Hybrid journal (It can contain Open Access articles) ISSN (Print) 1101-1262 - ISSN (Online) 1464-360X Published by Oxford University Press[415 journals]
Authors:Allebeck P; Paget D, Nagyova I. Pages: 1 - 1 Abstract: The publishing landscape is rapidly shifting. A few decades ago, almost all journals were based on subscriptions, paid by libraries, universities and research institutes. During this century, we have seen a strong growth of open access journals, where the cost of publishing is covered by authors. PubDate: Wed, 27 Jan 2021 00:00:00 GMT DOI: 10.1093/eurpub/ckaa231 Issue No:Vol. 31, No. 1 (2021)
Authors:Todd A; Bambra C. Pages: 2 - 2 Abstract: ‘This virus does not discriminate’ was a phrase frequently used by politicians across the world to emphasize that no one is free of risk when it comes to contracting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Whilst there is no discrimination based on the pathogenicity of the virus, there is social discrimination—based on the inequalities inherent within the society in which we live in. Indeed, people from black, Asian and minority ethnic (BAME) groups, as well as those living in more deprived areas are more likely to be infected by SARS-CoV-2, as well as having poorer outcomes from the disease. In countries including England and Sweden, for example, mortality rates are more than twice as high for people living in the most deprived areas, compared to those living in the most affluent.1 Similarly, after adjusting for the effect of sex, age, deprivation and region, people of Bangladeshi ethnicity have around twice the risk of death when compared to people of White British ethnicity. These socioeconomic and ethnic inequalities, in both COVID-19 prevalence and mortality, have been reported in different health systems across Europe and America.1 As Bambra et al. have argued, for the most disadvantaged communities in our society, COVID-19 is experienced as a syndemic—that is, a co-occurring synergistic pandemic, which interacts with, and is exacerbated by, chronic health and unequal social conditions.1 PubDate: Wed, 27 Jan 2021 00:00:00 GMT DOI: 10.1093/eurpub/ckaa243 Issue No:Vol. 31, No. 1 (2021)
Authors:Bhopal R; Gruer L, Agyemang C, et al. Pages: 3 - 4 Abstract: The first World Congress on Migration, Ethnicity, Race and Health took place in Edinburgh, Scotland in 2018, jointly hosted by the European Public Health Association (EUPHA) with the scientific abstracts published by the EJPH.1 Migration, ethnicity and race are sensitive yet unavoidable topics in today’s globalized, multicultural societies.2 Their impact on health and well-being is beyond doubt, but understanding how and why and addressing the consequent disparities and injustices are huge global challenges. The aim of the Congress was to bring together researchers, practitioners, community members, activists and policymakers from across the world who were working on at least one of these three intersecting health-related topics. It was driven by a vision that much would be gained by sharing information, insights and concerns and working together to improve the health of all. At the outset, there was a fierce debate about its name, in particular about whether to include the word race. Some argued it was a discredited concept. It was decided to retain it while providing Congress participants with a glossary of definitions for migration, ethnicity, race and other related words, aimed at creating a shared vocabulary and enhancing mutual understanding.3 PubDate: Wed, 27 Jan 2021 00:00:00 GMT DOI: 10.1093/eurpub/ckaa191 Issue No:Vol. 31, No. 1 (2021)
Authors:Namer Y; Razum O. Pages: 4 - 5 Abstract: In their viewpoint, the Global Society on Migration, Ethnicity, Race and Health pen a cogent call to move beyond the discomfort and embrace the construct of ‘race’ in research on migration and health.1 They recognize the sources of this discomfort: race was utilized to create hierarchies in and across societies, which gave rise to unspeakable atrocities, from slavery to genocide and the Shoah. In many societies, these atrocities are still very recent, restorative justice or reparations have not materialized, and privileges earned from being placed higher in the hierarchy have had enduring legacy, generating multi-layered and multi-generational inequalities. PubDate: Wed, 27 Jan 2021 00:00:00 GMT DOI: 10.1093/eurpub/ckaa198 Issue No:Vol. 31, No. 1 (2021)
Authors:Yudell M. Pages: 5 - 6 Abstract: The concept of race has a troubled history in public health. From the infamous Tuskegee Study in the USA to the Nazi’s Final Solution, racial ideologies have long been utilized in public health, causing grievous harm to people and populations.1,2 PubDate: Wed, 27 Jan 2021 00:00:00 GMT DOI: 10.1093/eurpub/ckaa240 Issue No:Vol. 31, No. 1 (2021)
Authors:Hradsky O; Komarek A. Pages: 12 - 16 Abstract: BackgroundThe numbers of coronavirus disease 2019 (COVID-19) deaths per million people differ widely across countries. Often, the causal effects of interventions taken by authorities are unjustifiably concluded based on the comparison of pure mortalities in countries where interventions consisting different strategies have been taken. Moreover, the possible effects of other factors are only rarely considered.MethodsWe used data from open databases (European Centre for Disease Prevention and Control, World Bank Open Data, The BCG World Atlas) and publications to develop a model that could largely explain the differences in cumulative mortality between countries using non-interventional (mostly socio-demographic) factors.ResultsStatistically significant associations with the logarithmic COVID-19 mortality were found with the following: proportion of people aged 80 years and above, population density, proportion of urban population, gross domestic product, number of hospital beds per population, average temperature in March and incidence of tuberculosis. The final model could explain 67% of the variability. This finding could also be interpreted as follows: less than a third of the variability in logarithmic mortality differences could be modified by diverse non-pharmaceutical interventions ranging from case isolation to comprehensive measures, constituting case isolation, social distancing of the entire population and closure of schools and borders.ConclusionsIn particular countries, the number of people who will die from COVID-19 is largely given by factors that cannot be drastically changed as an immediate reaction to the pandemic and authorities should focus on modifiable variables, e.g. the number of hospital beds. PubDate: Wed, 27 Jan 2021 00:00:00 GMT DOI: 10.1093/eurpub/ckaa226 Issue No:Vol. 31, No. 1 (2021)
Authors:Fabiani M; Mateo-Urdiales A, Andrianou X, et al. Pages: 37 - 44 Abstract: BackgroundInternational literature suggests that disadvantaged groups are at higher risk of morbidity and mortality from SARS-CoV-2 infection due to poorer living/working conditions and barriers to healthcare access. Yet, to date, there is no evidence of this disproportionate impact on non-national individuals, including economic migrants, short-term travellers and refugees.MethodsWe analyzed data from the Italian surveillance system of all COVID-19 laboratory-confirmed cases tested positive from the beginning of the outbreak (20th of February) to the 19th of July 2020. We used multilevel negative-binomial regression models to compare the case fatality and the rate of admission to hospital and intensive care unit (ICU) between Italian and non-Italian nationals. The analysis was adjusted for differences in demographic characteristics, pre-existing comorbidities, and period of diagnosis.ResultsWe analyzed 213 180 COVID-19 cases, including 15 974 (7.5%) non-Italian nationals. We found that, compared to Italian cases, non-Italian cases were diagnosed at a later date and were more likely to be hospitalized {[adjusted rate ratio (ARR)=1.39, 95% confidence interval (CI): 1.33–1.44]} and admitted to ICU (ARR=1.19, 95% CI: 1.07–1.32), with differences being more pronounced in those coming from countries with lower human development index (HDI). We also observed an increased risk of death in non-Italian cases from low-HDI countries (ARR=1.32, 95% CI: 1.01–1.75).ConclusionsA delayed diagnosis in non-Italian cases could explain their worse outcomes compared to Italian cases. Ensuring early access to diagnosis and treatment to non-Italians could facilitate the control of SARS-CoV-2 transmission and improve health outcomes in all people living in Italy, regardless of nationality. PubDate: Fri, 08 Jan 2021 00:00:00 GMT DOI: 10.1093/eurpub/ckaa249 Issue No:Vol. 31, No. 1 (2021)
Authors:Mathisen J; Jensen N, Bjorner J, et al. Pages: 186 - 192 Abstract: BackgroundIn 2013, Denmark implemented a reform that tightened the criteria for disability pension, expanded a subsidized job scheme (‘flexi-job’) and introduced a new vocational rehabilitation scheme. The overall aim of the reform was to keep more persons attached to the labour market. This study investigates the impact of the reform among persons with chronic disease and whether this impact differed across groups defined by labour market affiliation and chronic disease type.MethodsThe study was conducted as a register-based, nationwide cohort study. The study population included 480 809 persons between 40 and 64 years of age, who suffered from at least one of six chronic diseases. Hazard ratios (HR) and 95% confidence intervals (CI) of being awarded disability pension or flexi-job in the 5 years after vs. the 5 years prior to the reform were estimated.ResultsOverall, the probability of being awarded disability pension was halved after the reform (HR = 0.49, CI: 0.47–0.50). The impact was largest for persons receiving sickness absence benefits (HR = 0.31, CI: 0.24–0.39) and for persons with functional disorders (HR = 0.38, CI: 0.32–0.44). Also, the impact was larger for persons working in manual jobs than for persons working in non-manual jobs. The probability of being awarded a flexi-job was decreased by one-fourth (HR = 0.76, CI: 0.74–0.79) with the largest impact for high-skilled persons working in non-manual jobs.ConclusionAccess to disability pension and flexi-job decreased after the reform. This impact varied according to labour market affiliation and chronic disease type. PubDate: Mon, 04 Jan 2021 00:00:00 GMT DOI: 10.1093/eurpub/ckaa228 Issue No:Vol. 31, No. 1 (2021)
Authors:Allebeck P; Delnoij D, Leyland A, et al. Pages: 238 - 240 Abstract: A scientific journal exists only because of the good will and assistance of its reviewers. We can only publish approximately a fifth of the papers we receive and, in order to publish really high-quality papers, we depend on the expertise of many people. During 2020 a total of 480 reviewers have helped us to decide about the papers that we should publish. Their names are listed below and we would like to take this opportunity to thank them. The list refers to reviewers completing their task until 1st of December 2020. PubDate: Wed, 27 Jan 2021 00:00:00 GMT DOI: 10.1093/eurpub/ckaa256 Issue No:Vol. 31, No. 1 (2021)
Authors:Naurin E; Markstedt E, Stolle D, et al. Pages: 7 - 13 Abstract: BackgroundOne of the groups that is most vulnerable to the COVID-19 pandemic is pregnant women. They cannot choose to refrain from care; they and their children are at risk of severe complications related to the virus; and they lose comfort and support as clinics prohibit their partners and as societal restrictions demand isolation from friends and relatives. It is urgent to study how this group is faring during the pandemic and we focus here on their health-related worries.MethodsA longitudinal survey at a Swedish hospital starting 6 months before (16 September 2019) and continuing during the COVID-19 outbreak (until 25 August 2020). A total of 6941 pregnant women and partners of diverse social backgrounds were recruited. Ninety-six percent of birth-giving women in the city take early ultrasounds where recruitment took place. Sixty-two percent of the women with an appointment and fifty-one percent of all partners gave consent to participate.ResultsPregnant women experienced dramatically increased worries for their own health, as well as for their partner’s and their child’s health in the beginning of the pandemic. The worries remained at higher than usual levels throughout the pandemic. Similar, but less dramatic changes were seen among partners.ConclusionsThere is a need for heightened awareness of pregnant women’s and partners’ health-related worries as a consequence of the COVID-19 pandemic. Related feelings, such as anxiety, have been linked to adverse pregnancy outcome and might have long-term effects. The healthcare system needs to prepare for follow-up visits with these families. PubDate: Tue, 24 Nov 2020 00:00:00 GMT DOI: 10.1093/eurpub/ckaa223 Issue No:Vol. 31, No. 1 (2020)
Authors:Tripepi G; Plebani M, Iervasi G, et al. Pages: 7 - 12 Abstract: BackgroundItaly was the second country in the world, after China, to be hit by SARS-CoV-2 pandemic. Italy’s experience teaches that steps to limit people’s movement by imposing ‘red zones’ need to be put in place early by carefully identifying the cities to be included within these areas of quarantine. The assessment of the relationship between the distance from an established outbreak of SARS-CoV-2 infection with transmission-linked cases and mortality observed in other sites could provide useful information to identify the optimal radius of red zones.MethodsWe investigated the relationship between SARS-CoV-2 cases and the distance of each Italian province from the first outbreak of SARS-CoV-2 epidemic in Italy (the city of Lodi placed in the Lombardia region). In 38 provinces of Lombardia and neighboring regions, we performed a breakpoint analysis to identify the radius of the red zone around Lodi minimizing epidemic spread and mortality in neighboring cities.ResultsIn all Italian provinces, a non-linear relationship was found between SARS-CoV-2 cases and distance from Lodi. In an analysis including the provinces of Lombardia and neighboring regions, SARS-CoV-2 cases and mortality increased when the distance from Lodi reduced below 92 and 140 km, respectively, and such relationships were amplified by ozone (O3) pollution.ConclusionsThe breakpoint analysis identifies the radius around the outbreak of Lodi minimizing the public health consequences of SARS-CoV-2 in neighboring cities. Such an approach can be useful to identify the red zones in future epidemics due to highly infective pathogens similar to SARS-CoV-2. PubDate: Tue, 24 Nov 2020 00:00:00 GMT DOI: 10.1093/eurpub/ckaa221 Issue No:Vol. 31, No. 1 (2020)
Authors:Van der Ploeg C; Grevinga M, Eekhout I, et al. Pages: 7 - 12 Abstract: BackgroundLittle is known about costs and effects of vision screening strategies to detect amblyopia. Aim of this study was to compare costs and effects of conventional (optotype) vision screening, photoscreening or a combination in children aged 3–6 years.MethodsPopulation-based, cross-sectional study in preventive child health care in The Hague. Children aged 3 years (3y), 3 years and 9 months (3y9m) or 5–6 years (5/6y) received the conventional chart vision screening and a test with a photoscreener (Plusoptix S12C). Costs were based on test duration and additional costs for devices and diagnostic work-up.ResultsTwo thousand, one hundred and forty-four children were included. The estimated costs per child screened were €17.44, €20.37 and €6.90 for conventional vision screening at 3y, 3y9m and 5/6y, respectively. For photoscreening, these estimates were €6.61, €7.52 and €9.40 and for photoscreening followed by vision screening if the result was unclear (combination) €9.32 (3y) and €9.33 (3y9m). The number of children detected with amblyopia by age were 9, 14 and 5 (conventional screening), 6, 13 and 3 (photoscreening) and 10 (3y) and 15 (3y9m) (combination), respectively. The estimated costs per child diagnosed with amblyopia were €1500, €1050 and €860 for conventional vision screening, €860, €420 and €1940 for photoscreening and €730 (3y) and €450 (3y9m) for the combination.ConclusionsCombining photoscreening with vision screening seems promising to detect amblyopia in children aged 3y/3y9m, whereas conventional screening seems preferable at 5/6y. As the number of study children with amblyopia is small, further research on the effects of these screening alternatives in detecting children with amblyopia is recommended. PubDate: Mon, 07 Sep 2020 00:00:00 GMT DOI: 10.1093/eurpub/ckaa098 Issue No:Vol. 31, No. 1 (2020)
Authors:Asgeirsdottir B; Kristjansson A, Sigfusson J, et al. Pages: 7 - 12 Abstract: BackgroundSince the implementation of the Icelandic Model for Primary Prevention of Substance Use in Iceland (IPM), substance use has decreased steadily among 14–16-year-old adolescents and primary prevention factors have improved. Although the IPM is being implemented in several other regions around the world, information documenting its effectiveness in other country contexts is lacking. This study assessed trends in substance use and primary prevention variables in three cities in Lithuania following the implementation of the IPM.MethodsData collected from repeated, comparative cross-sectional self-report surveys conducted among a total of 30 572 10th graders in the cities of Kaunas, Klaipeda and Vilnius, Lithuania, from 2006 to 2019, were analyzed. Cochran–Armitage test for linear trend and analysis of variance for linear trend was used to assess time-trends in prevalence of substance use and mean levels of primary prevention variables over time.ResultsFollowing the implementation of IPM rates of cigarette smoking and the use of alcohol, cannabis and amphetamine has decreased among 10th graders in Lithuania’s three largest cities and simultaneously preventive variables targeted have improved. Similar to Iceland, primary prevention variables were related to substance use in the expected direction, with the exception of organized sports participation, which was not associated with less likelihood of alcohol, cannabis and amphetamine use.ConclusionTrends in substance use and primary prevention variables following the implementation of the IPM are similar in the three cities in Lithuania as in Iceland. Further research is needed to better understand the mechanisms underlying these trends. PubDate: Thu, 27 Aug 2020 00:00:00 GMT DOI: 10.1093/eurpub/ckaa097 Issue No:Vol. 31, No. 1 (2020)
Authors:Modig K; Ahlbom A, Ebeling M. Pages: 17 - 22 Abstract: BackgroundSweden has one of the highest numbers of COVID-19 deaths per inhabitant globally. However, absolute death counts can be misleading. Estimating age- and sex-specific mortality rates is necessary in order to account for the underlying population structure. Furthermore, given the difficulty of assigning causes of death, excess all-cause mortality should be estimated to assess the overall burden of the pandemic.MethodsBy estimating weekly age- and sex-specific death rates during 2020 and during the preceding 5 years, our aim is to get more accurate estimates of the excess mortality attributed to COVID-19 in Sweden, and in the most affected region Stockholm.ResultsEight weeks after Sweden’s first confirmed case, the death rates at all ages above 60 were higher than for previous years. Persons above age 80 were disproportionally more affected, and men suffered greater excess mortality than women in ages up to 75 years. At older ages, the excess mortality was similar for men and women, with up to 1.5 times higher death rates for Sweden and up to 3 times higher for Stockholm. Life expectancy at age 50 declined by <1 year for Sweden and 1.5 years for Stockholm compared to 2019.ConclusionsThe excess mortality has been high in older ages during the pandemic, but it remains to be answered if this is because of age itself being a prognostic factor or a proxy for comorbidity. Only monitoring deaths at a national level may hide the effect of the pandemic on the regional level. PubDate: Tue, 10 Nov 2020 00:00:00 GMT DOI: 10.1093/eurpub/ckaa218 Issue No:Vol. 31, No. 1 (2020)
Authors:Lee P; Marek J, Nálevka P. Pages: 23 - 30 Abstract: BackgroundTo stop the spread of the new coronavirus disease in 2019 (COVID-19), many countries had completely locked down. This lockdown restricted the everyday life of the affected residents and changed their mobility pattern, but its effects on sleep pattern were largely unknown.MethodsHere, utilizing one of the largest crowdsourced database (Sleep as Android), we analyzed the sleep pattern of 25 217 users with 1 352 513 sleep records between 1 January and 29 April 2020 in the US and 16 European countries (Germany, UK, Spain, France, Italy, The Netherlands, Belgium, Hungary, Denmark, Finland, Norway, Czech, Sweden, Austria, Poland and Switzerland) with more than 100 records in all days of 2020.ResultsDuring the COVID-19 pandemic, the sleeping pattern before and after the country-level lockdown largely differed. The subjects increased their sleep duration by an average of 11.3 to 18.6 min on weekday nights, except Denmark (4.9 min) and Finland (7.1 min). In addition, subjects form all 16 European countries delayed their sleep onset from 10.7 min (Sweden) to 29.6 min (Austria).ConclusionDuring the COVID-19 pandemic, residents in the US and 16 European countries delayed their bedtime and slept longer than usual. PubDate: Tue, 17 Nov 2020 00:00:00 GMT DOI: 10.1093/eurpub/ckaa208 Issue No:Vol. 31, No. 1 (2020)
Authors:Stolz E; Mayerl H, Freidl W. Pages: 44 - 49 Abstract: BackgroundTo halt the spread of COVID-19, Austria implemented a 7-week ‘lockdown’ in March/April 2020. We assess whether the ensuing reduction in social contacts led to increased loneliness among older adults (60+).MethodsThree analyses were conducted: (i) a comparison between pre-pandemic (SHARE: 2013–17) and pandemic (May 2020) levels of loneliness (UCLA-3 scale), (ii) an assessment of the cross-sectional correlation between being affected by COVID-19 restriction measures and loneliness (May 2020) and (iii) a longitudinal analysis of weekly changes (March–June 2020) in loneliness (Corona panel).ResultsWe found (i) increased loneliness in 2020 compared with previous years, (ii) a moderate positive association between the number of restriction measures older adults were affected from and their loneliness and (iii) that loneliness was higher during ‘lockdown’ compared to the subsequent re-opening phase, particularly among those who live alone.ConclusionsWe found evidence that COVID-19 restriction measures in Austria have indeed resulted in increased levels of loneliness among older adults. However, these effects seem to be short-lived, and thus no strong negative consequences for older adults’ mental health are expected. Nonetheless, the effects on loneliness, and subsequent mental health issues, could be both more long-lasting and severe if future restriction measures are enacted repeatedly and/or over longer time periods. PubDate: Sat, 19 Dec 2020 00:00:00 GMT DOI: 10.1093/eurpub/ckaa238 Issue No:Vol. 31, No. 1 (2020)
Authors:Horstmann K; Buecker S, Krasko J, et al. Pages: 49 - 51 Abstract: To slow the spread of SARS-CoV-2, the German government released the ‘Corona-Warn-App’, a smartphone application that warns users if they have come into contact with other users tested positive for SARS-CoV-2. Since using the ‘Corona-Warn-App’ is health-relevant behavior, it is essential to understand who is (and who is not) using it and why. In N = 1972 German adults, we found that non-users were on average older, female, healthier, in training and had low general trust in others. The most frequently named reasons by non-users were privacy concerns, doubts about the effectiveness of the app and lack of technical equipment. PubDate: Sat, 19 Dec 2020 00:00:00 GMT DOI: 10.1093/eurpub/ckaa239 Issue No:Vol. 31, No. 1 (2020)
Authors:Ledda C; Rapisarda V, Maltezou H, et al. Pages: 56 - 56 Abstract: BackgroundVaccination of healthcare workers (HCWs) reduces the risk of occupational vaccine-preventable diseases (VPDs), prevents their nosocomial transmission and preserves healthcare delivery during outbreaks. Extensive implementation of vaccination programmes for HCWs allowed the elimination or control of several VPDs within healthcare facilities; despite these, the vaccine adherence rates among HCWs are persistently suboptimal.MethodsA questionnaire was self-administered by HCWs to assess their vaccination rates against several VPDs and self-reported immunity in two university hospitals of Southern Italy (Catania and Palermo).ResultsA total of 2586 questionnaires were analysed. More than 50% of HCWs did not know their own immunization status against diphtheria, tetanus and pertussis. More than half of the HCWs interviewed at University Hospital (UH) of Catania (UHC) was immune against measles (72.1%), in contrast with data reported at the UH of Palermo (UHP) (45.9%). Immunization status against mumps (67.5% UHC vs. 40.6% UHP), rubella (69.9% UHC vs. 46.6% UHP) and varicella (70.4% UHC vs. 50.7% UHP). Overall, about 30% of HCWs did not know their own immunization status against these VPDs. Moreover, 84.2% at UHC and 66.7% at UHP stated that was previously vaccinated against hepatitis B.ConclusionVaccination coverage rates reported from the HCWs against influenza during the last three seasons were considerably low. In conclusion, totally inadequate vaccination rates against several VPDs were found in two university hospitals in Sicily, in terms of preventing not only disease transmission by susceptible HCWs, but also nosocomial outbreaks, confirming data from previous national and international studies. PubDate: Thu, 01 Oct 2020 00:00:00 GMT DOI: 10.1093/eurpub/ckaa179 Issue No:Vol. 31, No. 1 (2020)
Authors:Santos J; Santos D, Arcencio R, et al. Pages: 57 - 62 Abstract: BackgroundTuberculosis (TB) causes pressure on healthcare resources, especially in terms of hospital admissions, despite being considered an ambulatory care-sensitive condition for which timely and effective care in ambulatory setting could prevent the need for hospitalization. Our objectives were to describe the spatial and temporal variation in pulmonary tuberculosis (PTB) hospitalizations, identify critical geographic areas at municipality level and characterize clusters of PTB hospitalizations to help the development of tailored disease management strategies that could improve TB control.MethodsEcologic study using sociodemographic, geographical and clinical information of PTB hospitalization cases from continental Portuguese public hospitals, between 2002 and 2016. Descriptive statistics, spatiotemporal cluster analysis and temporal trends were conducted.ResultsThe space–time analysis identified five clusters of higher rates of PTB hospitalizations (2002–16), including the two major cities in the country (Lisboa and Porto). Globally, we observed a −7.2% mean annual percentage change in rate with only one of the identified clusters (out of six) with a positive trend (+4.34%). In the more recent period (2011–16) was obtained a mean annual percentage change in rate of −8.12% with only one cluster identified with an increase trend (+9.53%).ConclusionsOur results show that space–time clustering and temporal trends analysis can be an invaluable resource to monitor the dynamic of the disease and contribute to the design of more effective, focused interventions. Interventions such as enhancing the detection of active and latent infection, improving monitoring and evaluation of treatment outcomes or adjusting the network of healthcare providers should be tailored to the specific needs of the critical areas identified. PubDate: Tue, 29 Sep 2020 00:00:00 GMT DOI: 10.1093/eurpub/ckaa161 Issue No:Vol. 31, No. 1 (2020)
Authors:King E; Yakovleva A, Lisecki S, et al. Pages: 63 - 67 Abstract: BackgroundThere are over 1 million people living with HIV in Russia, and less than half of them are on antiretroviral treatment (ART). Earlier in the epidemic, Russia was successful in implementing prevention of mother-to-child transmission programmes; however, there is a gap in knowledge about postpartum adherence to ART among women living with HIV (WLHIV). The objective of our research study was to identify which factors are associated with postpartum engagement in HIV care and treatment in Russia.MethodsWe conducted a community-based participatory research study in five Russian cities. We surveyed 200 WLHIV who had given birth within the previous 24 months about their use of ART. We used multivariable logistic regression to determine which types of social support are associated with adherence to ART in the postpartum period.ResultsLess than half (40%) of mothers reported being adherent to ART. Multivariable analysis showed that having a supportive family environment [aOR = 2.64, 95% CI (1.91–5.83)], and active engagement with other HIV-positive mothers [aOR = 2.20, 95% CI (1.04–4.66)] were positively associated with postpartum adherence to ART. WLHIV who had more than one child were less likely to be adherent then WLHIV with just one child [aOR = 0.44, 95% CI (0.22–0.91)].ConclusionThe support that new mothers have or do not have can play an important role in WLHIV adherence to ART. The findings from our study provide ideas for improving the likelihood that women will continue to engage in HIV treatment and care after pregnancy. PubDate: Sun, 20 Sep 2020 00:00:00 GMT DOI: 10.1093/eurpub/ckaa133 Issue No:Vol. 31, No. 1 (2020)
Authors:Martino C; Rampacci E, Pierini I, et al. Pages: 68 - 72 Abstract: BackgroundPigs are considered the main reservoir of genotypes 3 and 4 of hepatitis E virus (HEV), which is the major cause of acute hepatitis of viral origin in humans worldwide. An increasing number of autochthonous HEV infections have been observed in recent years in industrialized countries, most likely as a result of zoonotic transmission through the consumption of raw or undercooked meat products.MethodsTwo hundred and thirty-three blood and liver samples were collected at four different local slaughterhouses from domestic pigs bred in Abruzzo, a region of south-central Italy, where there is the highest human seroprevalence to HEV compared with the rest of Italy. An indirect enzyme-linked immunosorbent assay kit was used for detecting anti-HEV IgG in the sera, while the presence of HEV RNA was investigated by performing a real-time reverse transcriptase-polymerase chain reaction (RT-PCR).ResultsBetween 87.3% and 100% of swine serum samples collected in different slaughterhouses of Abruzzo were positive for anti-HEV antibodies. Conversely, none of the liver samples collected from the same animals were positive for HEV by real-time RT-PCR.ConclusionsThe hypothesis of foodborne zoonotic transmission from local pigs as responsible for the hyperendemic status of Abruzzo cannot be corroborated. However, the high seroprevalence observed in pigs indicates that HEV is highly circulating in these territories. We propose to further investigate the role of wild fauna and trade in carrier pigs, and the maintenance of HEV virulence in the environment and meat supply chain to shed light on the possible sources of human infection and the degree of occupational risk. PubDate: Fri, 24 Jul 2020 00:00:00 GMT DOI: 10.1093/eurpub/ckaa112 Issue No:Vol. 31, No. 1 (2020)
Authors:Scholtes B; Breinbauer M, Rinnenburger M, et al. Pages: 73 - 79 Abstract: BackgroundThe extent to which patients are involved in their care can be influenced by hospital policies and interventions. Nevertheless, the implementation of patient participation and involvement (PPI) at the organisational (meso) level has rarely been assessed systematically. The aim of this study was to assess the occurrence of PPI practises in hospitals in Belgium, France, Germany and Luxembourg and to analyze if, and to what extent, the hospital vision and the presence of a patient committee influence the implementation of PPI practises.MethodsA cross-sectional study was carried out using an online questionnaire in hospitals in the border regions of the four countries. The data were analyzed for differences between regions and the maturity of PPI development.ResultsFull responses were obtained from 64 hospitals. A wide range of practices were observed, the degree of maturity was mixed. A majority of hospitals promoted patient partnership in the hospital’s philosophy of care statement. However, the implementation of specific interventions for PPI was not found uniformly and differences could be observed between the countries.ConclusionsHospitals in the region seem to be motivated to include patients more fully, however, implementation of PPI interventions seems incomplete and only partially integrated into the general functioning of the hospitals. The implementation of the concept seems to be more mature in the francophone part of the region perhaps due, in part, to a more favourable political context. PubDate: Thu, 24 Sep 2020 00:00:00 GMT DOI: 10.1093/eurpub/ckaa153 Issue No:Vol. 31, No. 1 (2020)
Authors:Maharani A; Dawes P, Nazroo J, et al. Pages: 79 - 86 Abstract: BackgroundSocioeconomic status is associated with health status among older adults, including hearing and vision impairments, and healthcare system performance is an important consideration in examining that association. We explored the link between a country’s healthcare system performance and the hearing and visual impairments of its people in Europe.MethodsThis study enrolled 65 332 individuals aged 50+ from 17 countries participating in the Survey of Health, Ageing and Retirement in Europe Wave 6. We used latent class analysis to identify groups of countries based on six domains of healthcare system performance. We then performed multiple logistic regressions to quantify the association between socioeconomic status and hearing and visual impairments adjusted for demographic and other co-variates; finally, we compared the patterns of observed associations in each of the country groups.ResultsThe latent class analysis separated countries into three groups based on the performance of their healthcare systems: poor, moderate and high. Respondents in countries with moderate and poor healthcare performance were more likely to experience hearing and visual impairment than those in countries with high healthcare performance. With respect to hearing and visual impairments, wealth gradients at the individual level varied among countries in different healthcare performance groups, with less wealth associated with worse hearing and seeing only in the countries with moderate and poor healthcare performance.ConclusionThe relationships between wealth and hearing and visual impairments differ among countries with different healthcare performance. PubDate: Tue, 06 Oct 2020 00:00:00 GMT DOI: 10.1093/eurpub/ckaa155 Issue No:Vol. 31, No. 1 (2020)
Authors:Spaak M; Cipriano M, Alla F, et al. Pages: 87 - 92 Abstract: Background—We aimed to identify the knowledge producers, the knowledge that they produce and the main areas of interest for health services research (HSR) in France, which is one of the priorities for public health research planning.Methods—A two-phase approach comprising a bibliometric analysis and semi-structured interviews with 20 researchers and 13 staff members of public health bodies was used.Results—In France today, interdisciplinary research teams are being organized in the main cities despite a lack of critical mass. The interviews showed that the term ‘health services research’ is vague with fuzzy boundaries between research, scientific expertise and evaluation. A keyword cluster analysis showed that French HSR is more hospital-centric compared to those countries that publish most frequently. The analysis also revealed a lack of research on methodological aspects.Conclusions—We analyzed the structure of HSR in France and the specificity of the French publications in this field, compared with other countries. The results indicate the obstacles faced by researchers and decision-makers and offer insight into how these barriers may be removed. PubDate: Sun, 29 Nov 2020 00:00:00 GMT DOI: 10.1093/eurpub/ckaa199 Issue No:Vol. 31, No. 1 (2020)
Authors:Zdunek K; Schröder-Bäck P, Alexander D, et al. Pages: 92 - 99 Abstract: BackgroundEvidence-based policies should underpin successful implementation of innovations within child health care. The EU-funded Models of Child Health Appraised project enabled research into effective methods to communicate research evidence. The objective of this study was to identify and categorize methods to communicate evidence-based research recommendations and means to tailor this to stakeholder audiences.MethodsWe conducted an online survey among national stakeholders in child health. Analysis of the most effective strategies to communicate research evidence and reach the target audience was carried out in order to ensure implementation of optimal child health care models at a national level.ResultsRepresentatives of stakeholders from 21 of the then 30 EU MS and EEA countries responded to the questionnaire. Three main approaches in defining the strategies for effective communication of research recommendations were observed, namely: dissemination of information, involvement of stakeholders and active attitude towards change expressed in actions. The target audience for communicating recommendations was divided into two layers: proximal, which includes those who are remaining in close contact with the child, and distal, which contains those who are institutionally responsible for high quality of child health services. They should be recipients of evidence-based results communicated by different formats, such as scientific, administrative, popular and personal.ConclusionsInfluential stakeholders impact the process of effective research dissemination and guide necessary actions to strengthen the process of effective communication of recommendations. Communication of evidence-based results should be targeted to each audience’s profile, both professional and non-professionals, by adjusting appropriate communication formats. PubDate: Thu, 17 Dec 2020 00:00:00 GMT DOI: 10.1093/eurpub/ckaa234 Issue No:Vol. 31, No. 1 (2020)
Authors:Liu W; Schwertz R, Welker A, et al. Pages: 105 - 111 Abstract: BackgroundPrevalence of overweight and obesity in Germany is increasing. High body weight can affect children’s growth and development. This paper aimed to determine the association between body mass index (BMI) and visual impairment among preschool children and explore the potential role of obesity in predicting visual developmental disorder.MethodsSix consecutive years of data from the School Entry Examination were collected for all preschool children aged from 4 to 6 years residing in Rhine-Neckar County and the City of Heidelberg, Germany from 2013 to 2018. Univariate and multivariate regression were used to analyze the complete data, multiple imputation was used to deal with missing data.ResultsAmong the group with an immigrant background, children with obesity [OR = 1.20, 99% (1.02–1.42)] were more likely to have visual impairment compared to those with normal body weight (P < 0.01) after adjusting for survey year, age, and gender of children, education and occupation of parents, screen time-frequency, whether a television was in their bedroom, and quality of preschool outdoor environment.ConclusionThere were significant associations between obesity and visual impairment among German preschool children with immigrant backgrounds. Strategies to support vulnerable groups were needed across all regional schools. PubDate: Wed, 28 Oct 2020 00:00:00 GMT DOI: 10.1093/eurpub/ckaa185 Issue No:Vol. 31, No. 1 (2020)
Authors:Augustynowicz A; Waszkiewicz M, Szopa S, et al. Pages: 111 - 115 Abstract: BackgroundIn Poland, between 1989 and 2018 the number of the elderly increased by over 3.9 million. Demographic changes justify a senior policy focussed on the longest possible social, professional and family activity of the elderly. Directions of undertaken actions should include health policy programmes aimed at creating conditions healthy and active life of the elderly. The programmes should be particularly important in rural areas as the health of rural and urban residents differs. The study presents programmes for creating conditions for a healthy and active life of the elderly run by rural and urban-rural communes in 2012–17.MethodsThe study was conducted on the basis of existing data analysis. Data from the summary information prepared by voivodes and provided to the Minister of Health about implemented health policy programmes were used. Data on programmes concerning a healthy and active life for the elderly conducted by rural and urban-rural communes between 2012 and 2017 were extracted from the aggregate information.ResultsBetween 2012 and 2017, 354 programmes were implemented, the most in 2016, and the least in 2015. There were 171 000 people participating in the programmes. The total cost was USD 2 491 664.ConclusionIt can be presumed that in 2016 communes implemented more diagnostic and therapeutic programmes than in 2017. A small number of programmes and a small involvement of financial resources in communes with the largest number of the elderly may indicate marginalization of the importance of an active and healthy life for the elderly. PubDate: Sun, 30 Aug 2020 00:00:00 GMT DOI: 10.1093/eurpub/ckaa154 Issue No:Vol. 31, No. 1 (2020)
Authors:Norheim K; Bøggild H, Andersen J, et al. Pages: 116 - 121 Abstract: BackgroundThe frailty phenotype is predictive of mortality and has been identified in the working population. This cross-sectional study aimed to investigate the prevalence of frailty and individual frailty symptoms among active and retired Danish manual workers and to delineate the relationship between frailty and lifestyle factors.MethodsManual workers aged 50–70 years answered questions relating to the Fried criteria for frailty (weight loss, exhaustion, slowness, weakness and inactivity). Only men were included in the analyses and respondents were stratified according to work status: active workers (n = 1555), early retirees (n = 289) and workers retired at or after normal pension age (n = 291). Associations between pre-frailty/frailty, work status and various lifestyle factors were estimated using binomial logistic regression.ResultsOverall, the prevalence of pre-frailty (one or two symptoms) and frailty (three or more symptoms) was 33.3% and 1.5%, respectively. Those who had retired early were more likely to be pre-frail/frail compared with active workers (odds ratio 2.20, 95% CI 1.61–3.01). Exhaustion was the most prominent symptom reported by 22.2% of active workers, 34.6% of early retirees and 16.5% of workers retired at normal retirement age. Lifestyle factors including obesity, physical inactivity and smoking but not alcohol intake were associated with pre-frailty/frailty.ConclusionSymptoms of frailty are identifiable and present among both active and retired manual workers. Data suggest discrepancies among Danish manual workers, with some having unhealthy lifestyles and being more prone to develop pre-frailty and frailty already in their sixth decade of life. PubDate: Tue, 10 Nov 2020 00:00:00 GMT DOI: 10.1093/eurpub/ckaa188 Issue No:Vol. 31, No. 1 (2020)
Authors:Valenzuela M; Waterhouse B, Aggarwal V, et al. Pages: 122 - 129 Abstract: BackgroundThe impact of consumption of sugar-sweetened beverages (SSB) on health outcomes such as obesity have been studied extensively, but oral health has been relatively neglected. This study aims to assess the association between SSB consumption and dental caries and erosion.MethodsSystematic review of observational studies. Search strategy applied to Medline, Embase, Cochrane Library, SciELO, LILACS, OpenGrey and HMIC. The risk of bias was assessed using the NIH Quality Assessment Tool for Observational Cross-Sectional Studies and evidence certainty using Grading of Recommendation Assessment Development and Evaluation. Relationships between SSB consumption and caries and erosion were estimated using random-effects model meta- and dose–response analyses.ResultsA total of 38 cross-sectional studies were included, of which 26 were rated as high quality. Comparing moderate-to-low consumption, there was significantly increased risk of both caries [OR = 1.57, 95% CI: 1.28–1.92; decayed, missing and filled teeth weighted mean differences (DMFT WMD) = 0.82, 95% CI: 0.38–1.26] and erosion (OR = 1.43, 95% CI: 1.01–2.03). Comparing high-to-moderate consumption, there was further increased risk of caries (OR = 1.53, 95% CI: 1.17–1.99; DMFT WMD = 1.16, 95% CI: −0.59–2.91) and erosion (OR = 3.09, 95% CI: 1.37–6.97). A dose–response gradient and high certainty of evidence was observed for caries.ConclusionsIncreasing SSB consumption is associated with increased risk of dental caries and erosion. Studies were cross-sectional, hence temporality could not be established, but the positive dose–response suggests this relationship is likely to be causal. These findings illustrate the potential benefits to oral health of policies that reduce SSB consumption, including sugar taxation. PubDate: Sun, 23 Aug 2020 00:00:00 GMT DOI: 10.1093/eurpub/ckaa147 Issue No:Vol. 31, No. 1 (2020)
Authors:González C; Bonet C, de Pablo M, et al. Pages: 130 - 135 Abstract: BackgroundEvidence from the scientific literature shows a significant variation in greenhouse gas (GHG) emissions from the diet, according to the type of food consumed. We aim to analyze the relationship between the daily dietary GHG emissions according to red meat, fruit and vegetables consumption and their relationship with risk of total mortality, and incident risk of chronic diseases.MethodsWe examined data on the EPIC-Spain prospective study, with a sample of 40 621 participants. Dietary GHG emission values were calculated for 57 food items of the EPIC study using mean emission data from a systematic review of 369 published studies.ResultsDietary GHG emissions (kgCO2eq/day), per 2000 kcal, were 4.7 times higher in those with high red-meat consumption (>140 g/day) than those with low consumption (<70 g/day). The average dietary GHG emissions were similar in males and females, but it was significantly higher in youngest people and in those individuals with lower educational level, as well as for northern EPIC centers of Spain. We found a significant association with the risk of mortality comparing the third vs. the first tertile of dietary GHG emissions [hazard ratio (HR) 1.095; 95% confidence interval (CI) 1.007–1.19; trend test 0.037]. Risk of coronary heart disease (HR 1.26; 95% CI 1.08–1.48; trend test 0.003) and risk of type 2 diabetes (HR 1.24; 95% CI 1.11–1.38; trend test 0.002) showed significant association as well.ConclusionsDecreasing red-meat consumption would lead to reduce GHG emissions from diet and would reduce risk of mortality, coronary heart disease and type 2 diabetes. PubDate: Thu, 01 Oct 2020 00:00:00 GMT DOI: 10.1093/eurpub/ckaa167 Issue No:Vol. 31, No. 1 (2020)
Authors:Winzer E; Wakolbinger M, Schätzer M, et al. Pages: 136 - 142 Abstract: BackgroundThe objective was to evaluate a 5-week nutrition education programme (ACTION) in fifth-grade schoolchildren in Austria on free sugar intake, nutrition-related knowledge (NRK) and with the RE-AIM framework on the overall public health impact.MethodsA prospective case-controlled cohort (pre–post design) from seven secondary schools in Vienna tested programme efficacy. NRK was assessed with a 20-item questionnaire and dietary behaviour and free sugar intake with a semi-quantitative Food Frequency Questionnaire. A total of 12 intervention classes (IG) received the programme, conducted by teachers and integrated in the curriculum, and 6 control classes followed their usual curriculum.ResultsIn 344 children, aged 10.4 (0.8) years, free sugar intake decreased significantly over time in IG by 13% (P=0.001) with a group difference of −10.1 (95% CI −18.8, −1.5; P=0.021) g/day. The food groups ‘sweets & pastries’, ‘soft drinks’, ‘fast food’ and ‘salty snacks’ mainly contributed to this reduction. Moreover, NRK increased significantly over time in IG with a group difference of 9.0% of correct answers (95% CI 5.8, 12.2; P<0.001; Cohen’s d 0.57). The programme was disseminated to 10% of fifth-grade classrooms in Austrian secondary schools and to 12% in Vienna.ConclusionsThe ACTION programme shows potential for public health impact with improving dietary behaviour as free sugar intake, NRK, and its dissemination. It required a minimum of money per schoolchild as the programme was conducted by teachers and was integrated in the curriculum. PubDate: Mon, 23 Nov 2020 00:00:00 GMT DOI: 10.1093/eurpub/ckaa219 Issue No:Vol. 31, No. 1 (2020)
Authors:Kastorini C; Markaki I, Tsiampalis T, et al. Pages: 143 - 150 Abstract: BackgroundTo explore the effect of household food insecurity on dietary patterns of children and adolescents participating in a school food-aid programme in regions of Greece with low socioeconomic status.MethodsA cross-sectional study was conducted during the school year 2013–14, among 406 schools in low socioeconomic status regions of Greece. Dietary habits and sociodemographic characteristics of students and their families were recorded. Factor analysis was used in order to derive children’s and adolescents’ dietary patterns and analysis of covariance was performed to examine the effect of households’ food insecurity level on those patterns. A total of 31 399 students participated in the study; 16 652 children (5–11 years) and 14 747 adolescents (12–18 years).ResultsFactor analysis identified five dietary patterns in both age groups, explaining the 49.1% (children) and 53.0% (adolescents) of the total variation in intake. After adjusting for various factors, the household’s food insecurity was significantly associated with the majority of the derived patterns in both age groups, with most pronounced differences being observed for the consumption of red meat, poultry and fish, fruits, as well as red processed meat, cereals and dairy products, which was lower among children and adolescents with food insecurity. Children with food insecurity consumed significantly more unhealthy food, such as chips, fast food, sugared drinks, sweets, French fries and mayonnaise sauce.ConclusionsPromotion of healthy eating to households facing food insecurity is of crucial importance, giving emphasis in the design of low cost, yet highly nutritious programmes. PubDate: Mon, 23 Nov 2020 00:00:00 GMT DOI: 10.1093/eurpub/ckaa178 Issue No:Vol. 31, No. 1 (2020)
Authors:De Cocker K; Ketels M, Bennie J, et al. Pages: 151 - 156 Abstract: BackgroundThere is increasing interest in the association between psychological distress and time spent in sedentary behaviour (e.g. sitting), a highly prevalent behaviour in modern society. The limited evidence is mixed and mainly based on studies using self-reported sedentary time. Few studies have investigated device-based total sedentary time in its association with distress. None, however, have examined device-based domain-specific sedentary time in relation to psychological distress. The aim of this study was to investigate whether device-based total and domain-specific sedentary behaviour were associated with psychological distress.MethodsFlemish employees (n = 401; 20–64 years; 42.6% male; 83.6% had a ‘physically active occupation’) of seven organizations in service and production sectors participated. Sedentary behaviour (exposure) was assessed by two Axivity AX3 accelerometers (one placed on the thigh and one placed between the shoulders) for two to four consecutive working days. Based on diary completion, domain-specific sedentary behaviour (leisure vs. work) was assessed. The 12-item General Health Questionnaire was used to assess psychological distress (outcome). Adjusted hierarchical multiple regression models were conducted to report on the associations between total and domain-specific sedentary behaviour and psychological distress.ResultsAbout 35% of the sample had high levels of distress and average total sedentary time was 7.2 h/day. Device-based total sedentary behaviour [B = −0.009, 95% confidence interval (CI), −0.087 to 0.068], leisure-time (B = 0.001, 95% CI, −0.017 to 0.018) and work-related (B = 0.004, 95% CI, −0.006 to 0.015) sedentary behaviour were not significantly associated with psychological distress.ConclusionThis cross-sectional study examining the association between device-based total and domain-specific sedentary behaviour and psychological distress among employees showed a lack of significant findings. PubDate: Thu, 03 Sep 2020 00:00:00 GMT DOI: 10.1093/eurpub/ckaa144 Issue No:Vol. 31, No. 1 (2020)
Authors:Kelly L; Harrison M, Richardson N, et al. Pages: 156 - 160 Abstract: BackgroundPhysical activity (PA) interventions capable of producing health benefits cost effectively are a public health priority across the Western world. ‘Men on the Move’ (MOM), a community-based PA intervention for men, demonstrated significant health benefits up to 52-weeks (W) post-baseline. This article details the economic evaluation of MOM with a view to determining its cost-effectiveness as a public health intervention to be rolled out nationally in Ireland.MethodsCost-effectiveness was determined by comparing the costs (direct and indirect) of the programme to its benefits, which were captured as the impact on quality-adjusted life-years (QALYs). For the benefits, cost–utility analysis was conducted by retrospectively adapting various health-related measures of participants to generate health states using Brazier et al.’s (2002) short form-6D algorithm. This in turn allowed for ‘utility measures’ to be generated, from which QALYs were derived.ResultsFindings show MOM to be cost-effective in supporting an ‘at risk’ cohort of men achieves significant improvements in aerobic fitness, weight loss and waist reduction. The total cost per participant (€125.82 for each of the 501 intervention participants), the QALYs gained (11.98 post-12-W intervention, or 5.3% health improvement per participant) and estimated QALYs ratio costs of €3723 represents a cost-effective improvement when compared to known QALY guidelines.ConclusionsThe analysis shows that the cost per QALY achieved by MOM is significantly less than the existing benchmarks of £20 000 and €45 000 in the UK and Ireland respectively, demonstrating MOM to be cost-effective. PubDate: Thu, 03 Sep 2020 00:00:00 GMT DOI: 10.1093/eurpub/ckaa152 Issue No:Vol. 31, No. 1 (2020)
Authors:López-Sánchez G; López-Bueno R, Gil-Salmerón A, et al. Pages: 161 - 166 Abstract: BackgroundThis is the first study analyzing levels of physical activity in a sample of quarantined adults with chronic conditions. The aim of this study was to compare moderate- and vigorous-intensity physical activity levels in Spanish adults with chronic conditions before and during coronavirus disease 2019 (COVID-19) quarantine.MethodsA cross-sectional online survey was administered during the COVID-19 quarantine in Spain. A total of 163 participants with chronic conditions (113 females and 47 males; age range 18–64 years) completed the survey. A total of 26 chronic conditions were included. Participants self-reported average minutes/day of moderate and vigorous physical activity before and during quarantine. Differences in moderate- and vigorous-intensity physical activity levels before and during COVID-19 quarantine (overall, by gender, by age, by number of chronic conditions and by each chronic condition) were assessed by Wilcoxon-signed rank test.ResultsDuring COVID-19 quarantine, there was a significant decrease of moderate-intensity physical activity in Spanish people with chronic conditions (in both males and females, in those aged 18–24, 25–34, 35–44 and 55–64 years, in those with multimorbidity, in those with one/two chronic condition/s, and in those diagnosed with asthma/hypercholesterolaemia/chronic skin disease/haemorrhoids). Also, there was a significant decrease of vigorous-intensity physical activity in Spanish males with chronic conditions and in those with multimorbidity.ConclusionsThese results should be considered to develop effective strategies of physical activity promotion targeting these specific groups when new quarantine or restriction measures are implemented, in order to avoid new significant decreases of physical activity in these vulnerable populations. PubDate: Sat, 10 Oct 2020 00:00:00 GMT DOI: 10.1093/eurpub/ckaa159 Issue No:Vol. 31, No. 1 (2020)
Authors:Bowe A; Healy C, Cannon M, et al. Pages: 167 - 173 Abstract: BackgroundThere is growing concern around youth mental health. A population health approach to improve mental health must address, among other issues, economic insecurity, access to housing and education, harm reduction from substance use. As a universal public health intervention, increasing physical activity at a population level may have an important role in our approach. The aim of this study was to examine the longitudinal association between physical activity patterns between childhood and early adolescence and emotional-behavioural difficulties in later adolescence.MethodsThis study was based on data from the ′98 Child cohort of the Growing Up in Ireland Study. Participants were categorized according to physical activity levels at ages 9 and 13. Emotional-behavioural difficulties at age 17 were measured using the parent-reported Strengths and Difficulties Questionnaire. Logistic regression was used to examine the association between physical activity and emotional-behavioural outcomes.ResultsAmong 4618 participants included in the regression model, those categorized as Inactive (n=1607) or Reducer (n=1662) were more than twice as likely to have emotional-behavioural difficulties at age 17 compared with those who were Active [adjusted odds ratio (AOR) 2.1, 95% CI 1.46–3.01, P<0.001; AOR 1.93, 95% CI 1.34–2.76, P<0.001, respectively]. Among those with emotional-behavioural difficulties at baseline (n=525), those categorized as Active had 2.3-fold reduced odds for emotional-behavioural problems at age 17 compared with those who were Inactive (AOR 0.43, 95% CI 0.23–0.78, P=0.006).ConclusionsIncreasing physical activity among adolescents is a safe and sustainable public health intervention associated with improved mental health. PubDate: Wed, 11 Nov 2020 00:00:00 GMT DOI: 10.1093/eurpub/ckaa182 Issue No:Vol. 31, No. 1 (2020)
Authors:Ford K; Batty G, Leist A. Pages: 174 - 180 Abstract: BackgroundLimited workplace control, an important dimension of job strain, can reduce occupational opportunities for problem solving and learning. Women may have fewer professional resources to mitigate effects of low control, while conversely, gender-role norms may moderate the influence of occupational psychosocial risk factors. We therefore examined whether the links between control and cognitive function were similarly gendered.MethodsThis observational, longitudinal study included respondents of the Survey of Health, Ageing and Retirement in Europe who were aged 50–64 years at entry, employed and provided at least two measurements of control and cognition (n = 6697). Relationships between control and cognition, quantified with standardized scores from verbal fluency, immediate and delayed word recall tests, were explored using linear fixed-effect and random-effect models with gender interactions.ResultsConsistent trends of improved verbal fluency performance with high control were evident across analyses, equal to producing around three-quarters of a word more under high control conditions, with an effect size ∼0.1 SD units (fully adjusted models, range 0.077–0.104 SD), although associations with recall tests were inconsistent. We did not find evidence of clear gender differences in control–cognition relationships for any of the cognitive domains.ConclusionsThe cognitive health of older European workers may benefit from improved workplace control irrespective of gender. Possible sources of bias that could explain the lack of gender differences are discussed, particularly gender differences in labour force participation, response behaviour in job control ratings and implications of gender-role norms on the importance of occupational risk factors. PubDate: Tue, 15 Sep 2020 00:00:00 GMT DOI: 10.1093/eurpub/ckaa173 Issue No:Vol. 31, No. 1 (2020)
Authors:McNamara C; Toch-Marquardt M, Albani V, et al. Pages: 181 - 185 Abstract: BackgroundSocial inequalities in non-communicable diseases (NCDs) are evident across all European regions. Employment and working conditions are important determinants of NCDs, however, few comparative studies have examined how these conditions contribute to health inequalities. This study therefore examines the association of non-standard employment and poor working conditions with occupational inequalities in multiple NCDs and whether there are differences by gender and across European regions.MethodsWe used cross-sectional data from 20 European countries for women and men aged 25–75 (n = 19 876), from round 7 of the European Social Survey. Data were analyzed for self-rated health (SRH) and 9 NCDs: heart/circulatory problems, high blood pressure, arm/hand pain, breathing problems, diabetes, severe headaches, cancer, obesity and depression. We used logistic regression models, stratified by gender, and adjusted rate ratios to examine whether occupational inequalities in NCDs were reduced after adjusting for non-standard employment and poor working conditions, across European regions.ResultsAfter adjustment, occupational inequalities were significantly reduced across all regions of Europe. Reductions were particularly large among the lowest occupational group and for poor-SRH, depression and obesity. For these conditions, reductions were in the range of 60–99%.ConclusionsEmployment and working conditions are important determinants of occupational inequalities in NCDs. Labour market regulations should therefore be considered in the formulation of NCD prevention strategies. PubDate: Wed, 18 Nov 2020 00:00:00 GMT DOI: 10.1093/eurpub/ckaa175 Issue No:Vol. 31, No. 1 (2020)
Authors:Rahbek O; Jauernik C, Ploug T, et al. Pages: 200 - 206 Abstract: BackgroundHealth authorities can influence citizens in subtle ways that render them more likely to participate in cancer screening programmes, and thereby possibly increase the beneficial effects. If the influences become too severe, the citizens’ ability to make a personal choice may be lost on the way. The purpose of this analysis was to identify and categorize the influences while questioning whether they still permit the citizens to make their own choices regarding participation.MethodsA two-stringed approach was used to obtain empirical examples of systematic influences that aim to raise participation rates in cancer screening programmes: First, a systematic literature search was conducted on three databases. Second, relevant experts were contacted via internationally based e-mail lists and asked for examples of systematic influences in cancer screening. The present analysis was based on direct, conventional content analysis to address different categories of systematic influences.ResultsThe literature search yielded 19 included articles and the expert inquiry yielded 11 empirical examples of which content analysis of the empirical examples generated six major categories of systematic influence: (i) misleading presentation of statistics, (ii) misrepresentation of harms vs. benefits, (iii) opt-out systems, (iv) recommendation of participation, (v) fear appeals and (vi) influencing the general practitioners and other healthcare professionals.ConclusionThe six categories of identified influences work through psychological biases and personal costs and are still in widely use. The use of these types of influence remains ethically questionable in cancer screening programmes since they might compromise informed decision making. PubDate: Mon, 07 Sep 2020 00:00:00 GMT DOI: 10.1093/eurpub/ckaa158 Issue No:Vol. 31, No. 1 (2020)
Authors:Pagliarin F; Pylkkanen L, Salakari M, et al. Pages: 206 - 214 Abstract: BackgroundThe evaluation of participant experience is an essential part of monitoring the quality of breast cancer screening services. Satisfaction of services can lead to good adherence and hence affect health outcomes.MethodsWe performed a systematic review to assess how satisfied women were with organized breast cancer screening programs. A literature search in Medline, CINAHL, Embase and PsycINFO from 1965 to October 2019 was performed. Articles reporting a quantitative measure of satisfaction collected via questionnaires in programs using mammography as a screening test were selected. We narratively synthesized the data and used tabulated summaries.ResultsOut of 4310 individual citations, 3099 abstracts were reviewed by two independent researchers, and 126 articles were selected for full-text reading. Finally, 48 studies, published between 1990 and 2018, were included in analysis, reporting 54 surveys in the context of an organized screening program, 37 on satisfaction with screening mammography, 14 on satisfaction with further assessments and 3 with counseling. Most studies reported a high level of satisfaction for both mammography and further assessments. Despite commonly reported temporary pain, discomfort and anxiety, the willingness to be re-screened was very high. Effective information transfer, the staff's interpersonal skills and quick delivery of results correlated with high satisfaction. Only 7 out of 54 surveys used recognized satisfaction instruments or their modifications.ConclusionsIn general, satisfaction with breast cancer screening is high, but its evaluation is mainly performed using non-validated instruments. Emphasis should be put on effective communication, the staff´s interpersonal skills and quick delivery of results. PubDate: Tue, 17 Nov 2020 00:00:00 GMT DOI: 10.1093/eurpub/ckaa202 Issue No:Vol. 31, No. 1 (2020)
Authors:Berete F; Heyden J, Demarest S, et al. Pages: 214 - 220 Abstract: BackgroundThe validity of self-reported mammography uptake is often questioned. We assessed the related selection and reporting biases among women aged 50–69 years in the Belgian Health Interview Survey (BHIS) using reimbursement data for mammography stemming from the Belgian Compulsory Health Insurance organizations (BCHI).MethodsIndividual BHIS 2013 data (n = 1040) were linked to BCHI data 2010–13 (BHIS–BCHI sample). Being reimbursed for mammography within the last 2-years was used as the gold standard. Selection bias was assessed by comparing BHIS estimates reimbursement rates in BHIS–BCHI with similar estimates from the Echantillon Permanent/Permanente Steekproef (EPS), a random sample of BCHI data, while reporting bias was investigated by comparing self-reported versus reimbursement information in the BHIS–BCHI. Reporting bias was further explored through measures of agreement and logistic regression.ResultsMammography uptake rates based on self-reported information and reimbursement from the BHIS–BCHI were 75.5% and 69.8%, respectively. In the EPS, it was 64.1%. The validity is significantly affected by both selection bias {relative size = 8.93% [95% confidence interval (CI): 3.21–14.64]} and reporting bias [relative size = 8.22% (95% CI: 0.76–15.68)]. Sensitivity was excellent (93.7%), while the specificity was fair (66.4%). The agreement was moderate (kappa = 0.63). Women born in non-EU countries (OR = 2.81, 95% CI: 1.54–5.13), with high household income (OR = 1.27, 95% CI: 1.02–1.60) and those reporting poor perceived health (OR = 1.41, 95% CI: 1.14–1.73) were more likely to inaccurately report their mammography uptake.ConclusionsThe validity of self-reported mammography uptake in women aged 50–69 years is affected by both selection and reporting bias. Both administrative and survey data are complementary when assessing mammography uptake. PubDate: Mon, 23 Nov 2020 00:00:00 GMT DOI: 10.1093/eurpub/ckaa217 Issue No:Vol. 31, No. 1 (2020)
Authors:Patterson L; Cruise S, Cardwell C, et al. Pages: 221 - 226 Abstract: BackgroundVariable consent rates threaten the validity of linked datasets. One modifiable element is the interviewer–respondent relationship. We examine interviewer attitudes to consent to linkage and the effect on respondent consent.MethodsSubjects were 27 380 respondents from the Wave 1 Understanding Society (US) survey in Great Britain and 449 interviewers who completed the US Interviewer Survey. Two types of consent were considered: (i) whether the interviewer would hypothetically agree to having their data linked if he/she was an US respondent and (ii) whether the respondent consented to have their data linked. Factors influencing the interviewer’s propensity to link data were examined using logistic regression. The association between interviewer consent and respondent consent to health record linkage was assessed using multi-level logistic regression models.ResultsThe interviewer’s propensity to consent to data linkage was strongly positively associated with its perceived usefulness: those that found it somewhat useful were 57% less likely to consent [adjusted odds ratio (AOR) 0.43, 95% CI: 0.22–0.82] compared to those who thought it was very useful. Positive beliefs about data security and their ability to understand the data linkage information were also associated. Respondents were 17% less likely to consent when interviewed by an interviewer who would not consent to record linkage (AOR 0.83, 95% CI: 0.71–0.97).ConclusionsThe interviewer’s propensity to consent was influenced by their beliefs about data linkage, which in turn influenced respondent consent. We recommend using interviewer training to emphasize the usefulness of data linkage and the measures around data security. PubDate: Wed, 16 Sep 2020 00:00:00 GMT DOI: 10.1093/eurpub/ckaa142 Issue No:Vol. 31, No. 1 (2020)
Authors:Beach E; Mulder J, O’Brien I, et al. Pages: 227 - 233 Abstract: BackgroundRecreational noise—specifically loud music experienced at music venues—has been recognized as a hazard for hearing damage and associated pathologies such as tinnitus. In Europe and other countries around the world, there is a range of regulatory and legislative approaches to managing the sound levels and minimizing the risk of hearing damage for those attending music venues. It is important to have an understanding of these different approaches to inform the development of future regulations and legislation.MethodsIn December 2018, an online search of legislative instruments was conducted, and we identified 18 items that were aimed at protecting the hearing of people attending entertainment venues.ResultsTwelve documents were from European jurisdictions and the remainder were from cities or states of North and South America. The regulatory measures included in the documents ranged from sound level limitations, real-time sound exposure monitoring, mandatory supply of protective devices, requirements for signage and warnings, loudspeaker placement restrictions and the provision of ‘quiet spaces’.ConclusionsEuropean countries are well advanced in terms of providing legislation and other regulatory documents aimed at protecting people at entertainment venues when compared with the rest of the world. Future research is required to assess the effectiveness of these regulatory measures in reducing the risk associated with sound exposure at music venues. PubDate: Sun, 04 Oct 2020 00:00:00 GMT DOI: 10.1093/eurpub/ckaa149 Issue No:Vol. 31, No. 1 (2020)
Authors:Zeegers Paget D; Nagyova I, Zeegers Paget D, et al. Pages: 235 - 237 Abstract: In this first European Public Health News of 2021, we are happy to see that things are looking up and that we—hopefully—can go back to the new normal this year. No more COVID-19 pandemic, but—with the building of a strong European Health Union—new plans, projects and activities to strengthen health for all in Europe. Nagyova and Zeegers are introducing a new tool that EUPHA is planning to develop this year: the EUPHA summer game(s). A playful educational tool that can build skills and bring people together for the good of public health. PubDate: Tue, 24 Nov 2020 00:00:00 GMT DOI: 10.1093/eurpub/ckaa257 Issue No:Vol. 31, No. 1 (2020)
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