bluuebunny/crossref_metadata_2025 huggingface dataset:
Association between job exposures and employment status 2 years after medical rehabilitation
Authors: Brünger M , Spyra K , Bernert S
Published: October 2022

Background

Research shows an important association between job exposures and various health- and employment-related outcomes. On contrast, little is known about the impact of job exposures on the employment status after medical rehabilitation. Thus, the aim of this study is to investigate the association between job exposures and employment, unemployment, and disability pension entry 2 years after rehabilitation.

Methods

A retrospective cohort study was performed based on the scientific use file “SUFRSDLV15B” of the German Pension Insurance containing rehabilitation and occupational data at a monthly level. We included n = 597,021 insured persons aged 18 to 63 years completing a medical rehabilitation between 2008 and 2013 in Germany and traced their employment status over a 24-month follow-up period. Job exposures were operationalised with the Overall Job Exposure Index (Kroll, 2015) by applying job-exposure-matrices.

Results

Persons with high job exposures in comparison to those with low job exposures were less likely to be employed (87.6% vs. 92.6%) and more likely to be unemployed (13.9% vs. 7.7%) and to draw disability pension (4.8% vs. 4.4%) for at least one month in the 2-year-period after rehabilitation. One minus survival curves showed that the differences were already evident in the first month after rehabilitation and further increased during the following 24 months. Cox regressions revealed that these associations remained stable when adjusting for gender, age, and employment status before rehabilitation.

Conclusions

The results underline the importance of addressing job exposures during rehabilitation to enhance return-to-work and stay-at-work after rehabilitation. These findings could help to identify particularly vulnerable groups of insured persons based on routine data at an earlier stage than has been the case so far and to give them access to structured workplace-oriented medical rehabilitation programmes that have been established in recent years.

Key messages

• High job exposures are associated with less work participation after medical rehabilitation.

• To increase return-to-work, it may be useful to address job exposures in rehabilitation more than before.
Categorical principal component analysis to characterize patients at Intensive Care Unit admission
Authors: Favara G , Barchitta M , Maugeri A , Campisi E , La Mastra C , La Rosa MC , Magnano San Lio R , Mura I , Agodi A ,   SPIN-UTI network
Published: October 2022

Background

Healthcare-associated infections (HAIs) are the most frequent complications in healthcare settings, with a major impact on adverse outcomes. Here, we aimed to identify the relationships between patients’ characteristics admitted to Intensive Care Units (ICUs).

Methods

We used data of patients included in the “Italian Nosocomial Infections Surveillance in Intensive Care Units” (SPIN-UTI) project, who stayed in ICU for more than 2 days. Using Categorical principal component analysis (CATPCA) two components of risk were assessed. Values of variance accounted for (VAF) >0.3 were accepted as the significant effect of a variable on each component. A Chronbach’s alpha >0.7 was accepted as a measure of the internal consistency of the model.

Results

A total of 22402 admissions (62% female) were included. The average age was 65.7 years (SD = 16.6). Our model explains 35.3% of the total variability, with a Cronbach's alpha value of 0.847. The visual examination of component loading plot allows to evaluate the correlation between the quantified variables and each of the two components. In particular, the first component is explained by the presence of intubation (VAF=0.826), central venous catheter (VAF=0.749), and urinary catheter (VAF=0.727), patient’s origin (VAF=0.584), antibiotic treatment (VAF=0.479), non-surgical treatment for acute coronary disease (VAF=0.375), type of admission (VAF=0.509), surgical intervention (VAF=0.419). In the second component, the variables with the greatest contribution were the SAPS II (VAF=0.660), age (VAF=0.583), type of admission (VAF=0.531), surgical intervention (VAF=0.522). Thus, the first component would represent the exposure to invasive devices and medical procedures, and the second component the severity of patients.

Conclusions

Our results proposed the usefulness of CATPCA to identify factors involved in the development of adverse outcomes, highlighting the role of exposure to invasive devices and severity of patients.

Key messages

• There are several relationships between patients clinical and personal characteristics.

• CATPCA represents a useful approach for the analytical exploitation of healthcare data.
Emergency Department: Analysis of Patient Flow and Length of Stay Variations
Authors: Fanti E , De Marco M , Lorenzini C , Porchia B , Dominijanni M , Gusinu R , Messina G
Published: October 2022

Background

Crowding in Emergency Departments(ED)is a severe public health issue.Length of stay(LOS)is not a direct measure of crowding,but it is an essential indicator for monitoring emergency care quality.LOS in ED can be associated with delays in treatment,decreased patient satisfaction and adverse outcomes.The aim of this study is to analyze ED LOS in the Teaching Hospital of Siena for further strategies.

Methods

A retrospective observational study was conducted between January 1,2019, and December 31,2021.To manage admissions and discharges, all patients’ data admitted to ED of the University Hospital of Siena were accessed by Aurora,the IT system.In addition,a descriptive analysis was performed, collecting the following variables:sex,age,arrival mode,ED visit reasons,triage code,discharge mode,hospital admission area and LOS(cut-off>8hours).The analysis was carried out using STATA 17:variables were analyzed with ANOVA test.

Results

Our sample consisted of 152.393 patients (F49.47% M50.53%),and the average age was 50.51(SD ± 26.07).During the years total ED visits decreased:65.426(2019);40.318(2020); 46.649(2021),and there was a significant increase (p < 0.001) of patients with LOS>8 hours:13.96%(2019); 21.51%(2020); 23.10%(2021).In the years 2019,2020 and 2021, admissions of patients with LOS>8 hours were respectively: 25.92%; 43.95% and 37.09%, with the following percentage in medical areas:69.96% in 2019;70.51% in 2020;64.55% in 2021.A progressive increase of admissions in COVID area resulted since 2020(2.23%-2020;6.07%-2021).

Conclusions

The spread of COVID-19 and the containment measures,such as lockdown,caused a significant decrease in ED access.The increase LOS>8h could be primarily due to the time needed to perform laboratory investigations for the search for SARS-CoV-2 but also to the overflow of SARS-CoV-2-infected patients rapidly saturating the ED boxes and hospital bed capacity,with the need sometimes to dedicate other medical areas to manage COVID patients.

Key messages

• ED-LOS is a proxy indicator to monitor emergency care quality.

• Further investigations should be performed to analyze the leading causes of ED LOS increase during the pandemic period.
The role of individual level health resources on health outcomes of newly settled migrants in Sweden
Authors: Al-Adhami M , Berglund E , Wångdahl J , Hedrick K , Salari R
Published: October 2022

Abstract citation ID ckac131.313 has been removed
Teachers at vocational schools as ambassadors for physical activity? Developing an empowering webinar
Authors: Kaiser V , Foitzik E , Hassel H
Published: October 2022

Background

Childcare centres have the potential to promote health-enhancing physical activity (PA) in children. However, institutions with need for action seem to be hard to reach. During the project “QueB 2 - developing quality with and through physical activity” different strategies to empower multipliers in spreading awareness for PA were tested. Currently, the aim of the project is to involve teachers at vocational schools for early childhood education in order to sensitize prospective educators and ensure quality in planning interventions.

Methods

The webinar was developed in three steps: (1) Four workshops were implemented in two vocational schools by participating 80 future educators to train them in planning PA interventions. (2) The collected students’ recommendations and sample projects were categorized in eight steps of a theoretical model for project planning. (3) After finalizing the webinar, questionnaires were used to reflect on its application, utilization, and design.

Results

The results of the second step were summarized in a manual for planning PA interventions in childcare centres. This forms the basis of the webinar to enable teachers to disseminate PA promotion in class. The developed modules were installed at a website and provided for free in order to be used by the interested public. In step three, teachers tested the webinar and filled in the questionnaire. The majority perceived the webinar as useful, appreciated its clear structure and appealing design, and expressed an increased awareness of factors concerning PA in childcare centres.

Conclusions

Teachers at vocational schools perceived the webinar as useful to integrate parts of planning PA interventions in childcare settings in the curriculum. Transferring developed manuals and training modules to multipliers by providing an appealing, informative webinar seem to be a successful and sustainable way to ensure quality in planning processes.

Key messages

• Involving teachers at vocational schools as multipliers for PA in childcare centres by performing a webinar is a sustainable strategy to maintain quality in intervention planning.

• Early childhood education students can act as ambassadors for PA.
What do future public health doctors know about the One Health concept in Portugal?
Authors: Alho AM , Vasconcelos R , Gomes B , Nunes AB
Published: October 2022

Background

The One Health (OH) approach brings together a transdisciplinary collaboration between human, animal, and environmental health, to tackle emerging zoonotic diseases, antimicrobial resistance, and food safety. Therefore, incorporating of OH principles in the education of health care providers is fundamental.

Methods

To assess OH knowledge, attitudes and practices (KAP), an anonymous, multiple-choice, online self-administered survey was sent to 1st year Portuguese Public Health Medical Residents (PPHMR), during an online congress targeted to them. A descriptive analysis was performed.

Results

A 50.0% response rate was obtained out of the 42 PPHMR attendees. Only 33.3% were familiar with OH concept; 57,1% had heard of it but were not aware of its meaning, and 9.5% had never heard of it. Concerningly, 9,5% believed zoonosis were diseases transmitted between animals and 42.9% considered that “antimicrobial resistance” is applied to antibiotics only. Regarding major zoonosis, etiologic agents were not recognized for Cryptosporidiosis (47.6%), Echinococcosis (42.9%), Toxoplasmosis and Leptospirosis (38.1%), Dermatophytosis (33.3%), Rabies (28.6%), Borreliosis/Brucellosis (23.8%). Half (52.4%) were unaware of the transmission route of Brucellosis/Dermatophytosis, followed by Leptospirosis (38.1%), Toxoplasmosis (28.6%) and Borreliosis/Rabies (23.8%). Remarkably, all participants showed willingness to be informed on OH issues and agreed that prevention and speed of intervention would be higher with greater collaboration between health technicians. About education towards OH throughout their medical curricula, 61.9% classified it as low, 23.8% as absent, 14.3% as sufficient and none classified it as adequate or very adequate.

Conclusions

This is the first study assessing KAP regarding the OH concept among PPHMR. Results highlight the need to bring OH to the Portuguese medical schools’ agenda to better prepare the next generation of PPHMR to the emerging health crisis.

Key messages

• Despite the interest shown by 1st year Portuguese Public Health Medical Residents concerning One Health, a general lack of knowledge on the topic was found.

• The majority qualified as insufficient their training on this subject, highlighting the need for medical schools to improve education and raise awareness regarding this transdisciplinary approach.
Masculinity norms and help-seeking intentions after experiences of interpersonal violence
Authors: Komlenac N , Lamp E , Maresch F , Hochleitner M
Published: October 2022

Background

High levels of self-compassion might increase men’s willingness to seek formal help, including those men, who rigidly conform to masculinity norms (CMN). However, self-compassion has rarely been considered as an enabling factor for women’s help-seeking intentions. The current study analyzed the links between CMN, self-stigma, self-compassion and willingness to seek formal help after experiences of interpersonal violence (IPV) in women and men.

Methods

A cross-sectional online-questionnaire study was conducted with 491 German-speaking participants (65.6% women/34.4% men; age: M = 36.1 years; SD = 14.2). Participants read three vignettes about experienced IPV. Afterwards, they indicated how likely they would be to seek medical or psychological help if they were in the main characters’ situation. The Conformity to Masculine Norms Inventory, Self-Stigma of Seeking Help Scale, Self-Compassion Scale were used. Separate manifest path models were calculated for women and men.

Results

CMN and low self-compassion were linked to strong self-stigma. In turn, strong self-stigma was associated with reduced help-seeking intentions. In men, the interaction term Self-Compassion x CMN on self-stigma indicated that strong CMN was linked to increased self-stigma, especially in men with low self-compassion. Also, indirect links between CMN and help-seeking intentions via self-stigma have been found. However, in people with strong self-compassion, direct links between CMN and help-seeking intentions became evident.

Conclusions

In women and men self-compassion was linked to reduced self-stigma. As is suggested from past research, self-compassion might “buffer” the link between CMN and self-stigma, especially in men. However, there might be an influence of strong CMN on help-seeking intentions also in people with strong self-compassion. This route might not be mediated by self-stigma and therefore, future research is needed to detect other potential mediators.

Key messages

• Self-compassion might “buffer” the link between CMN and self-stigma in men.

• Future research is needed to study mediators between strong CMN and help-seeking intentions in people with strong self-compassion.
Covid-19 vaccination adherence and correlated factors in patients with substance use disorders
Authors: Mondera F , Direnzo GFM , Cammalleri V , Forestiero FM , Turatto F , Baccolini V , Marzuillo C , Barra M , Villari P
Published: October 2022

Background

Analyzing trends and patterns of vaccination during COVID-19 pandemic is important to understand how current policies are working. Evidence regarding the general population is already available, but hard-to-reach populations as migrants or minorities, but also people suffering from a Substance Use Disorder (SUD), have not been fully explored. To understand the extent of vaccine adherence and evaluate associated factors in this population subgroup, we conducted a cross-sectional study in collaboration with Villa Marini Foundation, national agency of the Italian Red Cross for pathological addictions.

Methods

We developed a questionnaire regarding COVID-19 vaccination, adherence to prevention measures, concerns about COVID-19 and questions relating to drug use that we administered to each participant. Only people aged over 18 with a diagnosis of SUD were included in the study. A multivariable logistic regression model was built to identify the predictors associated with anti-SARS-CoV-2 vaccination, estimating adjusted odds ratios (aOR) and 95% confidence intervals (CIs).

Results

We recruited 200 participants between December 2021 and January 2022. Most respondents were male (84.5%), Italian (72%), aged 44 years on average. A total of 40 patients (20%) reported they haven't received any dose of COVID-19 vaccine; the most common motivations were lack of trust in the vaccine and fear of side effects. At multivariable analysis, the use of heroin appears to be negatively associated with vaccination acceptance (aOR=0.31 CI 95%: 0.11-0.81) as well as not being Italian (aOR=0.27 CI 95%: 0.12-0.63).

Conclusions

The vaccination rate in our sample was consistent with the one of the general Italian population in the same period, whereas the reasons behind the lower adherence to vaccination in the heroin group need to be further investigated. It’s also important to reduce possible bureaucratic obstacles that could explain the lower number of vaccinated foreign citizens.

Key messages

• People with Substance Use Disorder are a fragile and often overlooked population that needs to be considered during Public Health intervention and vaccination campaigns.

• The access to vaccination for foreigners should be made more simple and easier to increase accessibility and participation.
Information-seeking on the internet during the transition to motherhood: descriptive survey, Cyprus
Authors: Middleton N , Koliandri I , Kolokotroni O , Hadjigeorgiou E , Christodoulides V , Nicolaou C , Kouta C , Karanikola M , Middleton N ,   Baby Buddy Forward partnership
Published: October 2022

Background

Internet use in pregnancy is very prevalent. However, there are issues with information quality as well as acceptance by healthcare providers which can add to the frustration.

Methods

An online anonymous survey, shared via Baby Buddy Cyprus, addressed women who are pregnant or recently gave birth in Cyprus. Adapting previously used questionnaires, the survey covered reasons and patterns of internet use, perceptions of trustworthiness, appraisal means and usefulness in decision-making.

Results

Among 357 responses so far in this ongoing survey (38% pregnant, 62% new mums, 66% primiparas, 42% C/S, 78% private sector), searching online seems very frequent, even though 70% report coming across wrong or misleading information often. Checking for consistency across sites and/or with information by healthcare provider (HP) is the most common technique for assessing trustworthiness. While the majority discuss information with HP, only half characterize their reception as positive and welcoming. As many as 89% believe that HP should recommend sites, but only 6.5% report their HP made recommendations. The role of the internet in assisting decision-making is rated as moderate (M = 3.0, SD = 1.0 on 5-point scale averaged across 11 items); yet more than half search online to be prepared and have control over decisions. Among reasons cited for using the internet is insufficient time with HP and/or is unclear or unsatisfactory information. While only 11.6% prepare material for the next appointment, 54.5 % use the internet to verify information given by HP or for a second opinion.

Conclusions

While a prevalent source of information, the flow is problematic as it appears that women are more likely to search online to verify information rather than discuss this information with their providers. Insights about characteristics and attributes of internet use in pregnancy suggest that health services need to engage with, rather than ignore, this reality and offer appropriate guidance.

Key messages

• Pregnant women in Cyprus search for information online, due to insufficient time or information by healthcare providers, even though they recognize there are issues with quality and expect guidance.

• In a landscape of unguided information-seeking, searching for consistency and verification, a shift in current practices is needed whereby healthcare providers and services engage with this reality.
A preliminary study of bullying on University of Nursing in Taiwan
Authors: Hsieh M
Published: October 2022

Background

According to the COVID-19 pandemic progress, the increase in online learning and communication, the survey shows that 36.3% of children have been bullied online (Children’s Welfare Alliance, 2021). However, campus bullying has long-term effects on students’ physiology and psychology, and will also extend to society in the future to form a social problem.

Aims

It is generally believed that university students are relatively mature and have more freedom in taking courses. They believe that there are few bullying incidents that need attention on university campuses. Therefore, to understand the patterns of bullying on university campuses of nursing in Taiwan through this study.

Methods

Referring to the definition and selecting the published within good reliability and validity of ‘University Students’ Campus Life Experience and Interpersonal Interaction Experience Survey', the subjects in domestic university campuses choose the closest answer according to their own situation.

Results

In a total of 2570 valid questionnaires, the highest incidence of verbal bullying (38%), and those who don't want to answer gender “experienced bullying in person” (42.9%). Gender was shown to be statistically significant in bullying experience (p=.017). It shows that university students of nursing in Taiwan have obvious room for improvement in gender issues.

Conclusions

Through this study, it is known that campus bullying exists in different types of experiences on university campuses of nursing in Taiwan. The bullying impact is often not only in school, and the impact will even extend to enter social work. Faculties must also be the gatekeepers of bullying prevention, but in fact, even senior faculties may not be very clear about what bullying is, how to properly handle bullying incidents, and how to prevent bullying, so every faculty should have the ability to take appropriate, fast and effective treatment when bullying occurs.

Key messages

• Campus bullying has long-term effects on students’ physiology and psychology, and will also extend to society in the future to form a social problem.

• Verbal bullying (38%) had the highest incidence, those who don’t want to answer gender “experienced bullying in person” (42.9%).
Barriers to prevent second-hand smoke (SHS) exposure among pregnant women and children in Egypt
Authors: Hassanein Z , Langley T , Bogdanovica I , Murray R
Published: October 2022

Background

The prevalence of daily second-hand smoke (SHS) exposure among pregnant non-smoking women and children in Egypt is estimated to be about 50% and 55%, respectively. This study aimed to explore barriers to preventing SHS exposure among pregnant women/children and smoking behavior at home in Egypt.

Methods

Focus group discussions (FGDs) with pregnant women/mothers of children residing in urban/rural areas (n = 61). Data were coded and analyzed thematically.

Results

61 participants were recruited, aged 18-49. They reported being never smokers and SHS exposure for themselves and their children was mainly at home. Pregnant women/mothers had some general knowledge of the dangers of SHS, but their knowledge appeared incomplete. The most commonly reported barriers to preventing SHS exposure/adopting a smoke free home or workplace were having men who smoke in the household, doctors not being supportive regarding smoking cessation, SHS exposure is socially accepted and fear among women of damaging a relationship; being nervous about asking smokers to stop, and being worried about disputes and arguments with husband. The majority of interviewees’ families were reported to allow smoking anywhere in the home; others implemented some measures to prevent SHS, however, these tended to be inconsistently implemented and unlikely to be effective.

Conclusions

This study increases our knowledge of the barriers of non-smoking Egyptian pregnant women/mother of children in creating and maintaining smoke free environment for themselves and their children. There is a need to denormalise SHS exposure and better enforcement of smoke free policies.

Key messages

• Better enforcement of smoke free policies, and more support for smoking cession services are needed in Egypt.

• SHS policy, practice, and research should focus on male family members to increase their effectiveness.
Factors associated with SARS-CoV-2 infections among migrants in Germany
Authors: Koschollek C , Kajikhina K , Michalski N , Hövener C
Published: October 2022

Background

International research shows increased risks for SARS-CoV-2 infection and severe disease progression in people with migration history. In Germany, data on this topic is scarce. Aim of this contribution is to examine the association between migrant status and risk of SARS-CoV-2 infection and discuss potential explanatory mechanisms.

Methods

We analysed data from the German COVID-19 Snapshot Monitoring online-survey and performed hierarchical multiple regression models to calculate probabilities for a self-reported SARS-CoV-2 infection. Main predictor variable was the migrant status; besides, the association with gender, age, education, household size, household language (German vs. other), and occupation in the health sector was analysed.

Results

Of 45,858 participants, 3.5% reported a current or previous infection with SARS-CoV-2, 16% reported own or parental history of migration. The probability of reporting an infection was 3.95 percentage points higher among migrants. The effect of different characteristics on self-reported SARS-CoV-2 infection varied. Higher probabilities were shown for individuals living in bigger households and those not speaking German at home. Stepwise integration decreased the observed association with migrant status. When adding an interaction term of migrant status and occupation in the health sector, the probability to report an infection was 11.5 percentage points higher for migrants working in the health sector.

Conclusions

People with migration history, health sector employees and particular migrant health workers are at a higher risk of SARS-CoV-2 infection. However, the migrant status itself does not determine the risk of infection, but the living and working conditions. Therefore, targeted and multilingual prevention measures are needed that consider living and working conditions.

Key messages

• Higher SARS-CoV-2 infection risks are not solely determined by migrant status, but were shown for health care workers, people living in bigger households and those not speaking German at home.

• As not the migrant status determines infection risks, multilingual and targeted prevention measures considering the living and working conditions of people are necessary.
Design of value-added tax on medicines in 41 European countries
Authors: Vogler S , Zimmermann N
Published: October 2022

Background

Recently, among others due to the COVID-19 pandemic and the war in Ukraine, European countries have been experiencing rising inflation. Value-added taxes (VAT) on essential goods have gained public attention, and abolishing VAT for these goods has been discussed as a measure to prevent poverty and inequities. The study aims to investigate the relevance of value-added tax on medicines in European countries.

Methods

We collated information on medicines-specific and standard VAT rates in 41 countries of the WHO European Region (all 27 European Union Member States, Albania, Armenia, Iceland, Israel, Kazakhstan, Kyrgyzstan, Kosovo, Moldova, North Macedonia, Norway, Serbia, Switzerland, Turkey and United Kingdom). Data were reviewed from literature and were validated by national public authorities.

Results

In three countries (Albania, Kazakhstan and Malta), all medicines are exempt from VAT. 28 of the 38 countries with VAT on medicines impose a single VAT rate on all medicines, and in most of these countries (21 countries) the medicines-related VAT is lower than the standard VAT rate. Ten countries have differentiated VAT rates: In Ireland, Kyrgyzstan, Sweden and the UK defined medicines (e.g. oral medicines, prescription-only medicines) are exempt from VAT, whereas for the other medicines the standard VAT rate applies; six further countries have a lower VAT rate for some medicines (e.g. heparins, blood products, contraceptives or reimbursed medicines in general) compared to the remaining medicines, whose VAT rate equal the standard rate or is lower.

Conclusions

Some European countries apply specific mechanisms (exemptions, reduced rates) regarding the VAT for defined or all medicines. This may act as a protective measure for patients in case of non-reimbursed medicines and help public payers to ensure financial sustainability to funded medicines. Further medicines-specific research is needed to understand the impact of inflation.

Key messages

• Value-added tax is a relevant component of medicine prices.

• Lowering or abolishing the VAT on medicines can be an important policy espeically when patients pay out-of-pocket.
The study on health of older people in Germany (Health 65+): Design and first results
Authors: Fuchs J , Gaertner B , Perlitz H , Kuttig T , Scheidt-Nave C ,   Study Group Health 65+
Published: October 2022

Background

Integrating older persons into continuous national public health monitoring is crucial but challenging. Health 65+ is the first national health interview and examination survey in Germany specifically tailored to the needs of the population 65+ years.

Methods

Health 65+ is based on two-stage stratified random sampling from 128 local population registries. It is based on a previously tested three-step procedure to contact the study population (letter, telephone, home visits). 12,448 individuals 65+ years were invited for survey participation between June 2021 and April 2022. Participation comprised answering a baseline-questionnaire/interview covering a consented set of key health indicators including SARS-COV2 infections, and 3 follow-ups. After one year participants are invited to an examination (e.g. blood pressure, grip strength, cognitive function) during a home visit. All-cause mortality, health insurance data and information on social and built environment will be linked to survey data. The preliminary data set comprises 3,107 baseline participants.

Preliminary results

Only few individuals were excluded for survey participation as they had deceased before invitation, moved to an unknown residence or had insufficient German language skills. Of the adjusted gross sample, 32% took part in the survey (47.9% women, mean age 78.8 years). Only 3.3% of the participants did not receive any vaccination against COVID-19, with no differences between gender or age-groups. 3.5% had already experienced a laboratory-confirmed SARS-CoV-2 infection.

Conclusions

Health 65+ collects information that cannot be obtained from any other data sources. In combination with information from routine health data and official health statistics, the results will aid health policy planning and implementation research to improve health and wellbeing of older people in Germany. For example, preliminary results show, that vaccination acceptance was high in persons 65+ years in Germany.

Key messages

• Health 65+ will provide health data of people 65+ years in Germany.

• The results will aid health policy planning.
Monitoring tobacco use among a sample of Tunisian high school pupils
Authors: Zammit N , Amara A , Ghammam R , Ben Fredj S , Boujebha S , Maatouk A , Ouertani M , Ben Belgacem W , Maatoug J , Ghannem H
Published: October 2022

Background

Smoking is the leading cause of preventable death. This risk behavior usually begins during adolescence. However, only the third of the countries are monitoring this risk behavior among adolescents.

Objective

To assess the prevalence of tobacco use and to determine the predictors of its experimentation among high school students from Sousse (Tunisia) in 2018 and 2019.

Methods

In 2018 and 2019, two cross-sectional studies were led among 1399 and 1342 adolescents randomly selected from the same four high schools in Sousse. For data collection, the same pre-tested questionnaire was self-administered anonymously to the participants in the presence of pre-trained investigators.

Results

Girls represented 60.5% and 63.2% of participants in 2018 and 2019 respectively. The prevalence of tobacco experimentation was of 29.4% in 2018 and of 26.7% in 2019. Current cigarette smoking was objectified in 9.8% and 7.4% of participants in 2018 and 2019. Regardless of the year of the study, the main predictors of lifetime tobacco use among them were: current use of e-cigarette (adjusted OR of 6.4 [4.5-9.0]), cannabis experimentation (adjusted OR of 5.3 [2.7-10.7] and alcohol consumption (adjusted OR of 3.9 [2.5-6.3]).

Conclusions

Experimentation and current use of tobacco are common among the high school students of Sousse. The national smoking prevention program should be reinforced by multisectoral prevention actions targeting not only tobacco use but also the consumption of other substances.

Key messages

• Tobacco experimentation is high among the adolescents of Sousse.

• Tobacco experimentation is strongly associated with other substances use among the adolescents of Sousse.
Effects of Earth's gravitation and compressibility on co- and post-seismic deformations
Authors: Liu Tai , Tang He , She Yawen , Fu Guangyu
Published: October 2022

In this paper, we systematically analyse the effect of Earth's gravitation and compressibility on co- and post-seismic deformations. Based on the analytical solution of dislocation Love number (DLN) in a non-gravitational and incompressible homogeneous Earth model, it was seen that reducing the density of the homogeneous Earth model can provide results equivalent to a non-gravitational model while expanding the Lamé constant of the homogeneous model gives results equivalent to those from an incompressible model. Then, we applied a non-gravitational and incompressible treatment in a layered spherical Earth model, and calculated the co- and post-seismic Green's functions for four independent sources. It is found that the effect of Earth's gravitation and compressibility are dependent on source depth and time after the event. The effect of gravitation on the co-seismic Green's function of a shallow source is much smaller than that of compressibility, while the effect of gravitation on the post-seismic Green's function over longer timescales is much greater than that of compressibility. Finally, taking the 2011 Tohoku-Oki Mw9.0 and 2013 Okhotsk Mw 8.3 earthquakes as examples, the simulation results show that post-seismic deformation studies should consider the Earth's compressibility, which is more obvious in the early post-seismic period. Likewise, when the viscosity of the study area is low, the effect of gravitation cannot be ignored. For the slip inversion of Tohoku-Oki Mw 9.0 earthquake, the incompressible Earth model leads to a smaller slip magnitude than the compressible Earth model.
Modelling Earth’s lithospheric magnetic field using satellites in low-perigee elliptical orbits
Authors: Olsen Nils
Published: October 2022

The sensitivity of magnetic measurements taken by satellites in elliptical orbits to the lithospheric magnetic field is studied by comparing the formal error variances of the lithospheric Gauss coefficients for various satellite orbital constellations. Analytical expressions are presented for the variances of the Gauss coefficients when either all three magnetic vector components or only the radial component are used. We compare the results obtained using a satellite in a near-polar circular orbit at 350 km altitude with those from a satellite in an elliptical orbit with perigee at 140 km (and apogee at 1500 km) and find that the latter leads to Gauss coefficient variances at spherical harmonic degree n = 180 (corresponding to a horizontal wavelength of λ = 220 km) that are 104 times smaller compared to those derived from a similar number of data measured at 350 km altitude. The improvements in variance ratio at degree n = 145 (λ = 275 km) and n = 110 (λ = 360 km) are 103 and 102, respectively. These findings are supported by an analysis of synthetic magnetic data along simulated satellite orbits from which the lithospheric Gauss coefficients are estimated and compared with the original ones used to generate the synthetic data. Coefficients at degree n are successfully determined if the power of the difference between retrieved and original coefficients at that degree is smaller than the power of the lithospheric field (i.e. of the input coefficients). Using 3 yr of simulated data we conclude that magnetic measurements from a satellite in an elliptical orbit with perigee at 140 km allow for a reliable determination of the lithospheric field up to spherical harmonic n ≈ 170 while a satellite in a circular orbit at 350 km height only enables lithospheric field modelling up to n ≈ 100. The analysis demonstrates that low-altitude magnetic data collected by satellites in low-perigee elliptical orbits—although only available for a fraction of each orbit—enable improved global lithospheric field modelling at spatial wavelengths well beyond what is currently possible with data from satellites in circular orbits that do not reach such low altitudes. We applied the approach to the orbital configuration proposed for the Daedalus satellite mission (140 km perigee); the method will however also help in the preparation for other satellite missions in near-polar low-perigee elliptical orbits like the Macau Science Satellite pair MSS-2A and MSS-2B (perigee of 200 km or lower).
Metabolic, fibrotic and splicing pathways are all altered in Emery-Dreifuss muscular dystrophy spectrum patients to differing degrees
Authors: de las Heras Jose I , Todorow Vanessa , Krečinić-Balić Lejla , Hintze Stefan , Czapiewski Rafal , Webb Shaun , Schoser Benedikt , Meinke Peter , Schirmer Eric C
Published: October 2022

Emery-Dreifuss muscular dystrophy (EDMD) is a genetically and clinically variable disorder. Previous attempts to use gene expression changes to find its pathomechanism were unavailing, so we engaged a functional pathway analysis. RNA-Seq was performed on cells from 10 patients diagnosed with an EDMD spectrum disease with different mutations in seven genes. Upon comparing to controls, the pathway analysis revealed that multiple genes involved in fibrosis, metabolism, myogenic signaling and splicing were affected in all patients. Splice variant analysis revealed alterations of muscle-specific variants for several important muscle genes. Deeper analysis of metabolic pathways revealed a reduction in glycolytic and oxidative metabolism and reduced numbers of mitochondria across a larger set of 14 EDMD spectrum patients and 7 controls. Intriguingly, the gene expression signatures segregated the patients into three subgroups whose distinctions could potentially relate to differences in clinical presentation. Finally, differential expression analysis of miRNAs changing in the patients similarly highlighted fibrosis, metabolism and myogenic signaling pathways. This pathway approach revealed a transcriptome profile that can both be used as a template for establishing a biomarker panel for EDMD and direct further investigation into its pathomechanism. Furthermore, the segregation of specific gene changes into distinct groups that appear to correlate with clinical presentation may template development of prognostic biomarkers, though this will first require their testing in a wider set of patients with more clinical information.
A mutation inATP11Acauses autosomal-dominant auditory neuropathy type 2
Authors: Chepurwar Shashank , von Loh Sarah M , Wigger Daniela C , Neef Jakob , Frommolt Peter , Beutner Dirk , Lang-Roth Ruth , Kubisch Christian , Strenzke Nicola , Volk Alexander E
Published: October 2022

Auditory synaptopathy/neuropathy (AS/AN) is a distinct type of sensorineural hearing loss in which the cochlear sensitivity to sound (i.e. active cochlear amplification by outer hair cells) is preserved whereas sound encoding by inner hair cells and/or auditory nerve fibers is disrupted owing to genetic or environmental factors. Autosomal-dominant auditory neuropathy type 2 (AUNA2) was linked either to chromosomal bands 12q24 or 13q34 in a large German family in 2017. By whole-genome sequencing, we now detected a 5500 bp deletion in ATP11A on chromosome 13q34 segregating with the phenotype in this family. ATP11A encodes a P-type ATPase that translocates phospholipids from the exoplasmic to the cytoplasmic leaflet of the plasma membrane. The deletion affects both isoforms of ATP11A and activates a cryptic splice site leading to the formation of an alternative last exon. ATP11A carrying the altered C-terminus loses its flippase activity for phosphatidylserine. Atp11a is expressed in fibers and synaptic contacts of the auditory nerve and in the cochlear nucleus in mice, and conditional Atp11a knockout mice show a progressive reduction of the spiral ganglion neuron compound action potential, recapitulating the human phenotype of AN. By combining whole-genome sequencing, immunohistochemistry, in vitro functional assays and generation of a mouse model, we could thus identify a partial deletion of ATP11A as the genetic cause of AUNA2.
Development and validation of questionnaire assessing the perception of hospital patient safety practices in public health facilities of India
Authors: Krishnamoorthy Yuvaraj , Samuel Gerald , Elangovan Venmathi , Kanth Krishna , Krishnan Murali , Sinha Isha
Published: October 2022

Background

In ‘To Err is Human’ released by the Institute of Medicine Committee on Quality of Health Care, it was emphasized that it is important to establish a safety culture in the hospitals and ensure that patients are not inadvertently harmed by errors.

Objective

Hence, we developed and validated a questionnaire for assessing the perception of patient safety practices across secondary and tertiary care facilities in India.

Method

The scale was developed based on the literature review and expert opinion. It consisted of 10 questions, and the responses to these items were based on a five-point Likert scale ranging from ‘strongly agree’ to ‘strongly disagree’. All analysis was performed using STATA version 14.2 software. Exploratory factor analysis (EFA) was run using principal component analysis with oblique promax rotation and confirmatory factor analysis (CFA) using structural equation modelling with maximum likelihood estimation.

Results

The entire dataset was split into testing set to run EFA (with 692 participants) and validation set to run CFA (with 645 participants). In EFA, two factors were retained as they had eigenvalue more than one (4.76, 1.09) and the scree plot also showed that the slope flattens off after two factors. Factor loadings were generated using oblique promax rotation. Factor 1 consisted of seven items (Item 1, Item 2, Item 3, Item 4, Item 5, Item 6 and Item 7—questions related to patient–doctor communication, hospital environment and procedures) accounting for 47.6% of variance, and Factor 2 had three items (Item 8, Item 9 and Item 10—infection prevention and control practices in hospital) explaining 10.9% of the variance. Thus, together, the two factors explained 58.5% of the variance. CFA revealed good confirmatory fit indices of 0.85, standardized root mean square residual of 0.07 and acceptable Tucker-Lewis Index of 0.80. The reliability coefficient was 0.88 indicating very good internal consistency.

Conclusion

This study develops and validates a scale that can be used universally for assessing the patients’ perception on hospital safety practices across secondary and tertiary care facilities in India.
A historical perspective on diversity in Clinical Laboratory Sciences Programs
Authors: Ahamad Afrinash , Guglielmo Jeannie
Published: October 2022

Objective

Diversity is integral for an effective learning environment and pedagogy. In this study, we aim to determine the student and faculty diversity in the Clinical Laboratory Sciences programs at Stony Brook University.

Methods

We retrospectively analyzed data over 20 years for the traditional program and 8 years for the hybrid program.

Results

Over 20 years, 502 students graduated from the traditional program, and 96 students graduated from the hybrid program. In the traditional program, an average of 25 students enrolled with 75% female and 25% male and in the hybrid program, an average of 12 students with 8.5 female and 3.5 male enrolled. The traditional program had the highest proportion of Asian students (50%), with White students making up 24.5%, whereas the highest proportions in the hybrid program were 35% White students and 24% Hispanic students. Among the 5 boroughs of New York City, the highest proportion of student representation was from Queens and Manhattan in both traditional (24.1%) and hybrid programs (16.7%). There were 30% male and 70% female faculty served in the traditional program whereas the current representation of fulltime faculty is 100% female.

Conclusion

Our data show the diversity of students and faculty in clinical laboratory sciences programs at Stony Brook University institution.
Association of CEA, NSE, CYFRA 21-1, SCC-Ag, and ProGRP with Clinicopathological Characteristics and Chemotherapeutic Outcomes of Lung Cancer
Authors: Bi Huijuan , Yin Lina , Fang Wenhao , Song Shenglan , Wu Shan , Shen Jilu
Published: October 2022

Objective

The aim of this study was to investigate the association of serum carcinoembryonic antigen (CEA), nerve-specific enolase (NSE), cytokeratin 19 fragment (CYFRA21-1), squamous cell carcinoma antigen (SCC-Ag), and pro-gastrin-releasing peptide (ProGRP) with the clinicopathological characteristics and chemotherapeutic outcomes of patients with lung cancer.

Methods

A total of 189 patients with lung cancer (lung cancer group) diagnosed at the Fourth Affiliated Hospital of Anhui Medical University from January 2020 to December 2021 were included. During the same period, 199 patients with benign lung disorders were included as the benign lung disease group and 75 healthy people were selected as the control group. The serum concentrations of CEA, NSE, CYFRA21-1, SCC-Ag, and ProGRP in all the 3 groups were analyzed and compared in patients with different lung cancer tumor-node-metastasis (TNM) stages and pathological classifications. A total of 11 patients with small cell lung cancer (SCLC) and 18 patients with lung adenocarcinoma (LAC) were further evaluated for the dynamic changes of CEA, NSE, CYFRA21-1, SCC-Ag, and ProGRP before chemotherapy and during the 6 courses of chemotherapy, and the outcome of chemotherapy was evaluated every 2 courses.

Results

The serum concentrations of CEA, NSE, CYFRA21-1, SCC-Ag, and ProGRP in the lung cancer group were significantly higher than those in the control group (P < .05). We found statistically significant differences in serum CEA, NSE, CYFRA 21-1, SCC-Ag, and ProGRP among patients with different pathological types (LAC, squamous cell carcinoma, or SCLC) and different stages (I–IV). The ProGRP and NSE had the highest expression in SCLC, CEA showed the highest expression in LAC, whereas CYFRA21-1 and SCC-Ag showed the highest expression in lung squamous cell carcinoma (LSCC). The concentrations of all the markers were elevated in the advanced pathological stages. The receiver operating characteristic curve analysis showed that the diagnostic value of the combined detection of CEA, NSE, CYFRA 21-1, SCC-Ag, and ProGRP for lung cancer was significantly higher than using a single biomarker (P < .05). Our dynamic monitoring results show that ProGRP progressively decreased in remission cases of SCLC and CEA progressively decreased in LAC remission cases.

Conclusion

CEA, NSE, CYFRA 21-1, SCC-Ag, and ProGRP have good clinical value in the early diagnosis, differential diagnosis, and progression monitoring of lung cancer. The ProGRP and CEA concentrations are beneficial for evaluating the outcome of chemotherapy in SCLC and LAC. The combined detection of multiple biomarkers shows improved clinical value in the early diagnosis of lung cancer.