The purpose of this analysis was to assess the variations in COVID-19 related mortality in relation to the time differences in the commencement of virus circulation and containment measures in the ...European Region.
The data for the current analysis (N = 50 countries) were retrieved from the John Hopkins University dataset on the 7th of May 2020, with countries as study units. A piecewise regression analysis was conducted with mortality and cumulative incidence rates introduced as dependent variables and time interval (days from the 22nd of January to the date when 100 first cases were reported) as the main predictor. The country average life expectancy at birth and outpatient contacts per person per year were statistically adjusted for in the regression model.
Mortality and incidence were strongly and inversely intercorrelated with days from January 22, respectively -0.83 (p<0.001) and -0.73 (p<0.001). Adjusting for average life expectancy and outpatients contacts per person per year, between days 33 to 50 from the 22nd of the January, the average mortality rate decreased by 30.1/million per day (95% CI: 22.7, 37.6, p<0.001). During interval 51 to 73 days, the change in mortality was no longer statistically significant but still showed a decreasing trend. A similar relationship with time interval was found for incidence. Life expectancy and outpatients contacts per person per year were not associated with mortality rate.
Countries in Europe that had the earliest COVID-19 circulation suffered the worst consequences in terms of health outcomes, specifically mortality. The drastic social isolation measures, quickly undertaken in response to those initial outbreaks appear effective, especially in Eastern European countries, where community circulation started after March 11th. The study demonstrates that efforts to delay the early spread of the virus may have saved an average 30 deaths daily per one million inhabitants.
Background: The World Health Organization (WHO) European Childhood Obesity Surveillance Initiative (COSI) was established more than 10 years ago to estimate prevalence and monitor changes in ...overweight and obesity in children aged 6–9 years. Since then, there have been five rounds of data collection in more than 40 countries involving more than half a million children. To date, no comparative studies with data on severe childhood obesity from European countries have been published. Objectives: The aim of this work was to present the prevalence of severe obesity in school-aged children from 21 countries participating in COSI. Method: The data are from cross-sectional studies in 21 European WHO member states that took part in the first three COSI rounds of data collection (2007/2008, 2009/2010, 2012/2013). School-aged children were measured using standardized instruments and methodology. Children were classified as severely obese using the definitions provided by WHO and the International Obesity Task Force (IOTF). Analyses overtime, by child’s age and mother’s educational level, were performed in a select group of countries. Results: A total of 636,933 children were included in the analysis (323,648 boys and 313,285 girls). The prevalence of severe obesity varied greatly among countries, with higher values in Southern Europe. According to the WHO definition, severe obesity ranged from 1.0% in Swedish and Moldovan children (95% CI 0.7–1.3 and 0.7–1.5, respectively) to 5.5% (95% CI 4.9–6.1) in Maltese children. The prevalence was generally higher among boys compared to girls. The IOTF cut-offs lead to lower estimates, but confirm the differences among countries, and were more similar for both boys and girls. In many countries 1 in 4 obese children were severely obese. Applying the estimates of prevalence based on the WHO definition to the whole population of children aged 6–9 years in each country, around 398,000 children would be expected to be severely obese in the 21 European countries. The trend between 2007 and 2013 and the analysis by child’s age did not show a clear pattern. Severe obesity was more common among children whose mother’s educational level was lower. Conclusions: Severe obesity is a serious public health issue which affects a large number of children in Europe. Because of the impact on educational, health, social care, and economic systems, obesity needs to be addressed via a range of approaches from early prevention of overweight and obesity to treatment of those who need it.
The universal newborn hearing screening (UNHS) component of the multi-center EUSCREEN project is being piloted in Albania since January 1.sup.st 2018. The aim of this study was to explore mothers' ...perceptions about various elements of UNHS in Albania. A cross-sectional study was carried out in the three sites of UNHS in Albania, namely in Tirana, Kuk#235;s and Pogradec during May-June 2019. During this period 512 consecutively approached mothers giving birth to included maternity hospitals were interviewed face-to-face about different aspects of UNHS. Basic socio-demographic and socioeconomic information was also collected. Mean age of participating mothers was 28.6 years #177; 5.5 years. The overwhelming majority (93%) of mothers knew what their baby was being tested for, 33% were aware that hearing screening was offered in maternity hospital, 94% were very satisfied/satisfied with UNHS and about 62% were very stressed/stressed waiting for screening results, with significant sociodemographic and socioeconomic differences. The main information source about UNHS was screening staff in the maternity hospitals where mothers gave birth, reported in 67% of cases. All mothers (100%) agreed on the importance of early detection of newborn hearing problems, all mothers were willing to be informed early if their newborn baby had a hearing problem and all mothers were willing to contribute financially for testing the hearing of their newborn baby. These findings should guide information and education campaigns about UNHS in Albania. The public willingness to financially support neonatal hearing testing should be considered as an opportunity to achieve universal newborn hearing screening in the country.
Access to healthcare services is an essential component of promoting public health and sustainable development. Our aim was to assess socio-demographic correlates of barriers to accessing healthcare ...services among children in Albania, a post-communist country in Europe. An online survey was conducted in September 2022, including a nationwide representative sample of 7831 school children (≈54% girls) ranging from grades six to nine from all regions of Albania. A structured and anonymous questionnaire was administered to all children inquiring about a range of potential barriers to accessing healthcare services. Overall, about 42% of the children reported that they had barriers to accessing healthcare services. There were no gender differences, but there were significant ethnic differences (51% among Roma/Egyptian children vs. 42% among the general sample of the children); urban/rural differences (46% rural vs. 39% urban); and socio-economic differences (52% among children with a lower maternal education vs. 31% among children with a higher maternal education; 66% among children from poor families vs. 35% among children with a higher family income). In transitional Albania, children residing in rural areas, children from Roma and/or Egyptian communities, and especially those pertinent to low socio-economic families report considerably more barriers to accessing healthcare services, which is a cause of concern.
To develop and validate a comprehensive questionnaire to be used as an instrument in cross-sectional studies among beekeepers.
A comprehensive questionnaire in Slovenian was validated by an expert ...panel (n=13) for content relevance and a rater panel (n=14) for clarity and comprehensibility. The content validity indices (an item-level content validity index and scale-level content validity index based on the average and universal agreement method) and item-level face validity index were calculated in accordance with the recommended number of both the review panels with their implications on the acceptable cut-off scores. Piloting was performed in a sample (n=50) of the target population (N=1.080) using telephone interviews.
The item-level content validity index and scale-level content validity index based on the average method exhibited excellent content validity (0.97), while the scale-level content validity index based on the universal agreement method reached a value of 0.72. The item-level face validity index of 1.00 indicated that all items were clear and comprehensive.
The new instrument may be considered valid and feasible for use in nationwide population-based studies among Slovenian beekeepers and eventually in other populations.
Determinants of hypertension diagnosis and/or awareness and control among older adults are understudied in Albania, a former communist country in South Eastern Europe, which is experiencing rapid ...demographic, socioeconomic and epidemiological transition. This paper examines the association of individual, interpersonal, organizational and community factors with hypertension awareness and control among older adults in Tirana, the Albanian capital.
Using 2012 International Mobility in Aging Study data on older adults from Albania's capital city (n = 393) and the socioecological model as a conceptual framework, multinomial regression models identified factors associated with controlled, uncontrolled and undiagnosed hypertension.
For hypertension, 17.3% participants had none, 23.4% were controlled, 48.4% were uncontrolled and 10.9% were undiagnosed/unaware. Compared to those with controlled hypertension, in multivariable models, a high level of friend support was negatively associated with uncontrolled (OR: 0.4; 95% CI: 0.2-0.9) and undiagnosed (OR: 0.2; 95% CI: 0.1-0.6) hypertension. A high level of perceived neighbourhood safety was negatively associated with uncontrolled (OR: 0.6; 95% CI: 0.3-1.0) and undiagnosed (OR: 0.4; 95% CI: 0.2-1.0) hypertension. Compared to those with no hypertension, children's social support was positively associated with uncontrolled (OR: 2.2; 95% CI: 1.1-4.3) and undiagnosed (OR: 3.6; 95% CI: 1.3-9.6) hypertension.
This study provides new insights about distinct risk factors for inadequate hypertension management in Albania. It highlights the importance of community-level factors (safety) and interpersonal factors (family and friend ties) to hypertension diagnosis/awareness and control, which may provide novel intervention opportunities for hypertension programs.
Western Balkan countries exhibit high levels of alcohol consumption, which constitutes a serious public health concern. We aimed to quantitatively assess the influence of the Europeanization process ...on levels of alcohol consumption in Western Balkans, an issue that has been under-researched.
The process of Europeanization was defined as the penetration of European dimension, procedures, policy paradigms, beliefs and norms in national arenas of politics and policy development. Data about alcohol consumption in six Western Balkan countries from 1991 to 2011 were gathered from the World Bank and World Health Organization databases. Azerbaijan and Georgia were considered control countries. A difference-in-differences approach was used to assess the impact of Europeanization process on levels of alcohol consumption.
The Europeanization process impacts alcohol consumption in Western Balkan countries through the European Union directives and tax policies. After starting the Europeanization process, the spirits consumption in Croatia and The Former Yugoslav Republic of Macedonia decreased by 1.06 litter per capita (95% CI: from -1.63 to - 0.49) and 1.02 litter per capita in Serbia (95% CI: from -1.9 to - 0.1).
Our analysis provides useful evidence about the possible influence of Europeanization process especially on spirits consumption levels in Western Balkans. These findings draw attention to the need to implement new policies in order to prevent alcohol health-related harm due to the possible increase of wine and beer consumption.
Abstract Objective Our aim was to assess the level and socio-demographic correlates of the ability to maintain health among children in Albania, a post-communist country in the Western Balkans. ...Methods A cross-sectional study was conducted in Albania in September 2022. The study population consisted of a nationwide representative sample of 7,831 schoolchildren (≈54% girls) aged 12–15 years. A structured self-administered and anonymous questionnaire inquired about the children’s attitudes toward health promotion (ability to maintain and improve health) and a range of key dimensions on knowledge and practices regarding healthcare services. Socio-demographic data were also collected. Binary logistic regression was used to assess the socio-demographic correlates of children’s ability to maintain health. Results Overall, about 71% of schoolchildren exhibited the best attitudes toward health promotion (ability to maintain and improve health). In the multivariable adjusted logistic regression models, poorer attitudes toward health promotion (ability to maintain and improve health) were significantly related to older age (OR=1.2, 95% CI=1.0–1.3), middle/low maternal education (OR=1.2, 95%CI=1.1–1.3), poor/very poor economic situation (OR=1.5, 95%CI=1.2–1.8), lack of appropriate knowledge about rights to healthcare (OR=1.3, 95% CI=1.1–1.5), lack of knowledge about obtaining healthcare services (OR=1.7, 95%CI=1.4–2.2), and lack of consultations/visits with health professionals excluding vaccinations (OR=1.2, 95%CI=1.1–1.4). Conclusions Almost 1/3 rd of Albanian schoolchildren included in this study did not exhibit the best attitudes toward health promotion (ability to maintain and improve health). The best attitudes were related to a higher socioeconomic level and adequate knowledge and practices regarding healthcare services. There is thus a need to increase health literacy levels among children in order to ultimately induce sustainable healthy behavioural/lifestyle practices.
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