bluuebunny/crossref_metadata_2025 huggingface dataset:
Communication between cancer patients, caregivers and oncologists about out-of-pocket spending
Authors: Tur-Sinai A , Bentur N , Urban D
Published: October 2022

Background

Concern about the cost and affordability of cancer drugs is widespread and well known. Even in countries with universal healthcare systems or health insurance for all, additional patient out-of-pocket (OOP) expenses are prevalent. Studies showed that honest communication between oncologists and patients is an important component in alleviating financial burden of cancer care. The study explores patient-caregiver-oncologist communication regarding the affordability of OOP medication and the extent to which this communication is related to families’ financial burden after their loved ones’ death.

Methods

A cross-sectional survey is conducted in Israel among 491 primary caregivers of deceased cancer patients, Jewish and Arab, in three oncology centers.

Results

About 43% caregivers said that they and/or the patients had paid OOP for medications during the last half-year of the patient's life. Most (73%) oncologists who suggested an OOP medication hardly asked or did not ask about financial ability and took little or no interest in ability to afford it, 43% hardly explained or did not explain the advantages of an OOP medication, and 52% hardly explained or did not explain any treatment alternatives. A linear regression analysis reveals that older age and female gender are related to less communication about an OOP medication and that better education, greater affluence, and having private health insurance are related to more communication. About 56% of caregivers say that OOP payment for medications inflicted a very heavy or heavy financial burden on patients and their households. A regression analysis revealed that physicians’ interest in their financial ability and in the explanation they gave decreased their burden.

Conclusions

Discussing and explaining the meaning of OOP payment alleviates the financial burden that families experience. It is crucial to develop and invest in improving oncologists’ education and skills to communicate costs more openly.

Key messages
Temporal dynamics of socioeconomic inequalities in COVID-19 – a scoping review
Authors: Beese F , Wollgast L , Waldhauer J , Hoebel J , Wachtler B
Published: October 2022

Background

International evidence shows a socially unequal burden of SARS-CoV-2 infections and COVID-19 outcomes across different socioeconomic groups. However, less is known about the temporal dynamics of socioeconomic inequalities in COVID-19 throughout the pandemic. We conducted a scoping review to systematically map and synthesize the available evidence.

Methods

We conducted a systematic literature search in Embase and Scopus with pre-defined eligibility criteria, including empirical research from 1 January 2020 to 24 August 2021. Additionally, several journals and the reference lists of all included articles were hand-searched to identify relevant studies. We used a standardized charting approach to extract relevant content and narratively synthesized the included evidence. The study follows the PRISMA guidelines for scoping reviews.

Results

From 8,011 identified records, we finally included 46 articles in the analysis. 50.0% of all included studies were conducted in the United States. The majority of all studies analyzed surveillance data (n = 44) and used area-based socioeconomic indicators on an ecological level (92.5%). The study results show temporal dynamics in COVID-19 inequalities, frequently initiated through higher outcome rates in more affluent populations and subsequent crossover dynamics to higher rates in more deprived populations (41.9%). Furthermore, 91.4% of the analyses show maintaining or worsening social inequalities in health with ongoing pandemic progression, which hit the most deprived populations the hardest.

Conclusions

The results show worsening social inequalities in COVID-19 over the course of the pandemic, with the most disadvantaged populations most affected during its progression. Targeted prevention and interventions, such as low-threshold testing and vaccination programs, infection protection for precarious jobs or living conditions, and targeted information are crucial to face socioeconomic inequalities throughout pandemics.

Key messages
Psychosocial wellbeing of Berlin school children during the COVID-19 pandemic, June 2020-March 2021
Authors: Theuring S , van Loon W , Hommes F , Bethke N , Mall MA , Kurth T , Seybold J , Mockenhaupt FP
Published: October 2022

Background

The COVID-19 pandemic and related restrictions have affected the wellbeing of school children worldwide. Specific problems evolving during the pandemic, their extent and duration haveńt been sufficiently explored yet. We aimed at describing school childreńs psychosocial and behavioral parameters and associated factors during the COVID-19 pandemic in Berlin, Germany.

Methods

Our longitudinal study included students from 24 randomly selected Berlin primary and secondary schools, assessing psychosocial wellbeing and behaviors at four time points between June 2020 and March 2021. We analyzed temporal changes in the proportions of anxiety, fear of infection, reduced health-related quality of life (HRQoL), physical activity and social contacts, as well as sociodemographic and economic factors associated with anxiety, fear of infection and HRQoL.

Results

Of initially 384 recruited students, 324 still participated in the fourth study round after nine months. During the observation period, presence of anxiety symptoms increased from 26.2% (96/367) to 34.6% (62/179), and fear of infection from 28.6% (108/377) to 40.6% (73/180). The proportion of children with limited social contacts (<1/week) increased from 16.4% (61/373) to 23.5% (42/179). Low physical activity (<3 times sports/week) was consistent over time. Low HRQoL was observed among 44% (77/174). Factors associated with anxiety were female sex, increasing age, secondary school attendance, lower household income, and presence of adults with anxiety symptoms in the student's household. Fear of infection and low HRQoL were associated with anxiety.

Conclusions

A substantial proportion of school children experienced unfavorable psychosocial conditions during the COVID-19 pandemic in 2020/2021. In particular, students from households with limited social and financial resilience require special attention.

Key messages
Research ethics with real-world data (RWD) on COVID-19 infections: the unCoVer study
Authors: Riva S , Kabir Z , Biscoe N , O'Sullivan G , Soriano G , Penalvo J
Published: October 2022

Issue

The aim of the Horizon 2020 unCoVer project (Unravelling Data for Rapid Evidence-Based Response to COVID-19) is to coordinate research expertise in utilising Real World Data (RWD) to investigate the underlying risk factors for COVID-19 infection and severity, the effectiveness of treatments and the impact on health systems. RWD is particularly useful in a dynamic health context as it is relevant, timely, and more ecologically valid. Pooling clinical databases and integrating epidemiological principles and powerful biostatistical tools optimises resources and fully exploits routinely-collected data.

Description of the problem

RWD sharing poses new practical and ethical challenges to research. The unCoVer network has developed a federated data platform to access diverse databases for advanced analytics. This data access process entails GDPR, and regulatory and ethical nuances. The use of large-scale data from heterogeneous sources across multiple jurisdictions for research purposes presents a complex systems challenge.

Effects & Lessons

A dedicated team of unCoVer network members is responsible for addressing these challenges. Here, we describe the ethical and regulatory aspects of RWD sources, the role of the Data Protection Authorities and the Data Protection External Authority Board (DP-EAB) of the Uncover project, and the documentation involved, including a data processing agreement and a data transfer agreement. We provide an overview of the main principles for sharing RWD whilst maintaining integrity and security and how this translates into procedures to protect the rights, security, and well-being of human research participants. This represents a practical framework for researchers.

Key messages
Applicability of European legislation for the protection of data while using tracing applications
Authors: Mullerova P
Published: October 2022

Background

Since the beginning of the COVID pandemic, Member States have started using tracing applications. The European Commission immediately confirmed the possibility of collecting personal data without the obligation to obtain the citizens’ consent. Aware of the threat of data breach, the Commission has tried to remedy the situation and has given up the recommendation followed by a guide on how to use the tracing applications.

Methods

In order to achieve the determination of the applicable European legislation, we used the doctrinal method in combination with the quantitative empirical research in the area of comparison of individual tracing applications.

Results

The geolocal applications are regulated by GDPR. Based on Article 6 (1) GDPR, Commission confirmed the possibility to restrict the citizens’ privacy. The Commission drew the attention to the collection of personal data based on the exception of “public interest” without necessity of the citizens’ consent. In combination with Article 23, the Member states may restrict the lawful processing of data by legislative measure for protection of “public health”. The applications using Bluetooth exposure notification system (ENS) do not operate with personal data. Thus, these are in general out of scope GDPR and regulated by the Directive on privacy and electronic communications. Article 15 of the Directive allows processing of communication without citizens’ consent for the reasons listed in paragraph 1, which did not include “public health”, therefore the applications cannot be use without citizen's consent.

Conclusions

The use of applications with geolocation allows Member states to process personal data without guarantees in order to protect public health. This approach is unacceptable in relation to the right to privacy. If a situation like the covid pandemic occurs again, exclusively applications with ENS should be used. The use of these applications, even in times of pandemic, is conditioned by the citizens’ consent.

Key messages
Digital Health Literacy and Infodemic: the impact on Italian medical students between 2019-2020
Authors: Moretti V , Arnoldo L , Valdi G , Conte A , Masoni M , Guelfi MR , Anelli F , Brunelli L
Published: October 2022

Background

The COVID-19 infodemic is putting pressure on public health systems to control the pandemic. With the internet and social media playing a key role in emergency communication, digital health literacy (DHL) can be considered a determinant of health. This study aims to assess the impact of infodemic on the skills of medical students, for whom low levels of DHL may affect the ability to identify the best available medical evidence.

Methods

A cross-sectional web-based survey was conducted at the University of Florence (Italy) in Apr-May 2019 (pre-pandemic period) and in Nov-Dec 2020 (pandemic period) to investigate DHL skills. Two different cohorts of students, both in their first year of medical school, participated in the survey. The 8-item self-assessment tool (IT-eHEALS) with a 5-point Likert scale was used to examine DHL. The change in perception of ability between the two cohorts was examined using the Wilcoxon test.

Results

A total of 329 students participated in the survey in 2019 (F: 58.1%; mean age 20.6±2.1) and 341 in 2020 (F:61.9%; mean age 19.8±2.0). In 2019, participants’ DHL level was moderate with a IT-eHEALS overall mean score (MS) of 28.4±5.8. Students had a good idea of how to find helpful health information (MS 3.9±0.8) and how to use the web for this purpose (MS 3.8±0.9), but they were less confident about the usefulness of the information they received (MS 2.9±1.1). In 2020, the medical students’ DHL level deteriorated as the overall MS of IT-eHEALS decreased to 23.4±7.2 (p < 0.01). The scores of the IT-eHEALS items were significantly lower and students indicated that they found it difficult to assess the information they found (MS 2.4±1.1; p < 0.01).

Conclusions

DHL can contrast infodemic, but the latter in turn may have a negative impact on perceived DHL skills if personal knowledge base is not well structured. Training programmes for medical students as future health care providers should be reinforces to guide their practise.

Key messages
Burned area mapping using satellite data – a tool for monitoring effects on environment
Authors: Cara ML , Becheru A , Nicola L , Cara C , Prejbeanu IM
Published: October 2022

Background

Significant crop residue burning not only negatively affects local communities but is becoming an important public health issue for global climate change mitigation efforts. This practice is linked with air quality impairment, water contamination, soil degradation, fauna destruction. Chronic exposure to a high level of air pollution may cause permanent health injuries such as the development of lung diseases. The intentional burning of crop residues is a well-known practice across Romania even it is restricted by law.

Methods

We propose a generic software model capable of detecting burned areas based on a time series of multi-spectral optical images together with a multi-step algorithm that uses a pre-trained Gaussian Naive-Bayes classifier to map burned crop fields, named BCMA (Burned Crop Mapping Algorithm), using Copernicus Sentinel-2 acquisitions. BCMA can be trained and extended to recognize other user-defined burned areas and it can be used to produce burned crop fields maps at a global scale in near-real-time at high resolution. We focused on two restrained geographical areas where burned areas were signalized in local press as massive burning vegetation events.

Results

We provide burned area maps generated with an implementation of BCMA over two sites in Romania: Ostroveni - Dolj county and Domogled - Mehedinti county, based on acquisitions from July 2020.

Conclusions

This model provides a fast and reliable tool for detection of burned areas regardless of the landscape and vegetation that could help stakeholders to react and make a proper intervention. Our study highlights the meaningful implications of using this tool to track crop fields burning and to organize large scale awareness campaigns around sustainable crop residues management with positive impact on environment, human health, and agriculture. Further government agencies’ positions regarding using satellite monitoring of burning vegetables might be crucial.

Key messages
Trends of socioeconomic inequalities in overweight and obesity in children and adolescents in Germany
Authors: Hoebel J , Waldhauer J , Blume M , Schienkiewitz A
Published: October 2022

Background

Overweight and obesity in early life are risk factors for chronic health conditions in the later life course. Children and adolescents from socioeconomically disadvantaged families are more likely to be overweight or obese than their better-off peers. This study examined post-millennial trends of socioeconomic inequalities in the prevalence of overweight and obesity among young people in Germany.

Methods

Repeated cross-sectional data were used from the German health interview and examination survey for children and adolescents (KiGGS). Overweight and obesity were assessed by body mass index, based on measured height and weight of 3- to 17-year-old participants in KiGGS baseline (2003-06) and KiGGS wave 2 (2014-17). Socioeconomic position (SEP) was measured using a composite index of parental education, occupation and income. The regression-based slope index of inequality (SII) and relative index of inequality (RII) were calculated to estimate the extent of absolute and relative inequalities in the prevalence of overweight and obesity.

Results

The overall prevalence of overweight and obesity among 3- to 17-year-olds in Germany did not change over time and was recently 15.4% and 5.9%, respectively. In both survey waves, overweight and obesity were more prevalent in lower SEP-groups. From 2003-06 to 2014-17, overweight increased in the low-SES group, whereas it tended to decrease in those with higher SES. This trend was concomitant with increasing socioeconomic inequalities in overweight over the observation period (SII from 0.11 to 0.19, p = 0.054; RII from 2.1 to 3.7, p = 0.021). No such trend was found for obesity.

Conclusions

Socioeconomic inequalities in overweight have widened among the young in Germany since the early 2000s. Structural interventions that are effective in preventing and reducing overweight in young people from socially disadvantaged backgrounds are still needed.

Key messages
Area-level socioeconomic deprivation, non-national residency, and Covid-19 incidence
Authors: Rohleder S , Costa D , Bozorgmehr K
Published: October 2022

Introduction

Socioeconomic conditions affect the dynamics of the COVID-19 pandemic. We analysed the association between area-level socioeconomic deprivation, proportion of non-nationals, and Covid-19 incidence in Germany.

Methods

Using nationally representative data at the level of 401 German districts from three waves of infection (January-2020 to May-2021), we fitted Bayesian spatiotemporal models to assess the association between socioeconomic deprivation, proportion of non-nationals, and Covid-19 incidence, controlling for age, sex, vaccination coverage, settlement structure, spatial and temporal effects. We estimated risk ratios (RR) and corresponding 95% credible intervals (95%-CrI) for deprivation quintiles. We further examined the deprivation domains (education, income, occupation), interactions between deprivation, sex and the proportion of non-nationals, and explored potential pathways from deprivation to Covid-19 incidence.

Results

Covid-19 incidence risk was 15% higher (RR = 1.15, 95%-CrI=1.06-1.24) in areas with the highest deprivation quintile (Q5) compared to the least deprived areas (Q1). Medium-low (Q2), medium (Q3), and medium-high (Q4) deprived districts showed 5% (1.05, 0.98-1.13), 8% (1.08, 1.01-1.15), and 6% (1.00, 1.00-1.12) higher risk, respectively, compared to the least deprived. Districts with higher proportion of non-nationals showed higher risk compared to districts with lowest proportion, but the association weakened across the three waves. During the first wave, an inverse association was observed with highest risk in least deprived areas (Q1). Deprivation interacted with sex, but not credibly with the proportion of non-nationals.

Conclusions

Socioeconomic deprivation and proportion of non-nationals are independently associated with Covid-19 incidence. Regional planning of non-pharmaceutical interventions and vaccination strategies would benefit from consideration of area-level deprivation and non-national residency.

Key messages
Association between the Multidimensional Poverty Measure and COVID-19 mortality in Colombia
Authors: Bedoya JP Perez , Cardozo OI Mendoza , Aguirre CA Pérez , Galvis LM Ruiz , Escudero JP Sánchez , Jimenez J Cardona , Rey BA Rodríguez , Barengo NC , Valencia PA Diaz
Published: October 2022

Background

Different socioeconomic aspects have been related to mortality from COVID-19. For this reason, the objective of this study was to analyze the association between the Multidimensional Poverty Measure at the municipal level (MPM) and the clinical outcome of mortality in the resident population of Colombia with a diagnosis of COVID-19.

Methods

Observational, non-concurrent cohort study of confirmed cases of COVID-19 reported in Colombia by August 2021. The main outcome variable was mortality from COVID-19, and the main exposure variable was MPM. The covariates included in the analysis were patient's sex, age, and municipality of residence. Unadjusted and adjusted logistic models were used using balanced random samples of deaths and recovered patients, calculating odds ratios (OR) and 95% confidence interval ranges (CI).

Results

In total, 4,194,538 cases of COVID-19 were included in the analysis, of which approximately 3% died. According to the adjusted multivariate analysis, it was found that patients who live in municipalities with an MPM between 20 to 40%, 41 to 60%, 61 to 80% and more than 80% had an OR of 1.6 (95% CI 1.4 to 1.8), 1.6 (95% CI 1.3 to 1.9), 1.7 (95% CI 1.2 to 2.5), and 2.2 (95% CI 0.7 to 7.8), respectively, for mortality from COVID-19 compared with an MPM of less than 20%. When analyzing the data according to sex for the MPM from 20 to 40%, 41 to 60%, 61 to 80% and more than 80%, an OR for women of 1.7 (95% CI 1.5 to 2.0), 1.8 (95% CI % 1.5 to 2.1), 1.9 (95% CI 1.3 to 2.6) and 2.8 (CI 0.9 to 10.1) respectively. For men an OR of 1.5 (95% CI 1.3 to 1.7), 1.4 (95% CI 1.2 to 1.7), 1.6 (95% CI 1.1 to 2.3) and 1.9 (95% CI 0.6 to 6.0) respectively compared to a MPM less than 20%.

Conclusions

The risk of mortality from COVID-19 in Colombia is increased in populations with higher MPM. Social determinants of health have an important effect on the outcomes of COVID-19.

Key messages
Histopathological Findings of Lung Cancer in Black Coal Miners in the Czech Republic
Authors: Tomaskova H , Horacek J , Slachtova H , Splichalova A , Riedlova P , Dalecka A , Jirak Z , Madar R
Published: October 2022

Background

Coal miners with coal workers’ pneumoconiosis (CWP, J60 according to ICD-10) were previously found to have a significantly higher risk of lung carcinoma compared to the general male population. The presented study aimed to analyze the incidence of lung carcinoma in miners, histopathological findings in cohorts with and without CWP, and effect of smoking cessation on the histopathological profile.

Methods

Analysed cohorts consisted of miners with (n = 3476) and without (n = 6687) CWP. Data on personal and working history obtained from the medical records were combined with information on lung cancer from the Czech Oncological Register and histopathological findings. Statistical analysis was performed using non-parametric tests and the incidence risk ratio (significance level of 5%).

Results

In 1992-2015, 180 miners (2.7%) without CWP and 169 (4.9%) with CWP, respectively, were diagnosed with lung carcinoma. The risk of lung cancer in miners with CWP was 1.82 (95% CI: 1.48-2.25) times higher than in those without CWP. Squamous cell carcinoma (37%) was the most common histopathological type, followed by adenocarcinoma (22%) and small cell carcinoma (21%). A statistically significant difference between the cohorts (p = 0.003) was found in the histopathological subtypes, with the incidence of small cell carcinoma being 2 times higher in miners without CWP than in those with CWP. Only a few individuals with lung carcinoma were non-smokers. The incidence of small cell carcinoma, which is strongly associated with smoking, is significantly higher in miners without CWP.

Conclusions

Smoking constitutes the most important risk factor for developing lung carcinoma even in that cohort. However, CWP remains a very important risk factor.

This work was supported by grant of Research Support Foundation, Vaduz. Markus R. Tödtli Consulting and project Healthy Aging in the Industrial Environment CZ.02.1.01/0.0/0.0/16_019/0000798 (HAIE).

Key messages
Social Disparities in Cardiometabolic Health in Czechia and Venezuela Using the Allostatic Load Model
Authors: Polcrova A , Nieto-Martinez R , Mechanick JI , Neto GA Maranhao , Infante-Garcia MM , Pikhart H , Bobak M , Medina-Inojosa JR , Gonzalez-Rivas JP
Published: October 2022

Background

Subjects with lower socioeconomic status (SES) are exposed to higher levels of environmental stressors. The cumulative effects of chronic stressors on cardiometabolic health can be evaluated using the allostatic load (AL) score. Despite the accepted social gradient, clear relationships between social determinants and cardiometabolic health in populations with different socio-cultural contexts have been rarely explored. This study aimed to compare the relationships of social determinants with AL in different socioeconomic contexts: unstable Venezuela (VE) and stable Czechia (CZ).

Methods

25-64 years old subjects from two cross-sectional population-based samples from CZ (2013-2014, n = 1579, 56% females) and VE (2014-2017, n = 1652, 70% females). The AL score (scaled 0-8) was calculated using 8 cardiometabolic biomarkers (BMI, waist circumference, systolic and diastolic blood pressure, total and HDL-cholesterol, triglycerides). Social characteristics included education in both countries, household income in CZ, and composite measure of SES based on source of income, household head's profession, motheŕs education, and housing conditions in VE. Ordinal regression was performed separately in men and women.

Results

In CZ, men and women with low education and women with low income were more likely to have higher score of AL compared to those with high education and income (OR 1.45, 2.29 and 1.69). In VE, women with low education and low SES were more likely to have higher AL (OR 1.47 and 1.51), while men with low education and low SES were less likely to have higher AL (OR 0.64 and 0.61), compared to those with high education and high SES. Independently of age, sex, and socioeconomic characteristics, Venezuelans were more likely to have higher AL than Czechs.

Conclusions

Associations of social position indices and cardiometabolic health (proxied by AL) differed between CZ and VE, most likely reflecting differences in social environment between the countries.

Key messages
Preventing food contamination: preliminary results of a cross-sectional study among food handlers
Authors: Errico EA , Licata F , Maruca R , Costantino N , Di Giuseppe G , Napolitano F , Pelullo CP , Della Polla G , Angelillo S , Bianco A
Published: October 2022

Background

More than 600 million people around the world get sick every year due to eating contaminated food, which is impressive considering that all foodborne diseases (FDs) are preventable. Contamination during food preparation by food handlers (FHs) is one of the main causes of FDs. The aim of this study is to assess the knowledge and behaviors of FHs related to FDs.

Methods

The cross-sectional study was conducted in two regions (i.e. Calabria and Sicily) of Southern Italy. Data was collected through an anonymous self-administered questionnaire designed to retrieve sociodemographic information, knowledge about food safety, and food-handling behaviors among a randomly selected sample of FHs ≥ 18 years of age.

Results

Findings refer to a sample of 171 respondents with a mean age of 40 years (SD ± 12.7). A vast majority (63.7%) of FHs did not know the correct procedure for hand washing according to Food & Drug Administration (FDA) guidelines and 28.4% of subjects did not wash their hands after touching raw food, which constitutes a major risk of food cross-contamination. One-third of FHs were unknowledgeable that cross-contamination (e.g. using the same utensils for cooked and raw foods) could lead to FDs. Multiple logistic regression analysis showed a positive correlation (p < 0.001) among good knowledge and proper food-handling practices, such as using separate kitchen utensils to prepare cooked and raw foods and storing them in separate areas or fridges. Less than half of the sample (42.1%) reported the need for more information about FDs.

Conclusions

Preliminary results highlight a lack of knowledge about simple rules to avoid food cross-contamination that could negatively impact on food safety and food-handling behaviors. This study add evidence about areas where intervention are needed to reduce the occurrence of FDs.

Key messages
Actions to support local charitable organizations in countering the spread of food insecurity
Authors: Barocco G , Croci E , Longo T , Calabretti A , Bogoni P , Sepe J , Marsi A
Published: October 2022

Background

According to the Italian Statistic Institute data, in Italy between 2007 - 2020 individual absolute poverty (AP) grew from 4.1 to 9.4%. In 2020 13.5% of minors lived in AP, furthermore in 2017 22.3% of Italians lived in conditions of food poverty or food insecurity (FI), between 2018 - 2019 1 in 7 minors lived in conditions of FI. The scientific literature underlines how inadequate food access is one of the risk factors for the onset of chronic non-communicable diseases. The aims of the project were to evaluate in the 3 main local charitable organizations (LCOs) the qualitative - quantitative profile of the food basket and the content of protective components present in fruits and vegetables (FV) available for socially disadvantaged communities (SDCs); determine the main nutritional critical points (NCPs); and identify possible corrective actions (CAs).

Methods

The average composition of the food baskets available in 2021 for 1600 users by the 3 LCOs was compared with national nutritional recommendations. In February 2022, 23 samples of FV were collected from the LCOs for chemical analyses by the University of Trieste (UT). The outcomes were compared with the food composition database of the UT.

Results

The food baskets at the LCOs were characterized by: daily average availability of 50 to 145 g of FV (8 to 22% of the recommended requirement); weekly average availability from 26 to 200g of cheeses, from 0 to 132g of meat. The quantitative profile of the protective molecules present in FV samples was reduced by 11 to 40 % compared to the UT database. The main NCPs were lack of nutrition guidelines on targeted food programmes and of monitor systems to evaluate the food basket balance for SDCs. CAs have been planned to integrate food safety and food security in public health programs to support LCOs.

Conclusions

The results of the project can significantly support LCOs towards integrated actions in the food and nutritional policies at local and regional level.

Key messages
Influence of occupation on the subjective health of forced migrant doctors-a qualitative study
Authors: Locher V , Krämer A
Published: October 2022

Background

With the refugee movement in 2015, also forced migrated female and male medical professionals have arrived in Germany. The effect of occupation on the subjective health status of these physicians working in the German health care system was investigated on the basis of Antonovsky's sense of coherence (SOC) and the occupational science models of Siegrist and Karasek&Theorell.

Methods

Using a semi-structured interview guide, nine forced migrated physicians were interviewed before and nine forced migrated physicians were interviewed during their professional medical activity. Both interview groups had an Arabic cultural background. The transcribed interviews were analyzed according to Kuckartz's content structuring qualitative content analysis using the MAXQDA 2020 software tool.

Results

The SOC of migrated physicians is favorably influenced by meaningful occupational activity and the newly gained manageability of life. Positive influences are seen in professional appreciation and collegial support at all hierarchical levels. Negative effects are perceived in experiences of discrimination, insecurity and experienced injustice in the recognition of foreign qualifications. Physical stress results from occupational overload, unfamiliar work and time pressure.

Conclusions

The salutogenic effect of the work, the recognition in the profession and the collegial support are essential contributions to the promotion of especially mental health among forced migrated doctors. This speaks in favor of rapid and stringent integration into professional life. However, organizational barriers inherent in the German health care system should not be disregarded, which is why both legal and structural improvements should be made to the existing integration procedure before and during professional activity.

Key messages
Managers’ sick-leave recommendations - a video vignette study on common mental disorders
Authors: Hensing G , Hultquist J , Bertilsson M
Published: October 2022

Background

Sick leave due to common mental disorders (CMD) in Sweden is higher among women than men. Since the Swedish labor market is highly sex segregated a contributing factor might be managers’ attitudes towards CMD and sick leave. This video vignette study tests three hypotheses on managerś sex and recommendation for sick leave. The hypotheses are: (1) there is an association between negative attitudes towards CMDs and recommending sick leave, and (2) there is an association between educational level and recommending sick leave, and (3) there is an association between workplace factors and managerś recommendation of sick leave.

Methods

The study sample consisted of 2703 Swedish managers, female (34%) and male (66%). The online survey included a randomized female and male video vignette played by actors and specifically designed for the study. Associations were investigated by means of logistic regression. The covariates were attitudes towards depression, educational level, labor sector, size of company, proportion of women/men at the workplace, and sex of the person in the video vignette.

Results

The bi-variate crude analysis showed an OR of 1.28 (95% C.I. 1.08-1.51) for female vs. male managers’ recommendation of employee sick leave to the video vignette. Negative attitudes towards CMD did not add to the model, whereas educational level did, OR 1.34 (95% C.I. 1.13-1.59). The final, fully adjusted model showed an OR of 1.39 (95% C.I. 1.16-1.66) for female vs. male managers’ recommendation of employee sick leave.

Conclusions

The likelihood of a manager recommending sick leave after watching a CMD-labelled video vignette was slightly higher for female managers compared to male, and it remained in the final adjusted model. The results resonate with the registered sick leave and the sex segregation among managers and industries in the Swedish labor market.

Key messages
The various insecurities experienced among non-standard workers across different policy-contexts
Authors: Bosmans K , Vignola E , López V Álvarez , Pérez M Julià , Baron S , Bodin T ,   PWR consortium
Published: October 2022

Background

Over the last decades, the prevalence of non-standard employment (NSE) has increased in many countries, with negative implications for worker health and well-being. Research at the micro level, mostly quantitative, has linked NSE with poor health through insecurity. Macro-level studies investigating whether political economic factors buffer the harms of NSE have generated mixed results. This study describes how various types of insecurity are experienced by workers in NSE, in general and during COVID-19, and how this influences their health and well-being, in six countries with different welfare states: Belgium, Canada, Chile, Spain, Sweden and the United States.

Methods

In-depth interviews with 250 workers in NSE were analysed using a multiple-case study approach and using the welfare state typology as a macro-level framework.

Results

Despite differences in welfare states, workers in all six countries experienced multiple forms of insecurity as well as relational tension with employers or clients, with clear negative effects on their well-being, in ways that were shaped by broader social inequalities (e.g., related to gender, age, and access to family support). Simultaneously, differences in welfare states were reflected in the level of workers’ exclusion from social protections, the temporality of difficulties they faced in planning their lives (e.g., threats to daily survival or to longer-term life planning), and their ability to derive control from NSE despite the insecurity it created. Workers in less generous welfare states experienced heightened insecurity and greater stress from the COVID-19, but the severity of the health and economic crisis was felt by workers in all study countries.

Conclusions

This study sheds light on the ways that welfare regimes can support - or fail to support - workers in NSE, and suggests the need in all six countries for stronger state responses to NSE, a pressing social determinant of health.

Key messages
Employment at the onset of partial disability retirement and four years later
Authors: Polvinen A
Published: October 2022

Background

Increasing the labour market participation of people with a reduced ability to work is a big labour market challenge in many countries. In Finland, one third of all new disability pensions are granted as partial pensions. It is also known that most partial disability pensioners continue working while receiving a pension. There is only limited research about the length of employment of partial disability pensioners and the factors associated with employment in retirement. The aim of this study was to examine the employment at the onset of partial disability retirement and four years after retirement, and to examine how age, gender, educational level, employment sector, diagnosis and type of pension are associated with employment after partial disability retirement.

Methods

Our Finnish register data comprised 7,617 partial disability pensioners aged 20-58 who retired in 2013 or 2014. Logistic and multinomial logistic regression analysis were used to estimate OR:s and 95 percent CI:s for employment at the onset of partial disability retirement and four years after retirement.

Results

81 percent of partial disability pensioners were employed when retiring on a partial disability pension. Four years later, 50 percent were still drawing a partial disability pension, of whom 77 percent were working. 11 percent were employed but no longer drawing a partial disability pension. The partial disability pensioners who were more often employed were younger, female, more highly educated, working in the public sector and receiving a temporary disability pension.

Conclusions

Many sociodemographic factors are associated with employment at the onset of partial disability retirement and with continued working while drawing a partial disability pension.

Key messages
Occupational hazards and early retirement: German National Cohort (NAKO) baseline distributions
Authors: Hegewald J , Starke K Romero , Latza U , Seidler A
Published: October 2022

Background

Despite measures to ensure occupational safety, harmful workplace conditions that negatively impact worker health persist. The baseline assessment of the German National Cohort (NAKO) provides a basis for determining the prevalence of occupational hazards and early retirement (due to health reasons).

Methods

From 2014 to 2017, the NAKO examined 205,141 participants aged 20-69 years at 18 study centers across Germany. Working participants were asked about exposure to airborne particulates, occupational noise, evening and night work, sick days, presenteeism, and personal safety equipment use (respiratory masks, hearing protection). The assessment also included questions on retirement. We examined the distributions descriptively.

Results

A total of 84.2% (n = 172,766) participants were ever employed. Of these participants, 7.9% reported ever working in a job with dust or air particulate exposure where a respiratory mask was required for at least one year. However, nearly one-third (31.6%) of the particulate-exposed workers reported not having worn a mask. 11.4% worked at least a year in a job that required hearing protection, but 27.2% of noise-exposed workers did not comply with this safety measure. Over half of the workers sometimes worked between 6 and 10 pm, and 18.7% sometimes worked at night (11 pm to 6 am) in the last three months. On average, participants used 10.5 sick days in the previous year, and the 12-month prevalence of going to work sick at least one day (presenteeism) was 64.9%. Nearly one-fourth (24.4%; n = 9043) of retirees reported early retirement due to health reasons.

Conclusions

Hazardous working conditions were common, and there was only partial compliance with the use of available personal safety equipment and measures. The NAKO provides a basis for examining the distribution of occupational exposures in Germany, and future prospective data will permit an evaluation of the effectiveness of preventative regulations.

Key messages
Domestic violence in indian women: status of husbands’ alcohol consumption as a determinant factor
Authors: da Silva Maia J , China J Félix , Teixeira JP
Published: October 2022

Background

Domestic violence continues to be a major public health issue that affects millions of individuals worldwide. According to the 2015-2016 India National Family Health Survey, 33% of married women had been victims of spousal physical, sexual, or emotional violence. It was also revealed that spousal abuse differs depending on the level of the husband's alcohol consumption. In this case, determining the link between this consumption and domestic violence is critical.

Methods

The effects of husbands’ alcohol use on the occurrence of domestic violence and associated risk factors were investigated using data from the 2015-2016 India Individual Record Database (DHS) A binomial logistic regression model was used for the analysis.

Results

62554 married women aged 15 to 49 were chosen for this study, of which 31.2% have experienced some form of marital violence. Women with husbands who drink alcohol account for 31% of the sample, with 49.5% of those committing domestic violence against their wives. In a multivariate analysis, women whose spouses drink have a 3.11 times higher chance (p < 0.01; adjOR=3.11, 95%CI 3-3.23) of experiencing domestic violence than women whose husbands don't drink.

Conclusions

The effect of the husband's alcohol use on the occurrence of domestic violence can be used to guide evidence-based targeted intervention.

Key messages
An interdisciplinary intervention for health prevention and promotion in a Roman neighborhood
Authors: Lontano A , De Waure C , Marziali E , D'Ambrosio F , Galletti C , Mazza E , Mingarelli A , Urbani E , Galasso V , Laurenti P
Published: October 2022

Influencing behavioral patterns through primary prevention, possibly addressing more risk factors at a time, is the most effective means to tackle cardiovascular diseases. Many interdisciplinary prevention activities have been coordinated by community nurses outside of specialist centers, resulting in a more effective control of risk factors. Our study aims at describing the impact of an 18-month prevention and promotion, interdisciplinary intervention on lifestyle habits and cardiovascular risk. From December 2018 to May 2020, patients were recruited by 4 General Practitioners (GPs) in the Roman neighborhood of Torresina and received nutritional, physical and psychological counselling to learn healthy lifestyles. Until May 2020 patients had to self-manage their new healthy habits, but during this phase the SARS-CoV-2 pandemic broke out. Patients were assessed at baseline, 6, 12 and 18 months by a nutritionist, a physiotherapist, a psychologist, the 4 GPs and community nurses, and the cardiovascular risk score (CRS) was estimated at every examination. 76 patients were included, with a mean age of 54,6 years. Mean CRS showed a significant reduction between baseline and 12 months (from 4.9 to 3.8, p < 0.001), but this trend was not maintained at 18 months. As for variables included in the calculation of the cardiovascular risk score, both total cholesterol and systolic blood pressure significantly decreased at 6 months of follow up (respectively, from 211.1 to 192 (p < 0.001) and from 133.1 to 123.1(p < 0.001)). Nontheless, the reduction was maintained in the remaining points in time only for systolic blood pressure. Our interdisciplinary educational intervention in a primary care setting resulted in a CRS improvement at 12 months, but this changes where not maintained at 18 months. Community nurses were facilitators in improving health outcomes and patient's satisfaction in the described primary care setting.

Key messages
A systematic review of the effectiveness of community interventions to improve parent health literacy
Authors: Belfrage S , Husted M , Fraser S , Patel S , Faulkner J
Published: October 2022

Background

Many community-based interventions have been developed to increase parent/caregiver health literacy, yet no systematic review of their effectiveness has been published. Therefore, the aim of this systematic review was to examine the effectiveness of community-based health literacy interventions in improving the health literacy of parents/caregivers.

Methods

A systematic review of six databases; MEDLINE, PsycINFO, CINAHL, Cochrane Library, Embase, and Education Source were conducted to identify relevant articles. Risk of bias were assessed using version two of the Cochrane risk of bias tool for randomised controlled trials or the Cochrane Collaboration Risk of Bias in Non-Randomised Studies of Interventions. The study findings were grouped and synthesised following the Synthesis Without Meta-analysis framework.

Results

Eleven community-based health literacy interventions for parents/caregivers were identified. Study design included randomised controlled trials (n = 4), non-randomised studies with comparison group (n = 4), and non-randomised studies without a comparison group (n = 3). Interventions were delivered digitally, in person or a combination of the two. The main findings of the studies showed some potential for both in person and digital interventions to increase parental health literacy. The risk of bias was high in over half the studies (n = 7) Studies were heterogeneous preventing a meta-analysis.

Discussion

Although no definitive conclusion of the effectiveness of community-based interventions can be drawn there are suggestions of improvement in many of the studies included in this review. The review has brought into question whether the health literacy measurement tools used met the needs of assessing the interventions outcomes. When comparing the cost and resources needed for digital with in person interventions, the findings of this review have implications for both practise and research.

Key messages
“Laboratorium Repository”: a training tool for the Healthcare Workforce
Authors: Privitera GP , Arzilli G , Benedetto C Di , Di Serafino F , Morassi E , Zotti N , Luzi M , Papini F , Casigliani V , Brusaferro S
Published: October 2022

Background

The COVID-19 pandemic highlighted the need to redefine the healthcare workforce (HCW) competencies to face future emergencies linked to emerging infectious diseases, environmental, climate and social crises. As recently stated by WHO, there is a need to identify standards for education and competencies training for HCW in emergency and preparedness (E&P). The Italian National Institute of Health, in agreement with the deliberation of the G20 Health Ministers under the Italian Presidency, is developing an educational program named “Laboratorium” which includes a free access digital repository aimed to share selected documents and tools at the International Public HCW (PHCW) to increase the competencies in E&P response.

Objectives

A range of web domains selected according to their reliability was monitored using a keyword search tool for any relevant material published from February 14th up to April 28th, 2022. We included any publications, training materials, epidemiological data, initiatives, and communication items that addressed the topic of interest. Each item was submitted for approval by a scientific board and, if appropriate, classified by typology, language, topic, and country before publication.

Results

To date, out of 6197 items, 418 fulfilled the inclusion criteria. For the type of content, we included guidelines/recommendations (75), epidemiological data (58), websites (34), online courses (15) and books (16). PHCW was the most representative target group (361), followed by other stakeholders (127), hospital practitioners (90), primary care (87). The most represented topic was infectious diseases/SARS-CoV-2 (277) followed by vaccines (88), emergency interventions (34), emerging diseases (17), policies (26), public health preparedness (32).

Conclusions

Future training for PHCW should be designed with a modular approach with different levels of usability. The Laboratorium Repository provides a core of items for learning according to one's training needs

Key messages