bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk factors for internet addiction among Croatian university students during the COVID-19 pandemic
Authors: Miskulin M , Pavlovic N , Miskulin I , Kovacevic J , Laslo D , Vukoja I 
Published: October 2022

Abstract

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

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

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

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

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

Abstract

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

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

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

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

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

Abstract

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

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

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

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

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

Abstract

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

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

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

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

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

Abstract

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

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

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

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

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

Abstract

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

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

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

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

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

Abstract

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

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

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

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

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

Abstract

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

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

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

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

Abstract

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

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

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

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

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

Abstract

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

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

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

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

Key messages
Participatory development of inclusive health communication on COVID-19 with homeless people
Authors: Specht A , Sarma N , Hellmund T , Linzbach T , Hörig M , Wintel M , Mockenhaupt FP , Seybold J , Lindner AK 
Published: October 2022

Abstract

Background
The COVID-19 pandemic demonstrates the important role of providing people with easy to access up-to-date health information in digital formats. People experiencing homelessness have limited access to health information and were hardly ever directly addressed through communication channels in Germany. Lack of digitalization within shelters and social services, as well as technical and socio-economic barriers in purchasing and maintaining a smartphone are further barriers to information.

Methods
The Charité-COVID-19-project for and with homeless people has created digital health information videos and posters, with an interdisciplinary team and in a participatory approach. Two videos on general information and testing of COVID-19 were launched in 5 languages in February 2021. Vaccination posters in two language versions including 9 languages are available since April 2021.

Results
We will present the collaboration of research, practice and community, the production process, the distribution and the acceptance of the formats. The web link refers to the videos, posters and further information:
https://tropeninstitut.charite.de/forschung/charite_covid_19_projekt_fuer_und_mit_obdachlosen_menschen/

Conclusions
Exclusion from (digital) information is an increasingly important part of the structural marginalization of homeless people. This, as well as the inadequate consideration of this population in health communication and the pandemic response have to be addressed. Tackling the digital gap allows improved access to health information for homeless people and promotes health-seeking behaviour. Empowerment of the community through participation and a network between community, service providers, politics and research are also crucial for improvement of homeless people's health in the future.

Key messages