily need to be built as a whole; specific elements can implemented depending on needs, finances and possibilities. We hope that these practical solutions might inspire healthcare facilities worldwide to re-think the concept of an isolation room to improve the experiences of people involved in isolated care. This approach is useful for a broader range of infections with pathogens that require isolation precautions, among which SARS-CoV-2.

Key messages

A change on perspective of isolated care is needed. Although based on experiences with resistant bacteria, the isolation room of the future useful for a broader range of infections with pathogens that require isolation precautions.
A cross-country comparison on providing health services effectively during the first wave of COVID-19
Authors: Webb E , Hernández-Quevedo C , Williams G , Scarpetti G , Reed S , Panteli D
Published: October 2021

At the onset of the COVID-19 pandemic, health care providers had to abruptly change their way of providing care in order to simultaneously plan for and manage a rise of COVID-19 cases while maintaining essential health services. Even the most well-resourced health systems faced pressures from new challenges brought on by COVID-19, and every country had to make difficult choices about how to maintain access to essential care while treating a novel communicable disease. Using the information available on the HSRM platform from the early phases of the pandemic, we analyze how countries planned services for potential surge capacity, designed patient flows ensuring separation between COVID-19 and non-COVID-19 patients, and maintained routine services in both hospital and outpatient settings. Many country responses displayed striking similarities despite very real differences in the organization of health and care services. These include transitioning the management of COVID-19 mild cases from hospitals to outpatient settings, increasing the use of remote consultations, and cancelling or postponing non-urgent services during the height of the first wave. In the immediate future, countries will have to continue balancing care for COVID-19 and non-COVID-19 patients to minimize adverse health outcomes, ideally with supporting guidelines and COVID-19-specific care zones. Many countries expect to operate at lower capacity for routinely provided care, which will impact patient access and waiting times. Looking forward, policymakers will have to consider whether strategies adopted during the COVID-19 pandemic will become permanent features of care provision.
Changes in smoking, stress, and sleep duration among Israeli hospital workers during COVID-19
Authors: Bar-Zeev Y , Shauly-Aharonov M , Neumark Y , Hirshoren N
Published: October 2021

Background

Mental health impacts of the COVID-19 pandemic, especially among frontline health workers, have been widely noted. The aim of this study was to explore smoking behaviour changes and associations with perceived changes in stress levels and sleep duration among Israeli hospital workers during the COVID-19 pandemic.

Methods

An online cross-sectional survey was conducted (May-June, 2020) among employees of a large tertiary medical centre. Data collected included socio-demographic characteristics, smoking status, perceptions of risk for COVID-19 infection and disease severity, presence of a chronic illness, COVID-19 exposure and infection status, involvement in treating COVID-19 patients, changes in stress levels, sleep duration, and in smoking behaviour during the pandemic. Multi-nominal logistic regression modelling assessed the effect of covariates on smoking behaviour changes.

Results

More than half (59%) of the 920 respondents, reported an increase in stress levels, and 28% reported changes in sleep duration. One-third (35%) of current smokers (n = 132) reported smoking more during COVID-19. Increased smoking was associated with increased stress (OR = 3.45; 95% CI 1.2-9.4). In addition, a significant association was demonstrated between an increase in sleeping hours and a decrease in smoking (OR = 6.62, 95% CI 1.2-32). The negative association between changes in smoking and sleep duration was strongest among smokers who reported perceived levels of stress to be the same or slightly higher than pre-COVID-19.

Conclusions

The mental health implications of the COVID-19 pandemic, specifically for health workers, include negative changes in smoking behaviours and sleep patterns. Mental health support for health workers should address smoking behaviours alongside stress-management skills and coping strategies. Lessons learned from the current pandemic should guide us as the world prepares for a future health crisis.

Key messages

Increased stress was linked with increased smoking among Israeli hospital workers during COVID-19. Mental health support should target smoking together with offering stress-management skills.
Healthy Design and Urban Planning Strategies framing the SDG 11 Sustainable Cities and Communities
Authors: Rebecchi A , Capolongo S
Published: October 2021

According to the “Urban Health Rome Declaration” at European meeting “G7 Health” that defines the strategic aspects and actions to improve Public Health into the cities, and referring to the Agenda 2030 in which the 11th SDG argue about “Sustainable Cities and Communities. Make cities and human settlements inclusive, safe, resilient and sustainable”, one of the most expressive syntheses of the challenging relationship between urban planning and Public Health is stated by WHO (2016): “Health is the precondition of urban sustainable development and the first priority for urban planners”. Referring to the Healthy Cities & Urban Health definitions, we can consider Public Health not merely an aspect of health protection and promotion, but an individual and collective condition, strongly influenced by the environmental context and by the strategies implemented by local Governments. The “Health in All Policies” strategy, clearly underlines how health doesn't depend only on the supply of the healthcare services, but also, on the quality of outdoor and indoor living environments. Aim of the Presentation 3 is the share the findings of a literature review about the link between the urban contexts' morphological and functional features; the results are divided into: 14 Health Outcomes, representing the main Non-Communicable Diseases (NCDs) whose come from the urban environment's quality and by the adoption of healthy lifestyles; 8 types of Environmental Risk Factors (Urban Heat Island Effect; soil/air/acoustic/light pollution; vehicular traffic; Safety & Security; weak attractiveness of places); and 14 Healthy Urban Planning Strategies (green/blue/grey infrastructures; biodiversity protection; adverse meteoric events management; public transport systems; vehicular traffic reduction; pedestrian and cycling paths; social and functional mix; urban solid waste's management; renewable energy and efficiency; outdoor spaces lighting; Design for All).
Living lab AI4U - artificial intelligence for personalized digital mental health promotion and prevention in youth
Authors: Rauschenberg C , Goetzl C , Schick A , Koppe G , Durstewitz D , Krumm S , Reininghaus U
Published: October 2021

Background

Youth are particularly affected by mental health problems, but their use of preventive interventions remains limited. The advances in Artificial Intelligence (AI) enable the development of digital interventions for mental health promotion and prevention. This applies to ecological momentary interventions (EMI), which offer adaptive training components in daily life.

Methods

In a preparatory phase, focus groups (N = 2, aged: 15-21 years) and a representative survey (N = 666, aged: 16-24) with young individuals as well as qualitative interviews with stakeholders in routine public mental health provision were conducted.

Results

None of the stakeholders used digital interventions in their everyday work but were interested in their use. The importance of data protection and security, usability, and participation of the target population in all stages of the research process was emphasized. The risk of a digital divide, acceptance of used terminology, and difficulties of structural embedding were mentioned as important barriers for successful implementation. Young individuals had a positive attitude toward digitization and AI and their use in mental health promotion and prevention and underlined the importance of practical benefits for users. They had a pragmatic attitude toward data use policies. Around 70% of young individuals were already using mHealth apps. Psychological distress was associated with the use of, and positive attitude towards, mHealth apps.

Discussion

Findings have contributed to the ongoing main phase. The living lab AI4U will be carried out in transdisciplinary projects involving direct participation of relevant stakeholders, users from the target population and an interdisciplinary research group. Each of these projects includes one or more real-world experiments. These will be embedded in a transdisciplinary infrastructure, which will ensure ongoing quality assurance, sustainability assessment, public relations and networking.
Effects of Russian tobacco control law on rates of hospital admissions for acute coronary events
Authors: Gambaryan MH , Kontsevaya AV , Agishina T , Drapkina OM
Published: October 2021

Background

The Russian tobacco control law (TCL), implemented nationwide, aims to reduce smoking-related morbidity and mortality. However, its effects may vary among Russian regions. We aimed to assess the effects of TCL on rates of hospital admissions (HA) for angina pectoris (AP) and myocardial infarction (MI) in the Russian Federation (RF) and 10 Russian regions in relation to enforcement of the TCL.

Methods

We analysed HA rates for AP and MI to compare the periods before and after TCL in 2013, adjusting for possible confounders and long-term trends. Models were based on time-series of annual HA in the RF and 10 Russian regions during the years 2005-2019. We used interrupted time-series design and Poisson regression model with calculation of risk ratio (RR) and 95%CI. Regions were compared by means of TCL implementation scale (TCIS), developed based on the results of Russian TC policy evaluation survey in 10 Russian regions (n = 11625). We analysed the relationship between the TCL measures implementation scores and RR of reduction of HA for AP and MI after the TCL by means of Spearman's rank correlation and linear regression models.

Results

Results showed a 16.6% decrease in HA rates for AP (RR 0.83 95% CI 0.74-0.93) and 3.5% - for MI (RR 0.96 95% CI 0.96-0.97) after the TCL introduction in RF and effects of various magnitude in the regions. Regions with higher TCIS scores, i.e. better enforcement of full TCL package had greater reduction in HA rates for AP (rsp = −0.627 95%CI−1.05;−0.199; p=.004); with better enforcement of smoke-free policies - grater reduction in HA rates for MI (rsp = −0.793 95%CI−1.08;−0.506, p<.001). Both HA rates for AP and MI correlated with the higher scores for help to quit tobacco use (rsp = −0.56 95%CI −1.1; −0.01, p=.045), (rsp = −0.74 95%CI−1.12;−0.36, p=.027).

Conclusions

TCL leads to a decrease of HA for AP and MI with sustained effect. Differences in the magnitude of these effects in the regions are related to the extent of enforcement of TC measures.

Key messages

Tobacco control legislative measures may lead to reduction of hospital admission rates for acute coronary events. The effect of tobacco control law on hospital admission rates for acute coronary events may vary in relation with the extent of enforcement of tobacco control measures.
A core outcome set for school-based physical activity interventions: an international consensus
Authors: Ram B , Foley K , van Sluijs E , Hargreaves D , Viner R , Saxena S
Published: October 2021

Background

Studies of school-based physical activity interventions vary in the outcomes they measure. This prevents comparisons of results to establish impacts. We aimed to develop a core outcome set agreed by key stakeholders for future studies of school-based physical activity interventions.

Methods

We used a modified-Delphi consensus method. First, we conducted a systematic review to identify outcomes measured in relevant studies and listed these in a Delphi survey. Next, we recruited key stakeholders to complete 2 survey rounds: Round 1 was to rate each outcome from ‘not important' to ‘critical', and Round 2 was to re-rate the outcomes based on feedback from Round 1. Outcomes rated ‘critical' by 70% of stakeholders (i.e., reaching consensus) were highlighted. Then, using the full list of outcomes, we conducted a children's workshop to include their views. Finally, we held a stakeholder meeting to discuss results and agree consensus.

Results

We identified 50 outcomes from the systematic review. Sixty-five stakeholders (16 educators, 13 health professionals, 12 parents, 24 researchers) representing 9 countries completed both survey rounds; 13/50 outcomes reached consensus. Children (n = 16) identified 8 outcomes of importance; 3 were consistent with the survey results. Stakeholders attending the meeting (n = 13) reached consensus on 14 outcomes to be included in the core outcome set: fitness, physical activity intensity, energy, sleep, diet, happiness, stress, depression, anxiety, wellbeing, self-esteem, enjoyment, concentration, and focus. These core outcomes were reviewed and agreed by all 65 stakeholders.

Conclusions

Our core outcome set agreed by international stakeholders includes physical and mental health, and cognitive function. We recommend its use in future studies of school-based physical activity interventions. Findings from future studies can be compared and combined which will be relevant to public health policy makers and educators.

Key messages

School-based physical activity interventions should measure physical and mental health, and cognitive function. Wide use of this core outcome set will enable findings to be compared and combined.
Trend of substance abuse among medical students at University of Zagreb from 2008/2009 to 2018/2019
Authors: Majer M , Mužić R , Musil V , Štajduhar A , Jureša V
Published: October 2021

Background

Risk behavior of youth could have adverse health outcomes in adulthood, with an impact on individual and general population health. The aim of this study was to determine the prevalence and trend of cigarette smoking, alcohol consumption and experimentation with illicit drugs among first year students at School of Medicine, University of Zagreb, Croatia.

Methods

Retrospective study included first year medical students, from academic year 2008/2009 to 2018/2019. Data were collected each academic year by anonymous questionnaire, and analysed by descriptive (χ2 test, Fisher's exact test) and analytical statistics (simple linear regression model using the least squares method, t-test) with a significance level of α = 0.05.

Results

Data analysis included a total of 3155 medical students (96.7%), 62.6% girls. Prevalence of daily smoking varied across generation from 11.6% in 2008/2009 to 9.6% in 2018/2019, and although a slight decline is observed, no statistically significant difference in daily smoking was found among generations of students from the academic year 2008/2009 to 2018/2019 (t-test=-0.169; P = 0.869). Prevalence of occasional smoking ranged from 12.0% in 2008/2009 to 18.1% in 2018/2019, and showed a statistically significant increase (t-test=3.064; P = 0.014), respectively. The prevalence of binge drinking ranged from 60.3% in 2008/2009 to 72.5% in 2018/2019, and showed a statistically significant increase (t-test=2.3515; P = 0.043) across generation. The prevalence of illicit drug experimentation varied from 17.9% in 2008/2009 to 34.4% in 2018/2019, and showed a statistically significant increase (t-test = 3.0798; P = 0.013) across generations.

Conclusions

Results showed increase in occasionally smoking, binge drinking and experimentation with illicit drugs among first-year medical students in the eleven-year period, and indicate the need of comprehensive public health interventions to reduce risky behavior in the student population.

Key messages

Occasionally smoking, binge drinking and experimentation with illicit drugs are increasing problem among students. Comprehensive public health interventions are needed to reduce risky behavior in the population of students and youth.
Feasibility assessment of immunization carpool model for <2 years children in rural Pakistan
Authors: Ali RF , Iftikhar S , Shah MT , Ali Khan A , Siddiqi DA , Chandir S
Published: October 2021

Almost 20 million children globally do not get routine vaccines, 1.4 million of which reside in Pakistan. Immunization coverage in rural settings of Pakistan, comprising >60% population, is lower than their urban counterparts. Barriers such as distant-centers, lack of transportation, and restrictions on women to travel alone, exacerbate the problem. We introduced immunization carpool services in rural settings to facilitate vaccination of < 2 years children. Low-coverage immunization clinics were selected based on availability of vaccinators and vaccines in Shikarpur, a rural district in Pakistan. Local transport providers were identified and vehicles were rented-in. Community mobilization was done through awareness sessions and branding vehicles. Data was recorded on the number of round trips and immunization visits facilitated by each vehicle. Details of children transported and feedback on carpool services were captured from caregivers. Immunization coverage was calculated using the government's electronic immunization registry data. Between January to October 2020, 6 vehicles were deployed, which provided free transport services in 98 catchment areas of 4 immunization clinics. On average, each vehicle completed 420 (SD: 58.2) round trips and facilitated 781 (SD: 171) immunization visits. A total of 2,391 children were enrolled, 1,182 (49.7%) of them were females and 1,197 (50%) aged <6months. Enrolled children compared to non-enrolled at the same immunization clinic, showed 19.1% higher coverage rate for penta-3 (81% vs 68%, p < 0.00) and 23.6% for measles-2 (73% vs 57%, p < 0.00). Immunization timeliness among enrolled children increased by 4.8% for penta-3 (9% vs 4%, p < 0.00) and 18% for measles-2 (25% vs 7%, p < 0.00). Reported advantages of services include time-saving (92%), cost-saving (79%), and reduced dependence on family members (95%). Immunization carpool service is well-accepted by rural women and can improve immunization coverage and equity in rural areas.

Key messages

Provision of commuting options can overcome accessibility barriers and has the potential to improve immunization coverage and timeliness. Free transport services for rural women could aid in promoting gender equity and reducing urban-rural disparities.
Othering in public health using the example of Covid-19 management in German asylum camps
Authors: Tallarek M , Spallek J
Published: October 2021

Issue/problem

In 2020, several German reception centers and asylum camps were imposed mass quarantine after single residents had been infected with SARS-CoV-2. Civil and research networks criticized this measure, as crowded housing conditions limited the implementation of infection protection measures, and mass quarantine further increased the risk of infection. This raised the question why public health (PH) measures in these settings differed from those implemented in the general population, and which implications for future PH approaches can be identified.

Problem description

Considering the epidemiological evidence and ethical perspectives on the PH strategies described above, we applied the concepts of “Exclusionary Othering” and “Inclusionary Othering” to PH. We further discussed the Covid-19 management in German reception centers and asylum camps.

Results

We identified three conceptual approaches: 1) exclusionary, 2) inclusionary, and 3) diversity-sensitive approaches to PH. Exclusionary PH is characterized by an exclusion of less powerful groups despite negative health consequences. Inclusive approaches seek to empower less powerful groups in order to understand each other's needs, build cooperations, protect everyone and to prevent the development of “hot spots”. Diversity-sensitive PH approaches avoid othering and seek to implement measures for everyone, taking into account diverse needs, conditions, and resources.

Lessons

We propose a paradigm shift towards inclusionary and diversity-sensitive PH that benefits the entire population, including those forced to flee other countries. This requires a critical reflection of power dynamics and discrimination. The proposed concepts can be transferred to other social groups, regions, and areas of PH.

Key messages

Public health needs to shift its perspective from exclusion and subordination to inclusion and involvement. Inclusionary and diversity-sensitive PH approaches promote health equity.
The importance of behavioural insights in disease prevention and health promotion
Authors: Nagyova I
Published: October 2021

Issue/problem

The need for behavioural insights in disease prevention and health promotion could hardly be over-emphasised. Health behaviours constitute the foundation of good physical and mental health. It is well-know that people acquire a chronic disease because of a poor quality diet, physical inactivity, overindulgence in alcohol and tobacco use, but also because of non-adherence to the treatment regimen and adverse psychosocial influences such as negative affect, depression, or loneliness.

Description of the problem

Yet, how can we explain the chasm between knowledge about health determinants and action? Why we are not able to close the gap between what we know and what we put into practice to improve people's health? Maybe part of the answer is that we should break the silos and apply knowledge and expertise from also other fields and disciplines; and based on the synergistic use of knowledge from multiple sources to obtain new useful knowledge elements.

Results

One of the most promising knowledge fusions lie in behavioural insights that combine lessons from behavioural economics, psychology, neuroscience, and social science with empirically-tested results to provide a better understanding of how people behave and make decisions. The opportunities that behavioural insights may offer to fight chronic diseases have recently been acknowledged by several leading public health institutions and organisations. For instance, ‘Healthier choices: Incorporating behavioural insights' is one of the four flagship initiatives of the WHO's European Programme of Work 2020-2025.

Lessons

The potential benefits of behavioural insights are multiple as they are often very low cost, scalable, and light touch. This is especially relevant within the context of overstretched healthcare systems. What is needed is capacity building in order to broaden our understanding of measures that have originated from behavioural sciences and have a lot to offer to public health.
Fermentable Oligo-, Di-, Monosaccharides and Polyols and cancer risk in the NutriNet-Santé cohort
Authors: Debras C , Chazelas E , Srour B , Julia C , Schneider É , Agaësse C , Druesne-Pecollo N , Hercberg S , Deschasaux-Tanguy M , Touvier M
Published: October 2021

Background

Fermentable Oligosaccharides, Disaccharides and Monosaccharides And Polyols (FODMAPs), which are found in a variety of foods (dairy products, fruit, legumes, refined grains, sugary beverages, etc.) have been involved in risk for gastrointestinal disorders. In view of their pro-inflammatory potential and their interactions with the gut microbiota, their contribution to the etiology of other chronic diseases such as cancer has been postulated. However, no epidemiological study has investigated this hypothesis so far. Our objective was to investigate the associations between FODMAP intake (total and by type) and cancer risk (overall, breast, prostate and colorectal).

Methods

104,909 French adults from the NutriNet-Santé prospective cohort (2009-2020) were included (median follow-up time=7.7y). FODMAP intakes were obtained from repeated 24h-dietary records linked to a detailed food composition table. Associations between FODMAPs and cancer risks were assessed by Cox proportional hazard models adjusted for a large range of lifestyle, sociodemographic and anthropometric variables.

Results

Total FODMAP intake was associated with increased overall cancer risk (n = 3,374 incident cases, Hazard Ratio for quintile 5 vs quintile 1=1.21, 95% confidence interval 1.02-1.44, P-trend=0.04). Oligosaccharides seemed to be the FODMAP type particularly associated with cancer risk: a trend was observed for overall cancer (HR = 1.10 (0.97-1.25) P-trend=0.04) and colorectal cancer (n = 272, HR = 1.78 (1.13-2.79) P-trend=0.02). Associations remained stable across a series of sensitivity analyses.

Conclusions

Our findings suggest a potential role of FODMAPs in cancer onset. Further epidemiological and experimental studies are needed to confirm these results and provide data on the potential underlying mechanisms.

Key messages

In this large-scale prospective cohort of French adults, FODMAP intake was associated with increased cancer risk. These associations need to be studied in other prospective cohorts, in order to clarify FODMAPs role in cancer development.
Single Nucleotide Polymorphisms and Idiopathic Male Infertility in GWAS: A Meta-Analysis
Authors: La Gatta E , Zace D , Hoxhaj I , Beccia F , Di Pietro ML , Genuardi M
Published: October 2021

Background

Infertility is a multifactorial health issue, with males accounting for half of the cases, part of which appears to be idiopathic. Several genome-wide association studies (GWAS) have explored the role of single-nucleotide polymorphisms (SNPs) in idiopathic male infertility (IMI). However, considering the inconsistent evidence, this systematic review and meta-analysis aimed to assess the association between SNPs and IMI susceptibility, via GWAS.

Methods

PubMed, Scopus, Web of Science and GWAS databases were searched for eligible GWAS in English until March 17th, 2021. Primary data studies on the association between SNPs and IMI were included. Studies' quality was assessed by the Q-Genie tool. Random-effect meta-analyses were performed for SNPs evaluated in ≥ 2 studies for the same genotype, calculating pooled odds ratios (ORs) and 95% confidence intervals (CIs). I2 statistics was used to assess statistical heterogeneity.

Results

Out of 1356 articles, nine were included in the systematic review. These studies, conducted in Asian populations (78% in China and 22% in Japan), were of moderate to good quality. 121 genes and 199 SNPs were evaluated for their association with Non-Obstructive Azoospermia (NOA) (78%), oligoasthenospermia, oligozoospermia and asthenozoospermia, in 13145 cases and 21152 controls. 43% of the SNPs, among which 38 haplogroups of the Y chromosome, were significantly associated to IMI. Meta-analysis was conducted only for two SNPs: rs498422 and rs3129878, which were significantly associated to NOA (OR = 1.3, 95% CI 1.07-1.58 and OR = 1.36, 95% CI 1.28-1.44, respectively).

Discussion

Although several genetic variants have been identified, their contribution to IMI pathogenesis remains poorly understood. Further research is needed to establish the role of these SNPs for genetic testing in clinical and public health practice. Identifying populations at greater risk of infertility may result in personalized prevention and diagnostic programs.

Key messages

Genome wide association studies included in this metanalysis, conducted all in Asian countries, report several single nucleotide polymorphisms associated to idiopathic male infertility. Despite the number of SNPs identified in these studies, further research is needed to establish their role in clinical and public health practice, which may result in personalized prevention.
Pregnant asylum-seekers’ perspectives regarding mental health screening: a qualitative study
Authors: Soldati E
Published: October 2021

Background

This study aimed to identify a suitable and acceptable method to screen for depression, anxiety and PTSD in pregnant asylum seekers.

Methods

We conducted eight semi-structured interviews with pregnant asylum seekers. Before the interview participants filled out the Refugee Health Screener 15 (RHS-15) and a demographic questionnaire. During the semi-structured interview, we discussed the acceptability and suitability of the RHS-15 to screen and start dialogue about PTSD, anxiety and depression. To analyse data, an inductive thematic analysis was performed by two researchers. The interviews took place at the Asylum Seeker Centre of Ter Apel, the Netherlands in the months of November and December 2020.

Results

The following themes were identified: ‘Importance of mental health screening', ‘Talking about mental health' and ‘Use of the RHS-15'. Pregnant asylum seekers find themselves in an underserved, and disadvantaged situation. They find it meaningful and acceptable to talk about mental health with their midwife or other health care professionals, but they would not initiate a conversation on mental health spontaneously. They would appreciate encouragement in disclosing matters regarding their mental health and help with navigating the healthcare system. Barriers and enablers to talk about mental health included a language barrier, cultural differences, relationship with health care providers and practical barriers. Participants considered the RHS-15 suitable for mental health screening.

Conclusions

This is the first study in Europe that assesses the suitability and acceptability of mental health screening in pregnant asylum seekers from their perspective. Asylum-seeking women appreciate mental health screening during pregnancy and think the RHS-15 is an acceptable and suitable method. Further research is necessary for health care providers and policy makers to implement mental health screening for pregnant asylum seekers.

Key messages

The results of this study suggest that asylum-seeking women deem mental health screening during pregnancy nessesairy and find the RHS-15 a suitable and acceptible method of screening. This is the first study in Europe that investigates the opinion of pregnant asylum seekers on mental health screenings.
The potential role of diet on mental health outcomes in a Mediterranean cohort
Authors: Godos J , Currenti W , Micek A
Published: October 2021

Background

The prevalence of mental and sleep disorders is rising globally generating great costs to medical health care and several modifiable risk factors, including diet, has been recognized as major contributors. An escalation of overnutrition as a consequence of the transition from traditional dietary patterns, like Mediterranean diet, in favor to Western-like dietary patterns, rich in high-calorie processed and ultra-processed foods and deprived from bioactive components, has been observed.

Methods

The demographic and dietary habits of 2044 adults living in southern Italy were analyzed. Food frequency questionnaires (FFQs) were used to assess dietary intake and adherence to the Mediterranean diet. Polyphenol content in foods was estimated using the Phenol-Explorer database. Sleep quality was assessed using the Pittsburg Sleep Quality Index (PSQI), while cognitive status using the Short Portable Mental Status Questionnaire (SPMSQ). Multivariate logistic regression analyses were used to test the associations.

Results

Higher adherence to the Mediterranean diet was significantly associated with adequate sleep quality and inversely associated with impaired cognitive status. When considering bioactive components of the Mediterranean diet, a significant inverse association between a higher dietary intake of lignans and inadequate sleep quality was found. Similarly, a significant inverse association between higher dietary intake of total flavonoids and impaired cognitive status was observed.

Conclusions

The evidence indicates that diet Mediterranean diet together with its bioactive components may exert plausible effects toward cognitive health and sleep quality. There is a need to translate this evidence and to advocate healthy dietary practices as strategies for the prevention of these disorders.

Key messages

Higher adherence to the Mediterranean diet rich in bioactive compounds is recognized as healthy dietary practice associated with mental and sleep disorders. Dissemination of the benefits of adherence to the Mediterranean may contribute to the control of the rising prevalence of mental and sleep disorders.
Awareness and approaches of medical doctors and veterinarians on One Health concept
Authors: Ozguler Z , Aslan D
Published: October 2021

Background

One Health examines health relationships between humans, animals, and ecosystems, but there is a lack of implementation of the concept in health sciences. Medical doctors and veterinarians have crucial roles in improving both the concept and its practices. Therefore, we aimed to understand their awareness, approaches, and recommendations for improvement.

Methods

For this descriptive study, data were collected in two subsections. Quantitative data were collected through a form sent via email to members of Ankara Chamber of Medicine and Ankara Chamber of Veterinarians between 24 February and 24 April 2020. The quantitative data on both chambers' board of directors' opinions were obtained through semi-structured interviews on 13 and 22 June 2020.

Results

A total of 295 people (74 medical doctors, 221 veterinarians) completed the questionnaire. Most of the doctors (63.5%) and few of the veterinarians (6.3%) had not heard of the concept (p < 0.001). Majority of the veterinarians (7.3%) and a few of the doctors (35.1%) applied the concept (p < 0.001); however, they expressed its usefulness for the health promotion and prevention steps. Although they generally thought that various disciplines and sectors were related to the concept, they had not cooperated with them. Majority of the doctors (95.9%) and veterinarians (71.5%) did not receive any training on One Health (p < 0.001). We also inquired about doctors' and veterinarians' views and suggestions for implementing One Health on components such as scientific research, surveillance, clinical practice, education, health policies, and roles of both medical associations. Proposed views were promising to create collaborative work to advocate One Health approach.

Conclusions

We communicated recommendations to integrate the concept into curriculums, create joint training, research, and prioritize cooperation. We planned a panel meeting to discuss the realization of further steps to improve awareness and practice.

Key messages

There is a demand by medical doctors and veterinarians for implementing the One Health approach to health-related education and training, surveillance systems, and policies. Medical doctors and veterinarians need collaborative One Health platforms, including other professionals, for information sharing, joint research, prevention, and health promotion practices.
The knowledge exchange and dissemination plan of the We Can Quit2 community-based stop-smoking trial
Authors: Castello S , Darker C , Vance J , Buckley E , Reynolds C , Cronin N , Dougall N , Devane D , Bauld L , Hayes CB
Published: October 2021

Background

We Can Quit2 was a community-based randomised controlled trial which determined the feasibility and acceptability of We Can Quit (WCQ), a peer delivered stop-smoking programme comprising group support and free Nicotine Replacement Therapy (NRT) tailored to women living in socioeconomically disadvantaged areas in Ireland. Reengagement with key stakeholders took place as part of the trial Knowledge Exchange and Dissemination plan, to discuss strategies to optimise community engagement, recruitment and retention in a future definitive trial (DT), and the policy priorities arising from the trial.

Methods

Community stakeholders involved in trial recruitment and planning, Irish Cancer Society and Health Service Executive representatives were invited to an online interactive workshop in November 2020. Key trial findings were presented. Workshop discussion (field notes) and responses to a post-event anonymous questionnaire informed a list of challenges and suggestions for a future DT and policy development from a community perspective.

Results

Forty-one stakeholders attended the workshop, six completed the questionnaire. Dedicated additional time for community engagement and use of social prescribing as a recruitment tool were recommended. Greater adaptation of trial data and assistance to complete forms were suggested to address low literacy, which was a barrier to recruitment and retention. An intervention boost after WCQ delivery and encouragement of women to join other healthy community programmes to maintain their group, were recommended to facilitate retention and enhance sustainability. Policy priorities were to remove cost and administrative barriers to access NRT and ongoing provision of cessation services tailored to disadvantaged groups.

Conclusions

Important strategies to optimise design of a DT of WCQ effectiveness were recommended. Lessons learned may be relevant to other community-based health interventions in socioeconomically disadvantaged areas.

Key messages

The workshop provided a suitable forum for engagement of community and statutory stakeholders. Knowledge exchange activities facilitated an enhanced research design from a community perspective.
Impact of State of Emergency Declaration for COVID-19 on Cancer Screening Behavior in Japan
Authors: Takahashi H , Machii R
Published: October 2021

Status of cancer screening behavior is changing due to the effects of the state of emergency for Covid-19 in Japan. Based on data from three medical institutions that provide cancer screening throughout Japan, we compared the number of examinees undergoing cancer screening by month in 2019 and 2020. From April to May 2020, the number of examinees decreased by about 50-80% compared to the previous year, but after June, recovered to the same level as previous year. In addition, the number of examinees undergoing resident cancer screening tended to decrease more than that of occupational screening. The causes of the decrease are 1. examinee was wary of the risk of infection at the examination site. 2. medical institution postponed cancer screening because the Ministry of Health, Labor and Welfare issued a notice to refrain from endoscopy, which is less urgent. 3. It was considered that the municipalities that carried out the examinations were wary of the spread of the infection and postponed or canceled the recommendation of the cancer screening.

Key messages

Declaration of emergency has reduced the number of cancer screening examinees. Impact on cancer mortality will be an issue for the future.
In-hospital mortality in COVID-19 vs. pre-COVID-19 era in the Split-Dalmatia County, Croatia
Authors: Marasovic Šušnjara I
Published: October 2021

Background

The COVID-19 pandemic marked 2020 with numerous consequences for the health of the population. Therefore, this study aimed to explore whether the COVID-19 pandemic affected in-hospital mortality.

Methods

We employed a cross-sectional comparative study using two different time periods, pre-COVID-19 (2019 year) and COVID-19 era (2020 year) to explore possibilities of COVID-19 influences in-hospital mortality in Split-Dalmatia County, Croatia. The research used data from the national information system on hospitalizations from the Clinical Hospital Center Split, University Hospital Split. The indicators were statistically analyzed. The z-score test for two population proportions is used.

Results

In 2020, there was a significantly higher in-hospital mortality compared to 2019 (z = 9.0827; p < 0.00001), which was supported by a significant increase in mortality from respiratory diseases according to the comparison of disease categories of International Statistical Classification of Diseases and Related Health Problems (ICD-10) (z = 9.0427; p < 0.00001). Within hospital departments, significantly higher mortality was in the Intensive Care Unit (z = 5.2763; p < 0.00001) and the Infectious Diseases Department (z = 9.6982; p < 0.00001). Among deaths in 2020 with confirmed COVID-19, there were significantly more positive among deaths from respiratory diseases (z=-17.4462; p < 0.00001). There was no difference in mortality rates between 2020 and 2019 by age.

Conclusions

The results of the study indicate that COVID-19 has a contribution to hospital mortality. Given that the pandemic has not yet completed additional research, it will be necessary to obtain a more complete picture of the impact of COVID-19 on hospital mortality in Split-Dalmatia County, as well as in other regions and countries.

Key messages

The results of the study indicate that COVID-19 has a contribution to hospital mortality. Given that the pandemic has not yet completed additional research, it will be necessary to obtain a more complete picture of the impact of COVID-19 on hospital mortality.
Factors associated with physicians' decision making during the first wave of the COVID-19 pandemic
Authors: Bord S , Sharabani S , Admi H
Published: October 2021

Background

Frontline medical staff, combating the Covid-19 pandemic are forced to make clinical and behavioral decisions daily. Their decision-making process and the factors associated with it, are of utmost importance in preserving and supporting their own health and their patient's health.

Aims

Tto explore the factors associated with physicians' decision-making during the first wave of the COVID-19 pandemic in Israel

Methods

Cross- sectional data were collected among 200 physicians at the Israeli health care system between March and May 2020 via an online questionnaire. A multiple hierarchical regression was calculated to assess the contribution of the study variables to the physicians' decision making.

Results

Most physicians reported that they complied with hygiene guidelines at work, issued by the Israeli ministry of health (MOH), fully (42%) or very often (31%), and with the MOH COVID-19 behavior guidelines fully (27%), very often (34%), or in general (23%). According to the study

Results

trust, positive emotions, perception of COVID-19 threat, and risk perceptions were found significant and positive. In other words, higher trust, more positive emotions, and perceptions of greater threat and risk, were associated with higher compliance with the MOH guidelines and more cautious decision making.

Conclusions

While threat and risk perceptions may be inevitable during the pandemic, trust and positive emotions may act as protective factors, encouraging cautious decision making among physicians.

Key messages

Physicians' decision making is a complex process affected by their perceptions, emotions, and trust levels. High levels of trust and positive emotions may facilitate carful decision making.
The impact of COVID-19 on satisfaction with social contacts
Authors: Van den Houte N , Van der Heyden J
Published: October 2021

Background

The corona crisis caused many countries to instruct their citizens to stay at home and engage in “social distancing” to reduce the infection rate. This has caused a drastic change to our lifestyle and social contacts. This study investigates the impact of the corona crisis on the satisfaction of social contacts in Belgium.

Methods

Study participants included a subsample of adults aged ≥18 years (n = 510) of the Belgian health interview survey 2018, who also participated in a follow-up study in July 2020. Information on satisfaction with social contacts was measured twice with the same instrument. A multilevel logistic regression was used to analyse how the proportion of participants indicating they are unsatisfied with their social contacts had changed over time.

Results

Between 2018 and July 2020 the prevalence of being unsatisfied with social contacts increased from 10.0% to 19.0%. We observed important differences in the change in this indicator between the 3 Belgian regions. A significant increase was observed in Flanders (OR 3.6; 95% CI 1.8-7.1) and Brussels (OR 3.0; 95% CI 1.2-7.5), whereas this was not the case in Wallonia (OR 1.1; 95% CI 0.5-2.5). No relation was observed with age, gender and education. Strictly respecting the measures about the social bubble was inversely related with being unsatisfied with social contacts (OR 0.5; 95%CI 0.2-0.9).

Conclusions

There is a substantial increase in people being unsatisfied with their social contacts during the COVID-19 pandemic in Belgium. Regional variations could be related to cultural factors in the way the crisis was perceived, but were not explained by differences in non-compliance of the “social bubble”-rule.

Key messages

Social health is considered as a protective element for public health. Understanding those changes could help to guide public health policies. Further research is needed to study how social contacts evolve during this COVID crisis and which factors have an impact on this.