Publisher: Oxford University Press   (Total: 411 journals)

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Showing 1 - 200 of 411 Journals sorted alphabetically
ACS Symposium Series     Full-text available via subscription   (Followers: 3, SJR: 0.189, CiteScore: 0)
Acta Biochimica et Biophysica Sinica     Hybrid Journal   (Followers: 5, SJR: 0.79, CiteScore: 2)
Adaptation     Hybrid Journal   (Followers: 9, SJR: 0.143, CiteScore: 0)
Advances in Nutrition     Hybrid Journal   (Followers: 57, SJR: 2.196, CiteScore: 5)
Aesthetic Surgery J.     Hybrid Journal   (Followers: 6, SJR: 1.434, CiteScore: 1)
Aesthetic Surgery J. Open Forum     Open Access  
African Affairs     Hybrid Journal   (Followers: 72, SJR: 1.869, CiteScore: 2)
Age and Ageing     Hybrid Journal   (Followers: 94, SJR: 1.989, CiteScore: 4)
Alcohol and Alcoholism     Hybrid Journal   (Followers: 19, SJR: 1.376, CiteScore: 3)
American Entomologist     Hybrid Journal   (Followers: 8)
American Historical Review     Hybrid Journal   (Followers: 208, SJR: 0.467, CiteScore: 1)
American J. of Agricultural Economics     Hybrid Journal   (Followers: 53, SJR: 2.113, CiteScore: 3)
American J. of Clinical Nutrition     Hybrid Journal   (Followers: 217, SJR: 3.438, CiteScore: 6)
American J. of Epidemiology     Hybrid Journal   (Followers: 217, SJR: 2.713, CiteScore: 3)
American J. of Health-System Pharmacy     Full-text available via subscription   (Followers: 61, SJR: 0.595, CiteScore: 1)
American J. of Hypertension     Hybrid Journal   (Followers: 28, SJR: 1.322, CiteScore: 3)
American J. of Jurisprudence     Hybrid Journal   (Followers: 19, SJR: 0.281, CiteScore: 1)
American J. of Legal History     Full-text available via subscription   (Followers: 10, SJR: 0.116, CiteScore: 0)
American Law and Economics Review     Hybrid Journal   (Followers: 29, SJR: 1.053, CiteScore: 1)
American Literary History     Hybrid Journal   (Followers: 18, SJR: 0.391, CiteScore: 0)
Analysis     Hybrid Journal   (Followers: 25, SJR: 1.038, CiteScore: 1)
Animal Frontiers     Hybrid Journal   (Followers: 2)
Annals of Behavioral Medicine     Hybrid Journal   (Followers: 15, SJR: 1.423, CiteScore: 3)
Annals of Botany     Hybrid Journal   (Followers: 38, SJR: 1.721, CiteScore: 4)
Annals of Oncology     Hybrid Journal   (Followers: 59, SJR: 5.599, CiteScore: 9)
Annals of the Entomological Society of America     Full-text available via subscription   (Followers: 11, SJR: 0.722, CiteScore: 1)
Annals of Work Exposures and Health     Hybrid Journal   (Followers: 36, SJR: 0.728, CiteScore: 2)
Antibody Therapeutics     Open Access  
AoB Plants     Open Access   (Followers: 4, SJR: 1.28, CiteScore: 3)
Applied Economic Perspectives and Policy     Hybrid Journal   (Followers: 17, SJR: 0.858, CiteScore: 2)
Applied Linguistics     Hybrid Journal   (Followers: 61, SJR: 2.987, CiteScore: 3)
Applied Mathematics Research eXpress     Hybrid Journal   (Followers: 1, SJR: 1.241, CiteScore: 1)
Arbitration Intl.     Full-text available via subscription   (Followers: 22)
Arbitration Law Reports and Review     Hybrid Journal   (Followers: 14)
Archives of Clinical Neuropsychology     Hybrid Journal   (Followers: 32, SJR: 0.731, CiteScore: 2)
Aristotelian Society Supplementary Volume     Hybrid Journal   (Followers: 2)
Arthropod Management Tests     Hybrid Journal   (Followers: 2)
Astronomy & Geophysics     Hybrid Journal   (Followers: 45, SJR: 0.146, CiteScore: 0)
Behavioral Ecology     Hybrid Journal   (Followers: 55, SJR: 1.871, CiteScore: 3)
Bioinformatics     Hybrid Journal   (Followers: 384, SJR: 6.14, CiteScore: 8)
Biology Methods and Protocols     Hybrid Journal   (Followers: 1)
Biology of Reproduction     Full-text available via subscription   (Followers: 11, SJR: 1.446, CiteScore: 3)
Biometrika     Hybrid Journal   (Followers: 20, SJR: 3.485, CiteScore: 2)
BioScience     Hybrid Journal   (Followers: 30, SJR: 2.754, CiteScore: 4)
Bioscience Horizons : The National Undergraduate Research J.     Open Access   (Followers: 3, SJR: 0.146, CiteScore: 0)
Biostatistics     Hybrid Journal   (Followers: 18, SJR: 1.553, CiteScore: 2)
BJA : British J. of Anaesthesia     Hybrid Journal   (Followers: 212, SJR: 2.115, CiteScore: 3)
BJA Education     Hybrid Journal   (Followers: 67)
Brain     Hybrid Journal   (Followers: 75, SJR: 5.858, CiteScore: 7)
Briefings in Bioinformatics     Hybrid Journal   (Followers: 52, SJR: 2.505, CiteScore: 5)
Briefings in Functional Genomics     Hybrid Journal   (Followers: 3, SJR: 2.15, CiteScore: 3)
British J. for the Philosophy of Science     Hybrid Journal   (Followers: 40, SJR: 2.161, CiteScore: 2)
British J. of Aesthetics     Hybrid Journal   (Followers: 24, SJR: 0.508, CiteScore: 1)
British J. of Criminology     Hybrid Journal   (Followers: 619, SJR: 1.828, CiteScore: 3)
British J. of Social Work     Hybrid Journal   (Followers: 98, SJR: 1.019, CiteScore: 2)
British Medical Bulletin     Hybrid Journal   (Followers: 6, SJR: 1.355, CiteScore: 3)
British Yearbook of Intl. Law     Hybrid Journal   (Followers: 35)
Bulletin of the London Mathematical Society     Hybrid Journal   (Followers: 3, SJR: 1.376, CiteScore: 1)
Cambridge J. of Economics     Hybrid Journal   (Followers: 73, SJR: 0.764, CiteScore: 2)
Cambridge J. of Regions, Economy and Society     Hybrid Journal   (Followers: 12, SJR: 2.438, CiteScore: 4)
Cambridge Quarterly     Hybrid Journal   (Followers: 10, SJR: 0.104, CiteScore: 0)
Capital Markets Law J.     Hybrid Journal   (Followers: 2, SJR: 0.222, CiteScore: 0)
Carcinogenesis     Hybrid Journal   (Followers: 2, SJR: 2.135, CiteScore: 5)
Cardiovascular Research     Hybrid Journal   (Followers: 15, SJR: 3.002, CiteScore: 5)
Cerebral Cortex     Hybrid Journal   (Followers: 54, SJR: 3.892, CiteScore: 6)
CESifo Economic Studies     Hybrid Journal   (Followers: 24, SJR: 0.483, CiteScore: 1)
Chemical Senses     Hybrid Journal   (Followers: 1, SJR: 1.42, CiteScore: 3)
Children and Schools     Hybrid Journal   (Followers: 8, SJR: 0.246, CiteScore: 0)
Chinese J. of Comparative Law     Hybrid Journal   (Followers: 5, SJR: 0.412, CiteScore: 0)
Chinese J. of Intl. Law     Hybrid Journal   (Followers: 24, SJR: 0.329, CiteScore: 0)
Chinese J. of Intl. Politics     Hybrid Journal   (Followers: 11, SJR: 1.392, CiteScore: 2)
Christian Bioethics: Non-Ecumenical Studies in Medical Morality     Hybrid Journal   (Followers: 10, SJR: 0.183, CiteScore: 0)
Classical Receptions J.     Hybrid Journal   (Followers: 29, SJR: 0.123, CiteScore: 0)
Clean Energy     Open Access   (Followers: 3)
Clinical Infectious Diseases     Hybrid Journal   (Followers: 77, SJR: 5.051, CiteScore: 5)
Communication Theory     Hybrid Journal   (Followers: 28, SJR: 2.424, CiteScore: 3)
Communication, Culture & Critique     Hybrid Journal   (Followers: 29, SJR: 0.222, CiteScore: 1)
Community Development J.     Hybrid Journal   (Followers: 28, SJR: 0.268, CiteScore: 1)
Computer J.     Hybrid Journal   (Followers: 9, SJR: 0.319, CiteScore: 1)
Conservation Physiology     Open Access   (Followers: 3, SJR: 1.818, CiteScore: 3)
Contemporary Women's Writing     Hybrid Journal   (Followers: 11, SJR: 0.121, CiteScore: 0)
Contributions to Political Economy     Hybrid Journal   (Followers: 7, SJR: 0.906, CiteScore: 1)
Critical Values     Full-text available via subscription  
Current Developments in Nutrition     Open Access   (Followers: 5)
Current Legal Problems     Hybrid Journal   (Followers: 29)
Current Zoology     Full-text available via subscription   (Followers: 4, SJR: 1.164, CiteScore: 2)
Database : The J. of Biological Databases and Curation     Open Access   (Followers: 9, SJR: 1.791, CiteScore: 3)
Digital Scholarship in the Humanities     Hybrid Journal   (Followers: 15, SJR: 0.259, CiteScore: 1)
Diplomatic History     Hybrid Journal   (Followers: 24, SJR: 0.45, CiteScore: 1)
DNA Research     Open Access   (Followers: 5, SJR: 2.866, CiteScore: 6)
Dynamics and Statistics of the Climate System     Open Access   (Followers: 4)
Early Music     Hybrid Journal   (Followers: 17, SJR: 0.139, CiteScore: 0)
Econometrics J.     Hybrid Journal   (Followers: 33, SJR: 2.926, CiteScore: 1)
Economic J.     Hybrid Journal   (Followers: 120, SJR: 5.161, CiteScore: 3)
Economic Policy     Hybrid Journal   (Followers: 48, SJR: 3.584, CiteScore: 3)
ELT J.     Hybrid Journal   (Followers: 25, SJR: 0.942, CiteScore: 1)
English Historical Review     Hybrid Journal   (Followers: 58, SJR: 0.612, CiteScore: 1)
English: J. of the English Association     Hybrid Journal   (Followers: 21, SJR: 0.1, CiteScore: 0)
Environmental Entomology     Full-text available via subscription   (Followers: 12, SJR: 0.818, CiteScore: 2)
Environmental Epigenetics     Open Access   (Followers: 2)
Environmental History     Hybrid Journal   (Followers: 26, SJR: 0.408, CiteScore: 1)
EP-Europace     Hybrid Journal   (Followers: 3, SJR: 2.748, CiteScore: 4)
Epidemiologic Reviews     Hybrid Journal   (Followers: 9, SJR: 4.505, CiteScore: 8)
ESHRE Monographs     Hybrid Journal  
Essays in Criticism     Hybrid Journal   (Followers: 22, SJR: 0.113, CiteScore: 0)
European Heart J.     Hybrid Journal   (Followers: 66, SJR: 9.315, CiteScore: 9)
European Heart J. - Cardiovascular Imaging     Hybrid Journal   (Followers: 10, SJR: 3.625, CiteScore: 3)
European Heart J. - Cardiovascular Pharmacotherapy     Full-text available via subscription   (Followers: 2)
European Heart J. - Quality of Care and Clinical Outcomes     Hybrid Journal  
European Heart J. : Case Reports     Open Access   (Followers: 1)
European Heart J. Supplements     Hybrid Journal   (Followers: 8, SJR: 0.223, CiteScore: 0)
European J. of Cardio-Thoracic Surgery     Hybrid Journal   (Followers: 9, SJR: 1.681, CiteScore: 2)
European J. of Intl. Law     Hybrid Journal   (Followers: 230, SJR: 0.694, CiteScore: 1)
European J. of Orthodontics     Hybrid Journal   (Followers: 5, SJR: 1.279, CiteScore: 2)
European J. of Public Health     Hybrid Journal   (Followers: 21, SJR: 1.36, CiteScore: 2)
European Review of Agricultural Economics     Hybrid Journal   (Followers: 12, SJR: 1.172, CiteScore: 2)
European Review of Economic History     Hybrid Journal   (Followers: 30, SJR: 0.702, CiteScore: 1)
European Sociological Review     Hybrid Journal   (Followers: 45, SJR: 2.728, CiteScore: 3)
Evolution, Medicine, and Public Health     Open Access   (Followers: 12)
Family Practice     Hybrid Journal   (Followers: 16, SJR: 1.018, CiteScore: 2)
Fems Microbiology Ecology     Hybrid Journal   (Followers: 19, SJR: 1.492, CiteScore: 4)
Fems Microbiology Letters     Hybrid Journal   (Followers: 29, SJR: 0.79, CiteScore: 2)
Fems Microbiology Reviews     Hybrid Journal   (Followers: 38, SJR: 7.063, CiteScore: 13)
Fems Yeast Research     Hybrid Journal   (Followers: 14, SJR: 1.308, CiteScore: 3)
Food Quality and Safety     Open Access   (Followers: 1)
Foreign Policy Analysis     Hybrid Journal   (Followers: 25, SJR: 1.425, CiteScore: 1)
Forest Science     Hybrid Journal   (Followers: 8, SJR: 0.89, CiteScore: 2)
Forestry: An Intl. J. of Forest Research     Hybrid Journal   (Followers: 16, SJR: 1.133, CiteScore: 3)
Forum for Modern Language Studies     Hybrid Journal   (Followers: 6, SJR: 0.104, CiteScore: 0)
French History     Hybrid Journal   (Followers: 36, SJR: 0.118, CiteScore: 0)
French Studies     Hybrid Journal   (Followers: 21, SJR: 0.148, CiteScore: 0)
French Studies Bulletin     Hybrid Journal   (Followers: 10, SJR: 0.152, CiteScore: 0)
Gastroenterology Report     Open Access   (Followers: 3)
Genome Biology and Evolution     Open Access   (Followers: 17, SJR: 2.578, CiteScore: 4)
Geophysical J. Intl.     Hybrid Journal   (Followers: 38, SJR: 1.506, CiteScore: 3)
German History     Hybrid Journal   (Followers: 26, SJR: 0.161, CiteScore: 0)
GigaScience     Open Access   (Followers: 6, SJR: 5.022, CiteScore: 7)
Global Summitry     Hybrid Journal   (Followers: 1)
Glycobiology     Hybrid Journal   (Followers: 11, SJR: 1.493, CiteScore: 3)
Health and Social Work     Hybrid Journal   (Followers: 68, SJR: 0.388, CiteScore: 1)
Health Education Research     Hybrid Journal   (Followers: 18, SJR: 0.854, CiteScore: 2)
Health Policy and Planning     Hybrid Journal   (Followers: 26, SJR: 1.512, CiteScore: 2)
Health Promotion Intl.     Hybrid Journal   (Followers: 25, SJR: 0.812, CiteScore: 2)
History Workshop J.     Hybrid Journal   (Followers: 33, SJR: 1.278, CiteScore: 1)
Holocaust and Genocide Studies     Hybrid Journal   (Followers: 30, SJR: 0.105, CiteScore: 0)
Human Communication Research     Hybrid Journal   (Followers: 15, SJR: 2.146, CiteScore: 3)
Human Molecular Genetics     Hybrid Journal   (Followers: 11, SJR: 3.555, CiteScore: 5)
Human Reproduction     Hybrid Journal   (Followers: 77, SJR: 2.643, CiteScore: 5)
Human Reproduction Open     Open Access   (Followers: 1)
Human Reproduction Update     Hybrid Journal   (Followers: 19, SJR: 5.317, CiteScore: 10)
Human Rights Law Review     Hybrid Journal   (Followers: 64, SJR: 0.756, CiteScore: 1)
ICES J. of Marine Science: J. du Conseil     Hybrid Journal   (Followers: 58, SJR: 1.591, CiteScore: 3)
ICSID Review : Foreign Investment Law J.     Hybrid Journal   (Followers: 12)
ILAR J.     Hybrid Journal   (Followers: 3, SJR: 1.732, CiteScore: 4)
IMA J. of Applied Mathematics     Hybrid Journal   (SJR: 0.679, CiteScore: 1)
IMA J. of Management Mathematics     Hybrid Journal   (SJR: 0.538, CiteScore: 1)
IMA J. of Mathematical Control and Information     Hybrid Journal   (Followers: 2, SJR: 0.496, CiteScore: 1)
IMA J. of Numerical Analysis - advance access     Hybrid Journal   (SJR: 1.987, CiteScore: 2)
Industrial and Corporate Change     Hybrid Journal   (Followers: 10, SJR: 1.792, CiteScore: 2)
Industrial Law J.     Hybrid Journal   (Followers: 44, SJR: 0.249, CiteScore: 1)
Inflammatory Bowel Diseases     Hybrid Journal   (Followers: 45, SJR: 2.511, CiteScore: 4)
Information and Inference     Free  
Innovation in Aging     Open Access   (Followers: 1)
Insect Systematics and Diversity     Hybrid Journal  
Integrative and Comparative Biology     Hybrid Journal   (Followers: 10, SJR: 1.319, CiteScore: 2)
Integrative Biology     Full-text available via subscription   (Followers: 5, SJR: 1.36, CiteScore: 3)
Integrative Organismal Biology     Open Access  
Interacting with Computers     Hybrid Journal   (Followers: 10, SJR: 0.292, CiteScore: 1)
Interactive CardioVascular and Thoracic Surgery     Hybrid Journal   (Followers: 7, SJR: 0.762, CiteScore: 1)
Intl. Affairs     Hybrid Journal   (Followers: 69, SJR: 1.505, CiteScore: 3)
Intl. Data Privacy Law     Hybrid Journal   (Followers: 24)
Intl. Health     Hybrid Journal   (Followers: 7, SJR: 0.851, CiteScore: 2)
Intl. Immunology     Hybrid Journal   (Followers: 3, SJR: 2.167, CiteScore: 4)
Intl. J. for Quality in Health Care     Hybrid Journal   (Followers: 38, SJR: 1.348, CiteScore: 2)
Intl. J. of Constitutional Law     Hybrid Journal   (Followers: 57, SJR: 0.601, CiteScore: 1)
Intl. J. of Epidemiology     Hybrid Journal   (Followers: 285, SJR: 3.969, CiteScore: 5)
Intl. J. of Law and Information Technology     Hybrid Journal   (Followers: 5, SJR: 0.202, CiteScore: 1)
Intl. J. of Law, Policy and the Family     Hybrid Journal   (Followers: 25, SJR: 0.223, CiteScore: 1)
Intl. J. of Lexicography     Hybrid Journal   (Followers: 9, SJR: 0.285, CiteScore: 1)
Intl. J. of Low-Carbon Technologies     Open Access   (Followers: 1, SJR: 0.403, CiteScore: 1)
Intl. J. of Neuropsychopharmacology     Open Access   (Followers: 3, SJR: 1.808, CiteScore: 4)
Intl. J. of Public Opinion Research     Hybrid Journal   (Followers: 11, SJR: 1.545, CiteScore: 1)
Intl. J. of Refugee Law     Hybrid Journal   (Followers: 40, SJR: 0.389, CiteScore: 1)
Intl. J. of Transitional Justice     Hybrid Journal   (Followers: 14, SJR: 0.724, CiteScore: 2)
Intl. Mathematics Research Notices     Hybrid Journal   (Followers: 1, SJR: 2.168, CiteScore: 1)
Intl. Political Sociology     Hybrid Journal   (Followers: 41, SJR: 1.465, CiteScore: 3)
Intl. Relations of the Asia-Pacific     Hybrid Journal   (Followers: 24, SJR: 0.401, CiteScore: 1)
Intl. Studies Perspectives     Hybrid Journal   (Followers: 9, SJR: 0.983, CiteScore: 1)
Intl. Studies Quarterly     Hybrid Journal   (Followers: 55, SJR: 2.581, CiteScore: 2)
Intl. Studies Review     Hybrid Journal   (Followers: 24, SJR: 1.201, CiteScore: 1)
ISLE: Interdisciplinary Studies in Literature and Environment     Hybrid Journal   (Followers: 2, SJR: 0.15, CiteScore: 0)
ITNOW     Hybrid Journal   (Followers: 1, SJR: 0.103, CiteScore: 0)
J. of African Economies     Hybrid Journal   (Followers: 18, SJR: 0.533, CiteScore: 1)
J. of American History     Hybrid Journal   (Followers: 51, SJR: 0.297, CiteScore: 1)
J. of Analytical Toxicology     Hybrid Journal   (Followers: 14, SJR: 1.065, CiteScore: 2)
J. of Antimicrobial Chemotherapy     Hybrid Journal   (Followers: 16, SJR: 2.419, CiteScore: 4)
J. of Antitrust Enforcement     Hybrid Journal   (Followers: 1)
J. of Applied Poultry Research     Hybrid Journal   (Followers: 5, SJR: 0.585, CiteScore: 1)
J. of Biochemistry     Hybrid Journal   (Followers: 43, SJR: 1.226, CiteScore: 2)
J. of Breast Imaging     Full-text available via subscription   (Followers: 2)

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Similar Journals
Journal Cover
European Journal of Public Health
Journal Prestige (SJR): 1.36
Citation Impact (citeScore): 2
Number of Followers: 21  
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 1101-1262 - ISSN (Online) 1464-360X
Published by Oxford University Press Homepage  [411 journals]
  • The old Iron Curtain split our continent in half: the new ones could tear
           apart our nations
    • Authors: Hrzic R; Brand H.
      Pages: 1 - 1
      Abstract: In August 1989, the Iron Curtain began to crack. Thousands of East Germans were overstaying their summer vacations near Lake Balaton, resolved not to return. Fearing the coming winter and their resources already stretched thin by Romanian refugees, the Hungarian government had to act. The solution took the form of a ‘pan-European picnic’ near the Austrian–Hungarian border town of Sopron, which would temporarily suspend border controls and give the East Germans a chance to flee to the West.1 A German refugee crisis in the heart of Europe seems incredible today. But reconstructed mortality data shines a light on the dire state of East German health in the 1980s.2
      PubDate: Fri, 24 Jan 2020 00:00:00 GMT
      DOI: 10.1093/eurpub/ckz237
      Issue No: Vol. 30, No. 1 (2020)
  • European burden of disease network: strengthening the collaboration
    • Authors: Devleesschauwer B.
      Pages: 2 - 3
      Abstract: What are the most relevant diseases and risk factors in a country' How is the impact of different diseases evolving over time, and how does the health status compare between and within countries' With an increasing need for prioritizing available resources, a timely, sound and comprehensive answer to these essential questions is more than ever needed to inform public health decision making. Driven by the impact of the Global Burden of Disease (BoD) study,1 several researchers and health institutes across Europe have adopted the BoD approach to address these questions.2,3 Fundamental to this approach is the use of the Disability-Adjusted Life Year as a comprehensive and comparable summary measure of population health.4
      PubDate: Fri, 24 Jan 2020 00:00:00 GMT
      DOI: 10.1093/eurpub/ckz225
      Issue No: Vol. 30, No. 1 (2020)
  • European Public Health News
    • Authors: Zeegers Paget D; Azzopardi Muscat N, Zeegers Paget D, et al.
      Pages: 200 - 203
      Abstract: Welcome to the first European Public Health News in 2020. This will be an exciting year with a new EUPHA strategy, presented by Azzopardi-Muscat and new initiatives to further public health in Europe, as presented by Zeegers Paget. This is also a year of changes, we will have a new Regional Director for the WHO—Regional office for Europe and a new EU commissioner for health. Hans Kluge, WHO’s regional director designate presents his priorities for the coming years emphasizing the need to work together. And for the first time, we will have a combined conference with the World Federation of Public Health Associations and the Italian Society of Hygiene, preventive medicine and health, a second update from Barnhoorn is included here as well.
      PubDate: Fri, 24 Jan 2020 00:00:00 GMT
      DOI: 10.1093/eurpub/ckz240
      Issue No: Vol. 30, No. 1 (2020)
  • Does public report card matter' A 10-year interrupted time series
           analysis on total knee replacement
    • Authors: Chen T; Hsueh Y, Liaw C, et al.
      Pages: 4 - 9
      Abstract: AbstractBackgroundThere is a lack of evidence that shows whether a report card can improve health outcomes in terms of infection rates or unscheduled readmission by using rigorous methods to evaluate its impact.MethodsWe used the National Health Insurance Administration’s claims database from 1 January 2004 to 30 December 2013 and a time series analysis to evaluate the impact of the quality report card initiative on three negative outcomes of total knee replacement for each quarter of the year, including the rates of superficial infection of a knee replacement, deep infection of knee arthroplasty and unplanned readmissions for surgical site infection.ResultsThese negative outcomes (original scale) do not show significant decreases in terms of superficial infection (−0.05‰, −0.63 to 0.53‰, P = 0.87), deep infection (−0.003‰, −0.19 to 0.18‰, P = 0.97) and unscheduled readmission (0.02‰, −0.21 to 0.25‰, P = 0.88).ConclusionThe total knee replacement public report card initiative did not improve the rate of infection and unscheduled readmission for surgical site infection. This report card in Taiwan should involve physicians’ participation in the design and be tailored to be suitable for reading by patients in order to further enhance the chance of improvement in these negative outcomes.
      PubDate: Sun, 09 Jun 2019 00:00:00 GMT
      DOI: 10.1093/eurpub/ckz112
      Issue No: Vol. 30, No. 1 (2019)
  • A survey of knowledge, attitudes and awareness of the human papillomavirus
           among healthcare professionals across the UK
    • Authors: Sherman S; Cohen C, Denison H, et al.
      Pages: 10 - 16
      Abstract: AbstractBackgroundHuman papillomavirus (HPV) is a common sexually transmitted infection implicated in 5% of cancers worldwide including most cervical cancer cases. In the UK, the HPV vaccine has been offered routinely to girls aged 11–13 since 2008 while cervical screening is offered to women aged 25–64. HPV testing will soon replace cytology as the primary screening method. This research evaluates what healthcare professionals (HCPs) across the UK know about HPV.MethodsA total of 643 UK-based HCPs from primary and secondary care took part in an anonymous cross-sectional survey between March and April 2018. The survey measured general HPV knowledge; HPV triage and test of cure knowledge; HPV vaccine knowledge; attitudes to the HPV vaccine and self-perceived adequacy of knowledge.ResultsParticipants had a generally good understanding of HPV and the vaccination but there were gaps in detailed knowledge of the National Health Service HPV testing processes. There were some gaps in knowledge about the health sequelae of HPV for males. Years since HPV training was associated with triage and test of cure and vaccine knowledge scores. Furthermore, nurses and doctors in colposcopy clinics had much greater odds of having higher knowledge across all domains than other roles. In total, 76.2% of participants felt adequately informed about HPV and 35.6% made suggestions for improvements in training, many of which requested additional frequency and topics.ConclusionOur results suggest that additional training is needed to ensure HCPs are equipped to deal with the changing landscape of HPV screening and vaccination in the UK.
      PubDate: Mon, 10 Jun 2019 00:00:00 GMT
      DOI: 10.1093/eurpub/ckz113
      Issue No: Vol. 30, No. 1 (2019)
  • Healthcare use in patients with multimorbidity
    • Authors: Quinaz Romana G; Kislaya I, Cunha Gonçalves S, et al.
      Pages: 16 - 22
      Abstract: AbstractBackgroundThe existence of multiple chronic conditions in the same patient is a public health problem increasingly recognized as relevant to health systems. Individuals with multimorbidity have additional health needs, which imply a heavy burden in healthcare use. It is estimated that between 70% and 80% of the total health expenditure is used with chronic conditions. Patients with multimorbidity are responsible for up to 75% of primary care appointments. These patients are also high hospital users, with up to 14.6 times more risk of hospitalization.MethodsThis study analyses the association between healthcare use and multimorbidity in the Portuguese population aged 25–74 years old. The association between socioeconomic variables and healthcare use was studied, based on data from the first Portuguese Health Examination Survey using a logistic regression model, stratified by sex and adjusted for socioeconomic confounding variables.ResultsIn patients with multimorbidity, there was a greater use of primary healthcare consultations, medical or surgical specialist consultations and hospitalizations. An association was established between female, older age groups and lower educational levels, and increased healthcare use. When adjusted to socioeconomic variables, the likelihood of using healthcare services can be as high as 3.5 times, when compared to patients without chronic conditions.ConclusionOur results show a greater healthcare use in multimorbidity patients, both in primary and hospital care. The availability of scientific evidence regarding the use of healthcare services by multimorbidity patients may support health policy changes, which could allow a more efficient management of these patients.
      PubDate: Tue, 25 Jun 2019 00:00:00 GMT
      DOI: 10.1093/eurpub/ckz118
      Issue No: Vol. 30, No. 1 (2019)
  • Perceived quality of HIV care and client satisfaction across different
           service providers in Ukraine
    • Authors: Hailemeskal M; Sereda Y, Latypov A, et al.
      Pages: 23 - 30
      Abstract: AbstractBackgroundPrior studies have shown that high client satisfaction and quality of services are important drivers of uptake and retention in human immunodeficiency virus (HIV) care. Study objectives were to assess the perceived quality of HIV services, satisfaction and associated factors across different types of health facilities in Ukraine.MethodsWe conducted a cross-sectional study among 649 individuals receiving HIV services across 47 health facilities in three regions of Ukraine. Primary outcomes were satisfaction and perceived quality of services measured along five dimensions: accessibility, user-friendliness, privacy and confidentiality, comprehensiveness (separately for testing and treatment services). Quality dimensions were constructed by confirmatory factor analysis. Links between quality dimensions, satisfaction and related factors were measured by structural equation modelling.ResultsMedian scores for accessibility, user-friendliness, privacy and confidentiality, comprehensiveness of services and overall satisfaction ranged from 0.75 to 1 out of 1. User-friendliness was the main determinant associated with satisfaction (total effect: β = 0.515, P < 0.001). Satisfaction was higher at primary healthcare centres (direct effect: β = 0.145, P < 0.001; indirect effect through accessibility: β = 0.060, P < 0.001), narcological/tuberculosis dispensaries (direct effect: β = 0.105, P = 0.006; indirect effect through accessibility: β = 0.060, P < 0.001) and hospitals (indirect effects through user-friendliness and accessibility: β = 0.180, P < 0.001) when compared to acquired immune deficiency syndrome centres.ConclusionsUser-friendliness is a key driver of client satisfaction with HIV services in Ukraine. Decentralization of services, together with improved training and supervision for provider–client interactions may provide important levers to improve client satisfaction with HIV services and enrolment and retention in the cascade of HIV services.
      PubDate: Wed, 03 Jul 2019 00:00:00 GMT
      DOI: 10.1093/eurpub/ckz124
      Issue No: Vol. 30, No. 1 (2019)
  • The Dutch Public Health Foresight Study 2018: an example of a
           comprehensive foresight exercise
    • Authors: Verschuuren M; Hilderink H, Vonk R.
      Pages: 30 - 35
      Abstract: AbstractBackgroundThe use of foresight studies is common in some policy fields, but not in public health. Interest in such studies is growing. This paper gives a general overview of the Dutch Public Health Foresight Study (PHFS) 2018, providing insight into what performing a broad scenario exercise in the field of public health entails and its societal impacts.MethodsThe aim of the PHFS-2018 was: (a) to show how public health and healthcare in the Netherlands will develop over the next 25 years if we pursue our current course and detect ‘new’ developments; (b) to give options for dealing with the major future societal challenges. Part a was addressed by means of a quantitative business-as-usual scenario exercise complemented with qualitative thematic studies, and part b by elaborating courses of action for three key challenges, based on stakeholder consultation. Typical aspects of the PHFS methods are a multidisciplinary, participatory and conceptual approach and using a broad definition of health.ResultsThe PHFS-2018 is the basis for the upcoming National Health Policy Memorandum and the Trend Scenario is the baseline for the National Prevention Agreement. Unexpectedly, the findings about increasing mental pressure in young people received most attention. There still is room for expanding use of the study to its full potential.ConclusionsLong-term thinking could be stimulated by using back casting techniques and stronger involvement of policy-makers in the elaboration of options for action. Lessons learned from developing intersectoral policy at the local level could be applied at the national level.
      PubDate: Thu, 24 Oct 2019 00:00:00 GMT
      DOI: 10.1093/eurpub/ckz200
      Issue No: Vol. 30, No. 1 (2019)
  • The impact of Active Labour Market Policies on health outcomes: a Scoping
    • Authors: Puig-Barrachina V; Giró P, Artazcoz L, et al.
      Pages: 36 - 42
      Abstract: AbstractBackgroundSince the last Western great recession of 2008, an increasing interest on the effects of Active Labour Market Policies (ALMPs) on improving health has emerged. The aim of our review is to synthesize evidence on the effectiveness of ALMPs and whether some types of ALMP are more effective.MethodsUsing the Scoping review methodology, we conducted a literature review in PubMed/MEDLINE, Scopus and Web of Science and selected articles published between 1990 and 2017 in high income countries. We applied four sequential phases of document screening to the list of retrieved articles.ResultsOf the 416 documents detected in the search, 36 documents were finally selected. Most of them focused on mental health and related components (72.2%) and found positive results at least in one outcome (80.6%). The ALMPs reported mainly attempt to build capacity through job search assistance (31.6%) with a component on mental health, showing positive results on health; some offer job training (16.7%) and few subsidized employment (8.3%), showing more controversial results, although mostly positive. The rest include a combination of different types of ALMPs.ConclusionsThis review shows that ALMPs have a positive impact on health and quality of life. There are relatively few studies of the impact of ALMPs on general health, and most of the studies found are focused on Anglo-Saxon and Nordic countries. The most significant knowledge gaps are the mechanisms involved in achieving this improvement, and above all the differential health impacts according to axes of inequality and welfare state.
      PubDate: Mon, 25 Mar 2019 00:00:00 GMT
      DOI: 10.1093/eurpub/ckz026
      Issue No: Vol. 30, No. 1 (2019)
  • Cost-effectiveness of public health interventions against human influenza
           pandemics in France: a methodological contribution from the FLURESP
           European Commission project
    • Authors: Beresniak A; Rizzo C, Oxford J, et al.
      Pages: 43 - 49
      Abstract: AbstractBackgroundThe FLURESP project is a public health project funded by the European Commission with the objective to design a methodological approach in order to compare the cost-effectiveness of existing public health measures against human influenza pandemics in four target countries: France, Italy, Poland and Romania. This article presents the results relevant to the French health system using a data set specifically collected for this purpose.MethodsEighteen public health interventions against human influenza pandemics were selected. Additionally, two public-health criteria were considered: ‘achieving mortality reduction ≥40%’ and ‘achieving morbidity reduction ≥30%’. Costs and effectiveness data sources include existing reports, publications and expert opinions. Cost distributions were taken into account using a uniform distribution, according to the French health system.ResultsUsing reduction of mortality as an effectiveness criterion, the most cost-effective options was ‘implementation of new equipment of Extracorporeal membrane oxygenation (ECMO) equipment’. Targeting vaccination to health professionals appeared more cost-effective than vaccination programs targeting at risk populations. Concerning antiviral distribution programs, curative programs appeared more cost-effective than preventive programs. Using reduction of morbidity as effectiveness criterion, the most cost-effective option was ‘implementation of new equipment ECMO’. Vaccination programs targeting the general population appeared more cost-effective than both vaccination programs of health professionals or at-risk populations. Curative antiviral programs appeared more cost-effective than preventive distribution programs, whatever the pandemic scenario.ConclusionIntervention strategies against human influenza pandemics impose a substantial economic burden, suggesting a need to develop public-health cost-effectiveness assessments across countries.
      PubDate: Sun, 05 May 2019 00:00:00 GMT
      DOI: 10.1093/eurpub/ckz074
      Issue No: Vol. 30, No. 1 (2019)
  • Individual preferences for voluntary vs. mandatory vaccination policies:
           an experimental analysis
    • Authors: Meier N; Böhm R, Korn L, et al.
      Pages: 50 - 55
      Abstract: AbstractBackgroundMore and more countries are discussing the introduction of mandatory vaccination policies. Yet, little is known about individuals’ actual preferences for voluntary vs. mandatory vaccination policies, and the psychological processes underlying such preferences. Objective of the present research was to investigate the development of individual preferences for voluntary and mandatory vaccination policies.MethodsWe conducted a controlled laboratory study (N = 168) using a repeated interactive vaccination game with decision-contingent monetary incentives. In each round, participants decided in favour of either a voluntary or a mandatory vaccination policy, followed by the vaccination decision (voluntary policy) or vaccination (mandatory policy) which both resulted in actual (financial) consequences.ResultsWe observe large heterogeneity in participants’ preferences for the voluntary vs. mandatory policy. Under voluntary vaccination, the preference for the mandatory policy increased with decreasing vaccination rates (and increasing risk of infection). In contrast, experiencing vaccine-adverse events under mandatory vaccination increased the preference for the voluntary policy. The latter effect was larger for individuals with a negative (vs. positive) attitude toward vaccination. Overall, as individuals gathered experiences under both the voluntary and the mandatory policy, the preference for voluntary vaccination policy increased over time.ConclusionsIndividuals are more willing to accept mandatory vaccination policies when vaccination rates are low. In the long run, the occurrence of vaccine-adverse events may spark opposition to mandatory vaccination.
      PubDate: Fri, 18 Oct 2019 00:00:00 GMT
      DOI: 10.1093/eurpub/ckz181
      Issue No: Vol. 30, No. 1 (2019)
  • Living labs for health: an integrative literature review
    • Authors: Kim J; Kim Y, Jang H, et al.
      Pages: 55 - 63
      Abstract: AbstractBackgroundLiving labs are user-focused experimental environments in which users and producers co-create innovative solutions in real-life settings. The aim of this study was to review and synthesize health-related studies that used the living labs approach.MethodsAn integrative literature review of 15 studies was conducted on the application of living lab principles and their usefulness for investing health problems. Three reviewers independently used methodological assessment tools to evaluate the data quality.ResultsTwelve of 15 studies were published during the past 5 years, while 14 of the 15 studies were conducted in Europe. Older adults were the target population in 9 of the 15 studies. The research topics varied, including detecting and monitoring daily life, fall prevention and social support. All the studies applied multi-method approaches and a real-life setting. Use of the living lab approach appeared to improve the quality of life, physical and social health and cognitive function of the target populations.ConclusionsThe results showed that the living lab approach was more commonly used to investigate health problems in older adult populations. Living lab appears to be an appropriate method for developing innovative solutions to improve the health of vulnerable groups.
      PubDate: Thu, 06 Jun 2019 00:00:00 GMT
      DOI: 10.1093/eurpub/ckz105
      Issue No: Vol. 30, No. 1 (2019)
  • Health-related quality of life in home care recipients after a falls
           prevention intervention: a 6-month follow-up
    • Authors: Bjerk M; Brovold T, Davis J, et al.
      Pages: 64 - 69
      Abstract: AbstractBackgroundFalls in older adults are an increasingly important public health concern due to the expanding older population and contribute considerably to the global burden of disease. Home care recipients have a high incidence of falls and a low level of health-related quality of life (HRQOL). In this understudied group of older adults, exercise interventions could prevent falls, promote HRQOL and enable healthy ageing in the longer term.MethodsThe study is a single-blinded parallel-group randomized controlled trial, lasting 3 months with a follow-up at 6 months, conducted in primary care. The objective was to explore the effects of a falls prevention exercise programme post-intervention at a 6-month follow-up in home care recipients 67+ years with a history of falls. The Otago Exercise Programme lasting 3 months was performed. The primary outcome was HRQOL measured by the Short Form 36 Health Survey (SF-36). Linear mixed regression models and structural equation models were employed.ResultsAt 6-month follow-up, the intervention group scored significantly higher on SF-36’s physical component summary compared with the controls; 3.0 points, 95% confidence interval (CI) = 0.4, 5.6. This effect was mediated by an increased probability of maintaining exercise in the post-intervention period; odds ratio = 2.3 (CI = 1.1, 5.1). Exercising was associated with a 7.1-point increase in physical component summary (CI = 3.2, 10.9).ConclusionA falls prevention exercise programme can improve physical HRQOL in home care recipients post-intervention. The exercise programme also led to longer-term changes in exercise behaviour mediating this effect.
      PubDate: Thu, 06 Jun 2019 00:00:00 GMT
      DOI: 10.1093/eurpub/ckz106
      Issue No: Vol. 30, No. 1 (2019)
  • Prevention of chronic diseases in middle-age women: a cross-sectional
           study on an Italian large sample
    • Authors: Colombo A; Voglino G, Sessa A, et al.
      Pages: 70 - 75
      Abstract: AbstractBackgroundThe age around 50 years represents a crucial point for women: menopause leads to biological changes and it begins breast and colon-rectal cancer screening. This study aimed at assessing frequencies of cardiovascular risk factors and analyzing participation in screening and vaccination.MethodsIn 2017, a cross-sectional study was performed in Northern Italy. Totally, 12 249 women, aged between 50 and 54 years, were enrolled by General Practitioners (GPs). It was used a 21-item form, with information about: socio-demographic, anamnestic and clinical data, execution of a booster shot of tetanus-diphtheria-acellular pertussis (Tdap) vaccine in the last decade and of PAP-test, mammography and faecal occult blood test in the last 2 years. Descriptive and crosstab χ2 analyses were performed with STATA MP13. The significance level was P ≤ 0.05.ResultsOur findings showed the presence of cardiovascular risk factors, such as obesity (10.95%), hypertension (13.76%), hyperlipidaemia (11.57%), glycaemia ≥ 100 mg dl−1 (16.97%), poor physical activity (73.49%), smoking (18.28%), cardiovascular family history (FH) (51.70%). There were a lower participation in colo-rectal cancer screening (45.09%) compared with breast (85.06%) and cervical (77.16%) cancer screening and an insufficient Tdap booster dose compliance (17.56%). Chi-square analyses showed correlations between cardiovascular FH and body mass index, hypertension, hyperlipidaemia, glycaemia and smoking, and between cancer FH and participation in breast and colo-rectal cancer screening (P < 0.05).ConclusionsWomen with cardiovascular disease FH represent a priority target of educational interventions considering the prevalence of concomitant risk factors. Programmes aimed at increasing screening and vaccination participation should be implemented.
      PubDate: Mon, 01 Jul 2019 00:00:00 GMT
      DOI: 10.1093/eurpub/ckz121
      Issue No: Vol. 30, No. 1 (2019)
  • Large diversity in Danish health literacy profiles: perspectives for care
           of long-term illness and multimorbidity
    • Authors: Aaby A; Beauchamp A, O’Hara J, et al.
      Pages: 75 - 80
      Abstract: AbstractBackgroundHealth literacy is an important, modifiable, social determinant of health. This study aims to explore health literacy challenges of people with long-term illness or multimorbidity and provide detailed profiles revealing health literacy strengths and weaknesses within a Danish population.MethodsIn this cross-sectional study among Danish individuals (n = 490), health literacy was assessed using the nine-scale Health Literacy Questionnaire (HLQ). Using multiple logistic regression and hierarchical cluster analysis, we estimated the association between HLQ scale scores and the likelihood of long-term illness and multimorbidity, and identified socio-demographic and health characteristics related to profiles of health literacy strengths and weaknesses.ResultsAn increase in ‘actively managing my health’ and ‘social support for health’ decreased the odds of having a long-term illness [odds ratio, OR 0.53 (0.31–0.9); OR 0.43 (0.24–0.74)] and multimorbidity [OR 0.51 (0.26–0.98); OR 0.33 (0.17–0.62)], respectively. Conversely, an increase in ‘healthcare provider support’ increased the odds of having long-term illness [OR 2.97 (1.78–5.08)] and multimorbidity [OR 2.94 (1.53–5.87)], respectively. Five profiles were identified based on the cluster analysis. Each cluster was characterized by specific health characteristics, e.g. Cluster A by better health status (χ2 = 39.976 (4), P < 0.001) and well-being (χ2 = 28.832 (4), P < 0.001) and Cluster D by poor health status (χ2 = 39.976 (4), P < 0.001) and increased likelihood of long-term illness (χ2 = 18.641 (4), P < 0.001).ConclusionsThe association of health literacy with long-term illness and multimorbidity in combination with the health literacy profiling based on cluster analysis provides a comprehensive needs assessment and a promising starting point for the development of health literacy responsive interventions.
      PubDate: Tue, 30 Jul 2019 00:00:00 GMT
      DOI: 10.1093/eurpub/ckz134
      Issue No: Vol. 30, No. 1 (2019)
  • Self-efficacy and social competence reduce socioeconomic inequality in
           emotional symptoms among schoolchildren
    • Authors: Meilstrup C; Holstein B, Nielsen L, et al.
      Pages: 80 - 85
      Abstract: AbstractBackgroundMany adolescents experience mental health problems which may have serious consequences for short- and long-term health and wellbeing. This study investigates socioeconomic inequality in emotional symptoms, self-efficacy and social competence. Further, whether self-efficacy and social competence reduce socioeconomic inequalities in emotional symptoms.MethodsData stem from the cross-sectional Danish Health Behaviour in School-aged Children Methodology Development Survey 2012. Data were collected among all schoolchildren in grades 5–9 (11–15-year-olds) in 23 public schools in two municipalities. Participation rate was 76.8% (n = 3969). Analyses of the associations between daily emotional symptoms, occupational social class, self-efficacy and social competence were performed through logistic regression analyses using SAS version 9.3. Multilevel logistic regression analyses were used to study effect modification.ResultsSchoolchildren from lower socioeconomic positions have higher odds for daily emotional symptoms and lower levels of high self-efficacy and high social competence compared to schoolchildren from higher socioeconomic positions. High self-efficacy and high social competence buffer the association between socioeconomic position and emotional symptoms, i.e. they seem to protect children and adolescents from lower socioeconomic strata against the higher risk of daily emotional symptoms.ConclusionsHigh self-efficacy and high social competence buffer the negative effects of low socioeconomic status on emotional symptoms among schoolchildren. Self-efficacy and social competence can be promoted e.g. through school-based initiatives and may be an effective way to improve mental health and reduce socioeconomic inequality in emotional symptoms among children and adolescents.
      PubDate: Tue, 16 Apr 2019 00:00:00 GMT
      DOI: 10.1093/eurpub/ckz058
      Issue No: Vol. 30, No. 1 (2019)
  • Differences in life expectancy between four Western countries and their
           Caribbean dependencies, 1980–2014
    • Authors: Verstraeten S; van Oers H, Mackenbach J.
      Pages: 85 - 92
      Abstract: AbstractBackgroundIn the Caribbean, life expectancy in politically independent territories has increasingly diverged from that of territories that remained affiliated to their former colonizers. Because these affiliated territories differ in degree of political independence, they are not all governed in the same way. We assessed whether differences in life expectancy trends between Caribbean dependencies and their Western administrators were related to their degree of political independence, and which causes of death contributed to divergence or convergence in life expectancy.MethodsAnalysis of age-standardized death rates and decomposition of life expectancy differences between France, the Netherlands, UK, USA and their Caribbean dependencies by age and cause-of-death during the period 1980–2014.ResultsLife expectancy differences between Western countries and their dependencies have generally increased for men and narrowed for women, but trends have been much more favorable in the French- than in the Dutch-administered territories. The strongest contributions to widening gaps in life expectancy between Western countries and their dependencies were from mortality from cardiovascular diseases (ischemic heart disease) and external causes (homicide and traffic accidents).ConclusionDependencies with a stronger political affiliation to a Western country experienced more favorable life expectancy developments than dependencies that had more autonomy during the 1980–2014 period. The underlying mortality differences with Western countries are largely comparable among Caribbean territories but differ in magnitude, most notably for cardiovascular disease and external causes. This suggests that increases in a territory’s political autonomy impairs the diffusion of new knowledge and techniques, and/or reduces government’s effectiveness in implementing policies.
      PubDate: Sun, 09 Jun 2019 00:00:00 GMT
      DOI: 10.1093/eurpub/ckz102
      Issue No: Vol. 30, No. 1 (2019)
  • Socioeconomic inequalities in suicide mortality in European urban areas
           before and during the economic recession
    • Authors: Borrell C; Palència L, Marí Dell’Olmo M, et al.
      Pages: 92 - 98
      Abstract: AbstractBackgroundFew studies have assessed the impact of the financial crisis on inequalities in suicide mortality in European urban areas. The objective of the study was to analyse the trend in area socioeconomic inequalities in suicide mortality in nine European urban areas before and after the beginning of the financial crisis.MethodsThis ecological study of trends was based on three periods, two before the economic crisis (2000–2003, 2004–2008) and one during the crisis (2009–2014). The units of analysis were the small areas of nine European cities or metropolitan areas, with a median population ranging from 271 (Turin) to 193 630 (Berlin). For each small area and sex, we analysed smoothed standardized mortality ratios of suicide mortality and their relationship with a socioeconomic deprivation index using a hierarchical Bayesian model.ResultsAmong men, the relative risk (RR) comparing suicide mortality of the 95th percentile value of socioeconomic deprivation (severe deprivation) to its 5th percentile value (low deprivation) were higher than 1 in Stockholm and Lisbon in the three periods. In Barcelona, the RR was 2.06 (95% credible interval: 1.24–3.21) in the first period, decreasing in the other periods. No significant changes were observed across the periods. Among women, a positive significant association was identified only in Stockholm (RR around 2 in the three periods). There were no significant changes across the periods except in London with a RR of 0.49 (95% CI: 0.35–0.68) in the third period.ConclusionsArea socioeconomic inequalities in suicide mortality did not change significantly after the onset of the crisis in the areas studied.
      PubDate: Thu, 13 Jun 2019 00:00:00 GMT
      DOI: 10.1093/eurpub/ckz125
      Issue No: Vol. 30, No. 1 (2019)
  • Social mobility, accumulation of disadvantages and health. An analysis
           with retrospective data from the GSOEP (2002–14)
    • Authors: Knöchelmann A; Günther S, Moor I, et al.
      Pages: 98 - 104
      Abstract: AbstractBackgroundSocioeconomic position (SEP) in different life stages is related to health-related quality of life (HRQoL). Yet, research on the relevance of life course processes is scarce. This study aims to analyse the association between accumulation of disadvantages, social mobility and HRQoL.MethodsAnalyses were conducted using population-averaged panel-data models and are based on data from the German Socio-Economic Panel 2002–14, including retrospective biographical information, comprising 25 473 observations from 8666 persons. Intergenerational and intragenerational mobility included the occupational positions in childhood (parental position), first job and middle age. Accumulation of disadvantages was measured using an accumulation index. HRQoL was assessed using the Mental and Physical Component Summary Scores of the SF12v2.ResultsAccumulation of disadvantages was the main predictor for the Physical Component Summary in mid-age. Men and women in a stable low SEP or with a steep downward mobility showed the least favourable physical HRQoL. This holds for intergenerational and intragenerational mobility. Mental HRQoL did not seem to be associated with accumulation or social mobility.ConclusionThe results show that physical HRQoL is related to social mobility and accumulation of (dis-)advantages. Further research is needed thoroughly analysing this association.
      PubDate: Thu, 11 Jul 2019 00:00:00 GMT
      DOI: 10.1093/eurpub/ckz128
      Issue No: Vol. 30, No. 1 (2019)
  • Parental perceptions, attitudes and knowledge on European preschool
           children’s total screen time: the ToyBox-study
    • Authors: Miguel-Berges M; , Santaliestra-Pasias A, et al.
      Pages: 105 - 111
      Abstract: AbstractBackgroundPreschool children spend a significant proportion of their waking hours being sedentary. Parents play a critical role in developing and shaping their children’s lifestyle behaviours, particularly in the early years of life. This study aims to assess parental perceptions, attitudes and knowledge of their preschool children’s sedentary behaviours and the association with children’s television (TV)/video/DVDs viewing and total screen time.MethodsData were obtained from a sample of 4836 children (3.5–5.5 years), participating in the multi-centre ToyBox-study at baseline (T0) and at 1-year follow-up (T1) periods. Data on children’s sedentary behaviours were collected via a standardized proxy-administered primary caregiver’s questionnaire.ResultsRegarding total screen time, 66.6% of the children at T0 and 71.8% at T1 in the control group exceeded the recommendations, whereas the proportion in the intervention group varied from 69.7% at T0 to 72.5% at T1. The odds of exceeding total screen time recommendations were significantly higher when parental perceptions towards limiting the total screen time were negative [(both T0 and T1 and in the intervention and control groups (P < 0.05)]. Similarly, the odds of exceeding TV/video/DVDs viewing recommendations were significantly higher (both T0 and T1 is observed in both groups) when parental knowledge of recommendation were absent.ConclusionsPreschool children whose caregivers stated rules limiting their sedentary screen time were less likely to spend a high amount of time watching TV/video/DVDs. Interventions to increase parental practices may be a promising approach to decrease total screen time of preschool children but studies are needed to confirm this.
      PubDate: Mon, 09 Sep 2019 00:00:00 GMT
      DOI: 10.1093/eurpub/ckz151
      Issue No: Vol. 30, No. 1 (2019)
  • Associations between health literacy and patient outcomes in adolescents
           and young adults with cystic fibrosis
    • Authors: Jackson A; Kirwan L, Gibney S, et al.
      Pages: 112 - 118
      Abstract: AbstractBackgroundInteractive health literacy (HL) skills enable individuals to participate more fully in healthcare activities and play a role in improving their outcomes. We examine the associations between HL and cystic fibrosis (CF) outcomes and compare HL in a sample from both the Irish CF and general populations.MethodsA total of251 CF Registry participants aged 13–30 years completed the HLS-EU-Q16 survey and a disease-specific instrument for measuring quality of life (QoL) in CF. Health outcome and healthcare resource utilization (HCRU) data were sourced from the registry. CF patient outcomes were examined using generalized linear models (GLMs) with interactive HL categorization included as a factor. General population interactive HL data are from the 2011 European HL Survey (HLS-EU). Interactive HL in 180 age-sex matched CF and general population individuals was examined using a GLM with study population, sex and educational level included as factors and age as a covariate.ResultsSufficient interactive HL (total sum score ≥13) was self-reported by 81.7% of individuals with CF. Sufficient HL was associated with fewer outpatient visits [7.02(SD = 6.7: 7.4) vs. 8.74(SD = 7.9: 9.6), P < 0.001], days hospitalized [10.25(SD = 9.8: 10.7) vs. 12.8(SD = 11.8: 13.9), P < 0.001], days on intravenous antibiotics [15.3(SD = 14.7: 15.8) vs. 19.7(18.5: 21.1), P < 0.001], days on oral antibiotics [27.4(SD = 26.7: 28.1) vs. 48.48(38.7: 42.4), P < 0.001] and better QoL [77.1(SD = 75.4–78.9) vs. 64.6(60.8–68.3), P < 0.001]. Mean HL scores in CF and general populations were sufficient, although higher among individuals with CF (14.3 vs. 13.1, P < 0.01).ConclusionCF adolescents and young adults with sufficient levels of HL to obtain, understand, appraise and apply health information have better health-related outcomes.
      PubDate: Tue, 17 Sep 2019 00:00:00 GMT
      DOI: 10.1093/eurpub/ckz148
      Issue No: Vol. 30, No. 1 (2019)
  • The 2013–2016 Ebola epidemic: evaluating communication strategies
           between two affected countries in West Africa
    • Authors: Walker B; Adukwu E.
      Pages: 118 - 124
      Abstract: AbstractBackgroundEbola is a haemorrhagic disease with high fatality rates between 25 and 90%. The 2013–16 Ebola outbreak in West Africa was the largest to date with >28 000 cases and >11 000 fatalities. This outbreak exposed inadequacies in public health agencies and has spurred health officials to re-evaluate the way Ebola virus disease (EVD) epidemics are co-ordinated and communicated.MethodsThis project compares, using the systematic review method, differences in the communication of EVD in Nigeria and Liberia with data from selected articles analyzed using thematic analysis.ResultsThe most successful communication strategies were community engagement and targeted health-communication to the most at-risk groups. We also highlight the importance of a multi-modal strategy to effectively communicate prevention and management of EVD to affected communities. Secondary to these findings included the relevance of the media, particularly social media tools in managing such serious outbreak situations.ConclusionThis study provides the basis for the development of a theory-based framework to effectively communicate EVD and reduce the negative outcomes observed during the 2013–16 EVD outbreak.
      PubDate: Sun, 09 Jun 2019 00:00:00 GMT
      DOI: 10.1093/eurpub/ckz104
      Issue No: Vol. 30, No. 1 (2019)
  • Placing sexually transmitted infection surveillance data in perspective by
           using national probability sample surveys
    • Authors: Heijne J; van Aar F, Meijer S, et al.
      Pages: 124 - 131
      Abstract: AbstractBackgroundMany European countries do not have comprehensive sexually transmitted infection (STI) surveillance in place. The objective was to investigate whether national probability sample surveys are useful in placing STI surveillance into perspective.MethodsWe used data from the Dutch national cross-sectional probability sample survey on sexual health 2016 (18–34-year-old sexually active individuals). Descriptive analyses were performed regarding STI testing (last year). Test numbers were extrapolated from the survey and compared with surveillance data from sexual health centres (SHCs) (complete) and general practitioners (GPs) (representative estimates from 7% of all GPs). Statistical differences in characteristics between SHC attendees and general population (according to weighted survey participants) were determined using χ2 statistic. Predictors of recent testing at GPs or SHCs were determined using multinomial multivariable logistic regression.ResultsOf the 17 222 survey invitees, 3217 (19%) were eligible for analyses. Testing uptake was higher in women (17.2%, 14.8–20.0%) than men (11.5%, 9.1–14.3%). The majority of tests were conducted by GPs followed by SHCs and hospitals. Number of tests extrapolated from the survey was similar to SHC surveillance data, but higher than GP surveillance data (women only). Testing at SHCs was associated with high-risk behaviour and with living in highly urbanized areas. Low education level and older age were, next to high-risk behaviour factors, determinants of testing at GPs.ConclusionsNational probability sample surveys are useful for placing STI surveillance data into perspective by providing insights in testing patterns in the general population and identifying strengths and weaknesses of national surveillance systems.
      PubDate: Mon, 30 Sep 2019 00:00:00 GMT
      DOI: 10.1093/eurpub/ckz157
      Issue No: Vol. 30, No. 1 (2019)
  • Identifying people at risk for influenza with low vaccine uptake based on
           deprivation status: a systematic review
    • Authors: Vukovic V; Lillini R, Lupi S, et al.
      Pages: 132 - 141
      Abstract: AbstractBackgroundInfluenza vaccination is an important public health intervention for controlling disease burden, but coverage rates are still low also in risk groups. In order to identify non-vaccinating subgroups, deprivation and socio-economic indices, i.e. measures used to synthetically describe people’s socio-economic status while taking into account several dimensions, may be used. We aimed to synthetize evidence from studies investigating association between deprivation/socio-economic indices and influenza vaccination coverage in population at risk—persons ≥65 years of age, individuals with comorbidities, pregnant women and health-care workers.MethodsWe searched PubMed, ISI WoS, CINAHL and Scopus to identify observational studies published up to October 10th 2017 in English or Italian. Studies reporting quantitative estimates of the association between deprivation/socio-economic indices and influenza vaccination coverage in populations at risk were included.ResultsA total of 1474 articles were identified and 12 were eventually included in the final review. Studies were mostly cross-sectional, performed in European countries, from 2004 to 2017. Seven studies focussed on deprivation and five on socio-economic indices. Studies on deprivation indices and vaccination coverage showed that people from the most deprived areas had lower coverage. Regarding socio-economic condition, results were contrasting, even though it may also be concluded that people from lower groups have lower vaccination coverage.ConclusionsOur work supports the possibility to identify people likely to have lower influenza vaccination coverage based on deprivation/socio-economic indices. Efforts should be performed in order to further strengthen robustness, transferability and suitability of these indices in addressing public health problems.
      PubDate: Sat, 28 Sep 2019 00:00:00 GMT
      DOI: 10.1093/eurpub/cky264
      Issue No: Vol. 30, No. 1 (2019)
  • Surveillance of malaria in mainland Portugal in 2016 after the
           introduction of an electronic system: is it enough'
    • Authors: Miranda Ferrão R; Fronteira I, Sá Machado R, et al.
      Pages: 142 - 143
      Abstract: AbstractSince 2014, imported cases of malaria have been notified by SINAVE, the Portuguese nationwide electronic surveillance system that replaced paper-based notification. Nevertheless, the disease is still believed to be under-reported. Completeness of notification of malaria cases in 2016 was estimated using a two-source capture-recapture method, with SINAVE and the Diagnostic-Related Group cases. Completeness of SINAVE and the diagnosis-related group sources was computed in 32.9% and 72.3%, respectively. The results confirm that malaria is under-reported and highlight the need for more effective notification strategies, especially given the risk of resurgence of locally acquired cases.
      PubDate: Tue, 05 Nov 2019 00:00:00 GMT
      DOI: 10.1093/eurpub/ckz204
      Issue No: Vol. 30, No. 1 (2019)
  • Association between marital status and insomnia-related symptoms: findings
           from a population-based survey in Japan
    • Authors: Kawata Y; Maeda M, Sato T, et al.
      Pages: 144 - 149
      Abstract: AbstractBackgroundMarital status is one of the socio-economic factors associated with health. Several studies have indicated a significant association between marital status and insomnia. The increases in the percentages of unmarried people in Japan are expected to produce a significant impact on insomnia. The purpose of this study was to examine the association between marital status and insomnia.MethodsThe participants were 35 288 people aged 30–59 years selected from the 2010 comprehensive survey of living conditions. We categorized marital status into five groups: single, married couples living with other family members, married couples living without other family members, widowed and divorced. Insomnia-related symptoms (IRS) were based on the participants who chose the answer, ‘I couldn’t sleep’. Sex-specific multivariable odds ratios (ORs) and 95% confidence intervals (CI) of IRS according to marital status were calculated using the logistic regression model, which was adjusted for potential confounding factors.ResultsThe proportions of people with IRS were 2.5% in men and 2.8% in women. The multivariable ORs (95% CI) were 1.15 (0.89–1.49) for single, 1.69 (1.11–2.58) for divorced and 1.01 (0.73–1.39) for married couples living without other family members in men, and 1.56 (1.20–2.03) for single, 2.43 (1.83–3.22) for divorced and 1.31 (1.01–1.71) for married couples living without other family members in women.ConclusionsWe found divorced men and single, divorced and married women living without other family members had higher IRS than those who were married couples living with other family members in Japanese. This association was more evident in unemployed men.
      PubDate: Sat, 06 Jul 2019 00:00:00 GMT
      DOI: 10.1093/eurpub/ckz119
      Issue No: Vol. 30, No. 1 (2019)
  • Sedentary behaviour associations with health outcomes in people with
           severe mental illness: a systematic review
    • Authors: Bort-Roig J; Briones-Buixassa L, Felez-Nobrega M, et al.
      Pages: 150 - 157
      Abstract: AbstractBackgroundAlthough people with severe mental illness (SMI) show high sedentary behaviour (SB) levels, there is little research on how SB patterns influence health and which type of intervention is the most critical for reducing this behaviour. The aims of this study are to examine associations between SB and physical and mental health in people with SMI; and the extent to which physical activity interventions may effectively reduce SB.MethodsThis systematic review was conducted according to the PRISMA guidelines. Experimental and observational studies were searched in Medline, PsycInfo, Embase, CINHAL and Scopus up to June 2018. Eighteen studies (n = 15 observational; n = 3 experimental) met the inclusion criteria.ResultsBoth subjective and objective measurements for SB (an average of 8.5 and 10 h day−1, respectively) were positively associated with an increased cardiovascular and metabolic risk, worse global functioning, less quality of life, more severity of depressive symptoms, longer illness duration and higher doses of antipsychotic medication. Regarding intervention studies, active-lifestyle interventions (n = 2) reduced sedentary time (1.7–2.4 h day−1) while structured exercise (n = 1) reported no changes on SB.ConclusionsLevels of sedentariness in people with SMI are linked to an increased physical health risk, worse wellbeing and poorer mental health. Active-lifestyle interventions may be an indicated approach to reduce SB of people with SMI. However, a limited number of studies, their mixed quality and the heterogeneity of health outcomes made it difficult to provide robust conclusions on SB effects in people with SMI.Study protocol was registered to PROSPERO (CRD42017067592).
      PubDate: Thu, 21 Feb 2019 00:00:00 GMT
      DOI: 10.1093/eurpub/ckz016
      Issue No: Vol. 30, No. 1 (2019)
  • Psychotropic medication before and after disability retirement by
           pre-retirement perceived work-related stress
    • Authors: Halonen J; Chandola T, Hyde M, et al.
      Pages: 158 - 163
      Abstract: AbstractBackgroundRetirement has been associated with improved mental health, but it is unclear how much this is due to the removal of work-related stressors. We examined rates of psychotropic medication use before and after the transition to disability retirement due to mental, musculoskeletal and other causes by pre-retirement levels of perceived work stress (effort-reward imbalance, ERI).MethodsRegister-based date and diagnosis of disability retirement of 2766 participants of the Finnish Public Sector study cohort were linked to survey data on ERI, social- and health-related covariates, and to national records on prescribed reimbursed psychotropic medication, measured as defined daily doses (DDDs). Follow-up for DDDs was 2–5 years before and after disability retirement. We assessed differences in the levels of DDDs before and after retirement among those with high vs. low level of pre-retirement ERI with repeated measures regression.ResultsThose with high (vs. low) levels of ERI used slightly more psychotropic medication before disability retirement due to mental disorders [rate ratio (RR) 1.14, 95% confidence intervals (CI) 0.94–1.37], but after retirement this difference attenuated (RR 0.94, 95% CI 0.80–1.10, P for interaction 0.02). Such a change was not observed for the other causes of disability retirement.ConclusionsThe level of psychotropic medication use over the transition to disability retirement due to mental, but not musculoskeletal or other, causes was modified by pre-retirement perceived work-related stress. This suggests that among people retiring due to mental disorders those who had stressful jobs benefit from retirement more than those with low levels of work-related stress.
      PubDate: Sat, 20 Jul 2019 00:00:00 GMT
      DOI: 10.1093/eurpub/ckz131
      Issue No: Vol. 30, No. 1 (2019)
  • Night sleep duration and sleep initiation time with hypertension in
           Chinese rural population: the Henan Rural Cohort
    • Authors: Zhang H; Zhao X, Li Y, et al.
      Pages: 164 - 170
      Abstract: AbstractBackgroundThe study was conducted to evaluate the independent dose-response of the night sleep duration and sleep initiation time on hypertension, and to explore their combined effect with hypertension.MethodsParticipants from the Henan Rural Cohort were enrolled in this study. Information on sleep was collected using the Pittsburgh Sleep Quality Index. Hypertension was defined as systolic blood pressure/diastolic blood pressure ≥140/90 mmHg or self-reported hypertension and current use of anti-hypertensive medicines. Logistic regression and restricted cubic spline were conducted to evaluate the association of night sleep duration and sleep initiation time with hypertension.ResultsOf the 37 317 included participants, 12 333 suffered from hypertension. 14 474 (38.79%) were men and 22 843 (61.21%) were women, the mean age were 57.18 ± 12.10 and 55.24 ± 11.98 in men and women. Compared to reference (7–h), fully adjusted odd ratios (ORs) and 95% confidence interval (CI) of hypertension were 0.91 (0.66–1.25) in <5 h group and 1.74 (1.41–2.16) in ≥10 h among men, respectively. Fully adjusted ORs (95% CIs) for hypertension compared with reference (21:00–22:00) were 1.05 (95% CI 0.78–1.41) in the <20:00 group, 1.52 (1.25–1.85) in ≥24:00 in men. The combined effect of sleep duration and sleep initiation time on hypertension were statistically significant in the category of (≥8 h)/night and ≥24:00 (OR 1.87, 95% CI 1.07–3.25) compared to reference in fully adjusted model among men.ConclusionsLong night sleep duration and late sleep initiation time were associated with the higher odds of hypertension, and the sleep duration and sleep initiation time might cumulatively increase the prevalence of hypertension in men.Clinical trial registrationThe Henan Rural Cohort Study has been registered at the Chinese Clinical Trial Register (Registration number: ChiCTR-OOC-15006699).' proj=11375.
      PubDate: Mon, 26 Aug 2019 00:00:00 GMT
      DOI: 10.1093/eurpub/ckz142
      Issue No: Vol. 30, No. 1 (2019)
  • Effectiveness of a school food aid programme in improving household food
           insecurity; a cluster randomized trial
    • Authors: Dalma A; , Petralias A, et al.
      Pages: 171 - 178
      Abstract: AbstractBackgroundAim of this cluster randomized trial was to examine the impact of a school feeding programme combining healthy meals provision and educational activities to reduce food insecurity.MethodsSchools participating in the DIATROFI Program in Greece during the 2014–2015 school year were randomly allocated between a multicomponent intervention (MI: each student received a daily healthy meal along with educational actions; 28 schools) and an educational intervention (EI; 23 schools). A linear-mixed model was used to examine intervention effect on change from baseline in the food insecurity score, as measured via the Food Security Survey Module (FSSM). The analysis was based on 1442 pre–post intervention questionnaire pairs in the MI group and 986 in the EI group.ResultsThe reduction in food insecurity score in the MI group was statistically significantly greater compared to the EI group, by 9.8% or −0.31 [95% confidence interval (CI) −0.61 to −0.01] FSSM units after adjusting for potential confounders. MI intervention was significantly more effective compared to EI, among students in food insecure households (mean −0.44, 95% CI −0.84 to −0.04), students in households facing hunger (mean −1.04, 95% CI −1.91 to −0.17) and overweight/obese students (mean −0.36, 95% CI −0.72 to −0.01).ConclusionFor interventions aiming to address childhood food insecurity, public health focus should be oriented towards school-based programmes combining food assistance with activities that promote healthy nutrition.
      PubDate: Fri, 24 May 2019 00:00:00 GMT
      DOI: 10.1093/eurpub/ckz091
      Issue No: Vol. 30, No. 1 (2019)
  • Evaluating reach, adoption, implementation and maintenance of
           Internet-based interventions to prevent eating disorders in adolescents: a
           systematic review
    • Authors: Zeiler M; Kuso S, Nacke B, et al.
      Pages: 179 - 188
      Abstract: AbstractBackgroundPast research has yielded promising results on the effectiveness of Internet-based interventions to prevent eating disorders (EDs) in adolescents, but further information is needed to evaluate the public health impact of their large-scale dissemination. This article used an established framework to systematically review the extent to which indicators of the reach, effectiveness, adoption, implementation and maintenance [cf. Reach-Effectiveness-Adoption-Implementation-Maintenance (RE-AIM)-framework] of universal and targeted online ED prevention programmes are reported in the literature, in order to estimate their future dissemination potential.MethodsThe literature search was conducted on PubMed, Web of Science and PsycINFO, and complemented by searching existing reviews and the reference lists of the studies included. Twenty-two studies published between 2000 and April 2019 met the inclusion criteria. We extracted data on a total of 43 indicators, within RE-AIM dimensions for each article, including qualitative coding of fostering and hindering factors.ResultsReach (55.0%) and implementation (54.0%) were the dimensions reported on most frequently, followed by effectiveness (46.8%), adoption (34.7%) and maintenance (18.2%). While internal validity indicators were frequently reported (e.g. sample size, effects and intervention intensity), most studies failed to report on elements of external validity, such as representativeness of participants and settings, adoption rates, implementation costs and programme sustainability.ConclusionsEvidence indicates that Internet-based ED prevention programmes can reach a large number of adolescents and can be feasibly implemented in school settings. However, given the paucity of large-scale dissemination studies available for review, the degree to which schools are willing to adopt preventive interventions, as well as the transferability of programmes to different settings and geographical regions remains unclear.
      PubDate: Tue, 13 Aug 2019 00:00:00 GMT
      DOI: 10.1093/eurpub/ckz130
      Issue No: Vol. 30, No. 1 (2019)
  • Regional variation in type 2 diabetes: evidence from 137 820 adults on the
           role of neighbourhood body mass index
    • Authors: Dekker L; Rijnks R, Navis G.
      Pages: 189 - 194
      Abstract: AbstractBackgroundBody mass index (BMI) is a key covariate in the study of type 2 diabetes, but can also be theorized as a contextual effect. The purpose of this study was to explore the extent to which variation in individual risk factors and neighbourhood BMI explain the variation in type 2 diabetes prevalence across neighbourhoods and municipalities.MethodsCross-sectional data were collected from 137 820 adults aged ≥18 years from 3296 neighbourhoods in 296 municipalities in the Northern Netherlands. The odds of type 2 diabetes was assessed using a multilevel model. Median odds ratios were calculated and choropleth maps were created to visually assess neighbourhood variation in type 2 diabetes prevalence.ResultsThe overall prevalence of type 2 diabetes was 4%, ranging from 0 to ≥10 and 0–7% across neighbourhoods and municipalities, respectively. Of the regional variation, 67.0 and 71.6% is explained through variation of individual risk factors at the neighbourhood and municipality level, respectively. Analysis on the smallest spatial scale, i.e. the neighbourhood, best captured the regional variance. Statistically significant interaction between individual and neighbourhood BMI was found (OR = 1.06; 95% CI = 1.03–1.08, P for interaction < 0.001), adjusted for the individual risk profile.ConclusionThe results suggest a more cautious interpretation of neighbourhood effects in type 2 diabetes is warranted, and reveals the need for further investigation into risk-prone groups to guide the design of community-level interventions to halt the rise in type 2 diabetes prevalence.
      PubDate: Tue, 21 May 2019 00:00:00 GMT
      DOI: 10.1093/eurpub/ckz085
      Issue No: Vol. 30, No. 1 (2019)
  • Youth to adult body mass index trajectories as a predictor of
           metabolically healthy obesity in adulthood
    • Authors: Smith K; Magnussen C, Pahkala K, et al.
      Pages: 195 - 199
      Abstract: AbstractBackgroundAdiposity in childhood and adolescence (youth) has been shown to associate with adult metabolic health. What is not known, is whether youth body mass index (BMI) associates with metabolically healthy obesity (MHO) in adulthood, and if so, the age when the BMI to MHO association emerges. This study aimed to determine if BMI trajectories from youth to adulthood differed between adults with MHO and metabolically unhealthy obesity (MUHO).MethodsThe Cardiovascular Risk in Young Finns Study had measured weight and height up to eight times in individuals from youth (3–18 years in 1980) to adulthood (24–49 years). Adult MHO was defined as BMI ≥ 30 kg m−2, normal fasting glucose (<5.6 mmol l−1), triglycerides (<1.695 mmol l−1), high density lipoprotein cholesterol (≥1.295 mmol l−1 females, ≥1.036 mmol l−1 males), blood pressure (<130/85 mmHg) and no medications for these conditions. BMI trajectories were compared for adults with MHO and MUHO using multilevel mixed models adjusted for age, sex and follow-up time.ResultsMean (SD) follow-up time was 29 (3) years. Five hundred and twenty-four participants were obese in adulthood, 66 (12.6%) had MHO. BMI was similar through childhood, adolescence and young adulthood. BMI trajectories diverged at age 33, when individuals with MHO had at least 1.0 kg m−2 lower BMI than those with MUHO, significantly lower at 36 (−2.1 kg m−2, P = 0.001) and 42 years (−1.7 kg m−2; P = 0.005).ConclusionAdult MHO was characterized by lower adult BMI, not youth BMI. Preventing additional weight gain among adults who are obese may be beneficial for metabolic health.
      PubDate: Thu, 06 Jun 2019 00:00:00 GMT
      DOI: 10.1093/eurpub/ckz109
      Issue No: Vol. 30, No. 1 (2019)
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