Gestational Age, Parent Education, and Education in Adulthood

BACKGROUND: Adults born preterm (<37 weeks) have lower educational attainment than those born term. Whether this relationship is modified by family factors such as socioeconomic background is, however, less well known. We investigated whether the relationship between gestational age and educational attainment in adulthood differed according to parents’ educational level in 4 Nordic countries. METHODS: This register-based cohort study included singletons born alive from 1987 up to 1992 in Denmark, Finland, Norway, and Sweden. In each study population, we investigated effect modification by parents’ educational level (low, intermediate, high) on the association between gestational age at birth (25–44 completed weeks) and low educational attainment at 25 years (not having completed upper secondary education) using general estimation equations logistic regressions. RESULTS: A total of 4.3%, 4.0%, 4.8%, and 5.0% singletons were born preterm in the Danish (n = 331 448), Finnish (n = 220 095), Norwegian (n = 292 840), and Swedish (n = 513 975) populations, respectively. In all countries, both lower gestational age and lower parental educational level contributed additively to low educational attainment. For example, in Denmark, the relative risk of low educational attainment was 1.84 (95% confidence interval 1.44 to 2.26) in adults born at 28 to 31 weeks whose parents had high educational level and 5.25 (95% confidence interval 4.53 to 6.02) in adults born at 28 to 31 weeks whose parents had low educational level, compared with a reference group born at 39 to 41 weeks with high parental educational level. CONCLUSIONS: Although higher parental education level was associated with higher educational attainment for all gestational ages, parental education did not mitigate the educational disadvantages of shorter gestational age.

PUBLIC SELF-PERCEPTION, KNOWLEDGE AND PRACTICE ABOUT COVID-19 IN SAUDI ARABIA

Background And Aim: COVID-19 is a devastating pandemic which seriously affected population health and world’s economy. With all advances to diagnose, treat and prevent COVID-19, public knowledge about COVID-10 and adoption of healthy behaviors to avoid infection remain the cornerstone of effective disease control. This study aims to explore public knowledge, adherence to protection practices and self-perception about COVID-19 during the pandemic in Saudi Arabia. Materials And Methods: This cross-sectional study was conducted in Saudi Arabia from June to September 2020. People aged 18 years or older were invited to participate in an online questionnaire modified from the survey tool of the World Health Organization. The survey consisted of a total of 37 items assessing the demographics, knowledge, attitude and practice towards COVID-19. Results: The average COVID-19 knowledge score was 58.8%. More than two-third of participants were adherent to guidelines avoiding the infection. There was a positive moderate correlation between total knowledge score and total adherence score of protection. Majority reported very poor or poor level of knowledge. Most of participants reported that they have good knowledge on how to protect themselves. knowledge level was significantly higher among highly educated, younger male individuals with suspected or confirmed diagnosis of COVID-19. Conclusion: Saudi people with high educational level, younger age, males and individuals suspected or diagnosed to have COVID-19 were more likely to have higher knowledge score. Good COVID-19 knowledge is related with positive attitudes and appropriate COVID-19 practices, implying that health education programs focused at increasing COVID-19 knowledge can help encourage a positive attitude and promote safe practices. As the worldwide threat of COVID-19 continues to emerge, efforts through educational campaigns aimed at the public, particularly the undereducated, older females are important.

Perceived Diet Quality, Eating Behaviour, and Lifestyle Changes in a Mexican Population with Internet Access during Confinement for the COVID-19 Pandemic: ESCAN-COVID19Mx Survey

Perceived changes in diet quality, emotional eating, physical activity, and lifestyle were evaluated in a group of Mexican adults before and during COVID-19 confinement. In this study, 8289 adults answered an online questionnaire between April and May 2020. Data about sociodemographic characteristics, self-reported weight and height, diet quality, emotional eating, physical activity, and lifestyle changes were collected. Before and after confinement, differences by sociodemographic characteristics were assessed with Wilcoxon, Anova, and linear regression analyses. Most participants were women (80%) between 18 and 38 years old (70%), with a low degree of marginalisation (82.8%) and a high educational level (84.2%); 53.1% had a normal weight and 31.4% were overweight. Half (46.8%) of the participants perceived a change in the quality of their diet. The Diet Quality Index (DQI) was higher during confinement (it improved by 3 points) in all groups, regardless of education level, marginalisation level, or place of residence (p < 0.001). Lifestyle changes were present among some of the participants, 6.1% stopped smoking, 12.1% stopped consuming alcohol, 53.3% sleep later, 9% became more sedentary, and increased their screen (43%) as well as sitting and lying down time (81.6%). Mexicans with Internet access staying at home during COVID-19 confinement perceived positive changes in the quality of their diet, smoking, and alcohol consumption, but negative changes in the level of physical activity and sleep quality. These results emphasise the relevance of encouraging healthy lifestyle behaviours during and after times of crisis to prevent the risk of complications due to infectious and chronic diseases.

Pharmacists as immunizers in Lebanon: a national survey of community pharmacists’ willingness and readiness to administer adult immunization

Background Since the focus of healthcare has shifted toward prevention, pharmacists were highly encouraged to expand their practice to include immunization services. Our study aimed to assess the knowledge, attitudes and beliefs of community-based Lebanese pharmacists, in addition to their willingness to expand their practice scope to include vaccine administration. Methods A cross-sectional study was conducted during the phase preceding the arrival of the COVID-19 vaccine in Lebanon between 1 and 31st December 2020. Using a stratified random sampling method, data were collected from Lebanese community pharmacists (CPs) through an online survey that included information on socio-demographic characteristics, clinical experience, willingness to administer vaccines, knowledge about vaccination, attitudes towards immunization, reasons supporting utilizing pharmacists as immunizers and the requested elements to incorporate immunization in pharmacists’ practice scope. Multivariable analyses were performed to identify the factors associated with knowledge. Results A total of 412 community pharmacists participated in this survey. Of the total, 66.5% of the surveyed CPs are willing to administer vaccines. The majority of them (89.8%) had an overall good level. Out of all, 92.7% showed a positive overall attitude score toward immunization, 95.4% agreed that community pharmacists can play an important role in advertising and promoting vaccination. The main needed elements for implementing immunization services in pharmacies listed by participants were: support of health authorities (99.3%), statutory allowance (82.8%), patient demand (95.4%), pharmacist’s interest (96.1%) and continuous education and training workshops on immunization. Older CPs (50 years and above) [aOR = 0.703, CI 95% (0.598–0.812)] and those working in Bekaa and North have lower knowledge score than their counterparts. High educational level [aOR = 1.891, CI 95% (1.598–2.019)], previous experience in immunization [aOR = 3.123, CI 95% (2.652–4.161)] and working in urban areas [aOR = 3.640, CI 95% (2.544–4.717)] were positively associated with a good knowledge level. Conclusion Most of Lebanese community pharmacists are willing to offer immunizations. The expansion of the pharmacists practice scope to include provision of immunizations required a national plan that encompasses strengthening knowledge, training, certification for eligibility to administer vaccines, enhancing pharmacovigilance and statutory reform.

Validation of the Copenhagen Psychosocial Questionnaire-Long Version II (COPSOQ II) in Greek employees

The aim of this study was to validate the long second version of the Copenhagen Psychosocial Questionnaire (COPSOQ II) in the Greek language. The study was carried out in two phases following a mixed-method design. Six hundred and fifty-two Greek employees (response rate 93.3%) responded in the second phase of the study, either online or in writing. Both types of participation to the study were confidential for the participants and the companies as well. Most participants were females (68.1%), married (47.4%), aged 30-49 years (60.9%), with high educational level (60.4%). The majority were occupied in the health and the social care services (37.4%) and employed by the private sector (63.2%). Internal consistency of the GR-COPSOQ II was assessed with the Cronbach alpha criterion (Cronbach’s a) and it was acceptable (0.8>α>0.7) for most of the scales. Mean scores were high in many scales that describe exposure to psychosocial risk factors at the workplace. Construct validity was established by exploratory factor analysis (EFA) for the entire study sample and scales. In conclusion, the Greek version of the COPSOQ-II (GR-COPSOQ II) has good psychometric properties and can be recommended as a valid tool for the assessment of psychosocial risk in Greek employees.

301 - Symposium social health: a pathway to inclusion and cognitive health

Background:Inclusion is taken as a natural situation, until feelings of exclusion are perceived. Social relations are for human beings like water to plants. Social health has been defined in 1946 by the WHO as the social domain of health. It is an umbrella concept that covers how the individual relates to his or her social environment and vice versa. Social inclusion is a key marker or characteristic of social health, represented by specific markers such as participation in leisure activities.Objective:We aim to study theoretical mechanisms and social health markers relevant to inclusion and cognitive functioning.Methods:identification of mechanistic pathways and systematic review on the relationship between combinations of social health markers and cognitive functioning and dementia in healthy older adults.Results:We combined neurobiological and social pathways to guide our study. The search for social health markers yielded 4332 potentially relevant citations. Eleven articles were eligible for inclusion. Combining social health marker reflecting social exclusion (e.g. social isolation, financial deprivation, living alone and lacking basic social rights) revealed a significant risk factor for both the development of dementia and reduced cognitive functioning. A combination of a high educational level, high occupational complexity and participating in leisure activities was protective for good cognitive functioning and dementia.Conclusion:Several social health markers are a pathway to social inclusion and to cognitive functioning, with markers reflecting exclusion being a risk factor, while those reflection inclusion are associated with protective effects. These findings open doors for interventions using the potential of social health in prevention of cognitive decline and dementia.

Epidemiologic features and Management of Hypertension in Tunisia, the results from the NAtional TUnisian REgistry of HyperTensioN (NaTuRe HTN) about 25890 patients

BackgroundHypertension is the leading cause of morbi-moratlity in low, middle as well as high incomes countries. Tunisia is a developing country with a high cardiovascular profile and the prevalence of hypertension has widely increased during the last decades. Thus, we conducted this national survey on hypertension to analyze the profile of the Tunisian hypertensive patient and to assess the level of blood pressure control. MethodsNature HTN is an observational multicentric survey, including hypertensive individuals and consulting their doctors during the period of the study. The primary endpoint of our study was uncontrolled hypertension defined by a systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90mmHg. Our objective is to assess the predictors of uncontrolled hypertension in our population. Results Three hundred twenty one investigators from all the Tunisian governorates participated in the study. We enrolled 25890 patients with a female predominance (Sex ratio 1.21) and an average age 64.4±12.2 year-old. Most of individuals were treated in the public sector (74%), 39.4% of patients were diabetic, 25.8% were obese, 44.6% were overweight and 14% were smokers. Hypertension was controlled in 51.7% of cases if we consider 140/90 as BP target and only in 18.6% if we consider 130/80 as a target. The independents predictors of uncontrolled blood pressure were male sex (OR=1.09, 95%CI [1.02-1.16]), age> 65 year-old (OR=1.07, 95% CI[1.01-1.13], diabetes (OR=1.18, 95% CI [1.11-1.25], Smoking (OR=1.15, 95% CI [1.05-1.25]), Obesity (OR=1.14, 95% CI[1.07-1.21]), management in public sector (OR=1.25, 95% CI [1.16-1.34]) and Heart rate >80bpm (OR=1.59, 95% CI [1.48-1.71]). Contrarily, high educational level (OR=0.9, 95% CI [0.84-0.97], absence of history of coronary disease (OR=0.86, 95% CI [0.8-0.93]), salt restriction (OR=0.48, 95% CI [0.45-0.51]), drug compliance (OR=0.57, 95% CI[0.52-0.61]) and regular physical activity (OR=0.77, 95% CI[0.71-0.84]) are strong predictors of blood pressure control. Conclusion Nature HTN showed a remarkable improvement of blood pressure control amongst Tunisian people. The control remains low in patients with high cardiovascular profile and those treated in the public sector. A national health program based on therapeutic education, regular control and continuous giving much support to the public institutions is needed to decrease the hypertension burden affection rate in our population.

Library Services for the Population of the BAM Construction Areas (1970s—1980s)

The historical experience of library services for the population, accumulated in the areas of new economic development of the late Soviet era, needs to be generalized. At the same time, the processes of formation and development of libraries in sparsely populated territories of Siberia and the Far East have not received sufficient coverage in the special literature. This paper examines the features of the libraries organization in the construction areas of the Baikal-Amur Mainline (BAM) in the period of the 1970s — 1980s. The research materials include archival documents, most of which are introduced into research discourse for the first time, as well as oral stories of participants in the all-Union construction project, collected by the author in the BAM regions. The libraries formation in the mainline construction zone was carried out at an accelerated pace within the framework of the state network of the Ministry of Culture of the RSFSR and the trade union system of transport builders. As a result, the provision of library services to builders was higher than in neighboring regions. However, the accessibility of libraries remained low, because the construction areas were characterized by a low population density, poor development of transport and infrastructure facilities, personnel shortage, and insufficient material and technical support. At first, the book collections were acquired spontaneously from the number of the publications donated or collected from the local population. As soon as the library systems stabilized, the central organizations “Soyuzkniga” and “Roskniga” became the main sources of book supplies, but they could not meet the reader’s demand of the mainline builders. The BAM had formed a special readership, which was distinguished by a high educational level, cultural and linguistic diversity, and the shaped reader’s interests and needs. This was due to the careful selection of those arriving at the construction site as part of Komsomol detachments. Along with their main functions, the libraries were a place for communication and leisure for workers, which compensated for the lack of other social and cultural institutions. Due to the weakness of the Party and state control, they had greater independence in cultural and mass work, which was reflected in the widespread distribution of different associations and library clubs, the acquaintance of readers with the works of authors banned by the Soviet censorship, and the development of amateur literary creativity.

Protective Role of Caregiver Preparedness on the Relationship Between Depression and Quality of Life in Stroke Dyads

Background and Purpose: Depression and quality of life (QOL) have an interdependent and transactional nature in stroke survivor-caregiver dyads. While the strong relationship between depression and physical and emotional QOL in stroke survivor-caregiver dyads is well known, it is less clear if this relationship is moderated by caregiver preparedness, which could easily be targeted with interventions. In this study, we examined the moderating role of caregiver preparedness on the association between depression and QOL in stroke survivor-caregiver dyads. Methods: We used a longitudinal design with follow-ups every 3 months over a 1-year period. Considering the nonindependent nature of the data (survivors and their caregivers), we used multilevel modeling to analyze data at the dyad level. We implemented 4 longitudinal dyadic moderation models (one for each QOL domain: physical, psychological, social, and environmental) using hierarchical linear modeling. Results: A sample of 222 stroke survivor-caregiver dyads was analyzed. Stroke survivors were older ( M =70.8, SD=11.9) than their caregivers ( M =52.4, SD=13.1). Stroke survivors predominantly had an ischemic stroke, equally distributed by site. Caregivers were primarily female (66%), with a medium to high educational level (57%). Caregiver preparedness significantly moderated the association between survivor depression and survivor psychological ( B =0.56, P <0.01) and environmental ( B =0.58, P <0.01) QOL at baseline and social QOL over time ( B =0.24, P <0.05). Similarly, caregiver preparedness significantly moderated the association between caregiver depression and caregiver physical ( B =0.25, P <0.01) and environmental ( B =0.18, P <0.05) QOL over time. Conclusions: Caregiver preparedness has a positive influence on both members of the dyad. Assessment of stroke-caregiver preparedness could be helpful to motivate clinicians to develop and implement interventions for stroke survivor-caregiver dyads.

Mental health during the COVID-19 quarantine in five countries

Introduction. As part of the holistic concept of health, mental health can be focused on prevention of contagion and coping with the disease and its consequences in the context of the current COVID-19 pandemic. The present study describes, compares, and analyzes the association of the impact of the event, perceived stress, coping strategies, emotional regulation, and sociodemographic characteristics during the quarantine in various countries. Material and methods. This research is a multicentric and epidemiological study with a convenience online snowball sampling of the general population and university students. Results. 1.179 participants from Colombia, Brazil, Mexico, Italy, and Spain responded to the survey. Most of them included students and workers, with a high educational level and living with family during the quarantine. There are significant differences in the medians of all variables among countries and sociodemographic characteristics. The variables positively and significantly associated with the impact of the event during quarantine included the perceived stress, the coping strategies of alcohol/drug use, planning and active coping, focus on emotions and vent, the emotional regulation strategy expressive suppression, and living in Italy. Conclusions. These results have contributed to the understanding of mental, emotional, and behavioral response to quarantine, as well as underline the urgency of monitoring mental health among the vulnerable groups, in order to design specific prevention and intervention programs.