Relation of corona-specific health literacy to use of and trust in information sources during the COVID-19 pandemic

Background COVID-19 has developed into a worldwide pandemic which was accompanied by an «infodemic» consisting of much false and misleading information. To cope with these new challenges, health literacy plays an essential role. The aim of this paper is to present the findings of a trend study in Switzerland on corona-specific health literacy, the use of and trust in information sources during the COVID-19 pandemic, and their relationships. Methods Three online surveys each with approximately 1′020 individuals living in the German-speaking part of Switzerland (age ≥ 18 years) were conducted at different timepoints during the COVID-19 pandemic, namely spring, fall and winter 2020. For the assessment of corona-specific health literacy, a specifically developed instrument (HLS-COVID-Q22) was used. Descriptive, bivariate, and multivariate data analyses have been conducted. Results In general, a majority of the Swiss-German population reported sufficient corona-specific health literacy levels which increased during the pandemic: 54.6% participants in spring, 62.4% in fall and 63.3% in winter 2020 had sufficient corona-specific health literacy. Greatest difficulties concerned the appraisal of health information on the coronavirus. The most used information sources were television (used by 73.3% in spring, 70% in fall and 72.3% in winter) and the internet (used by 64.1, 64.8 and 66.5%). Although health professionals, health authorities and the info-hotline were rarely mentioned as sources for information on the coronavirus, respondents had greatest trust in them. On the other hand, social media were considered as the least trustworthy information sources. Respondents generally reporting more trust in the various information sources, tended to have higher corona-specific health literacy levels. Conclusions Sufficient health literacy is an essential prerequisite for finding, understanding, appraising, and applying health recommendations, particularly in a situation where there is a rapid spread of a huge amount of information. The population should be supported in their capability in appraising the received information and in assessing the trustworthiness of different information sources.

Development of the simulation-based German albuminuria screening model (S-GASM) for estimating the cost-effectiveness of albuminuria screening in Germany

Background Chronic kidney disease is often asymptomatic in its early stages but constitutes a severe burden for patients and causes major healthcare systems costs worldwide. While models for assessing the cost-effectiveness of screening were proposed in the past, they often presented only a limited view. This study aimed to develop a simulation-based German Albuminuria Screening Model (S-GASM) and present some initial applications. Methods The model consists of an individual-based simulation of disease progression, considering age, gender, body mass index, systolic blood pressure, diabetes, albuminuria, glomerular filtration rate, and quality of life, furthermore, costs of testing, therapy, and renal replacement therapy with parameters based on published evidence. Selected screening scenarios were compared in a cost-effectiveness analysis. Results Compared to no testing, a simulation of 10 million individuals with a current age distribution of the adult German population and a follow-up until death or the age of 90 shows that a testing of all individuals with diabetes every two years leads to a reduction of the lifetime prevalence of renal replacement therapy from 2.5% to 2.3%. The undiscounted costs of this intervention would be 1164.10 € / QALY (quality-adjusted life year). Considering saved costs for renal replacement therapy, the overall undiscounted costs would be—12581.95 € / QALY. Testing all individuals with diabetes or hypertension and screening the general population reduced the lifetime prevalence even further (to 2.2% and 1.8%, respectively). Both scenarios were cost-saving (undiscounted, - 7127.10 €/QALY and—5439.23 €/QALY). Conclusions The S-GASM can be used for the comparison of various albuminuria testing strategies. The exemplary analysis demonstrates cost savings through albuminuria testing for individuals with diabetes, diabetes or hypertension, and for population-wide screening.

Why do people consent to receiving SARS-CoV2 vaccinations? A Representative Survey in Germany

Objective: to answer the question: Why do people consent to being vaccinated with novel vaccines against SARS-CoV2? Design: Representative survey Setting: Online panel Participants: 1032 respondents of the general German population Method: a representative survey among German citizens in November/December 2021 which resulted in 1032 complete responses on vaccination status, socio-demographic parameters and opinions about the COVID-19 situation. Results: Almost 83% of the respondents were vaccinated. The major motivation was fear of medical consequences of an infection and the wish to lead a normal life again. The major motivation to be not vaccinated was the fear of side effects and skepticism about long-term effectiveness and safety. Sixteen percent of vaccinated respondents reported some serious side effect, while more than 30% reported health improvements, mostly due to the relief of psychological stress and social reintegration. We also validated a “Corona Orthodoxy Score – COS” consisting of 7 items reflecting opinions on Covid-19. The scale is reliable (alpha = 0.76) and unidimensional. The COS was a highly significant predictor of vaccination status and readiness to be vaccinated in a multivariable logistic regression model. Those who were vaccinated were more likely to live in smaller households (OR = 0.82, p=0.024), had a higher income (OR = 1.27, p<0.001), a higher COS score (OR 1.4, p<0.0001) and utilized less alternative media (OR = 0.44, p=0.0024) and scientific publications (OR=0.42, p=0.011) as information sources. Conclusions: The major motives for being vaccinated are fear of medical symptoms and the wish to lead a normal life. Those not wanting to be vaccinated cite a lack of knowledge regarding long-term safety and side effects as reasons. This can likely only be overcome by careful and active long-term efficacy and safety monitoring.

Caring About (COVID-19 Related) Social Issues Signals Trustworthiness: Direct and Conceptual Replication of Zlatev (2019)

With three convenient samples (n = 1,087) and one sample representative for the German population in terms of age and gender (n = 210), we replicate research by Zlatev (2019) showing that perceived benevolence-based and perceived integrity-based trustworthiness increase with a target’s level of caring about a social issue. We show that these results generalize to various issues ranging from environmental issues (i.e., installation of wind turbines in the North Sea) to issues related to the COVID-19 pandemic (i.e., online teaching to prevent the spread of the virus). Furthermore, we provide initial behavioral evidence for this effect by showing that transfers in a trust game increase with a target’s caring about a social issue. All results are robust for age, gender, and social issue. To provide best estimates for the effect of a target’s level of caring on perceived trustworthiness, we report results of three mini meta-analyses including our findings as well as the findings of the original research. Policy implications are discussed.

NĚMECKÁ PŘÍJMENÍ V PŘÍHRANIČNÍ OBLASTI JIŽNÍCH ČECH A JEJICH SÉMANTICKO-MOTIVAČNÍ TYPY

This article analyses German surnames from the point of view of their motivation and classification into respective semantic-motivational types. The analysis is based on a corpus of data compiled at the beginning of the 21st century from the archive records containing surnames of inhabitants of the towns of Prachatice, Volary, Vimperk and Kašperské Hory. All of these towns are situated close to the German border and, until the mid-1940s, had predominantly been inhabited by German population. The final section of the article identifies the most frequent semantic-motivational types of German surnames currently used by Czechs in the area explored. The article also explains the etymology and motivation of these surnames in relation to the history of the region and to ethnic groups inhabiting the area since the Middle Ages.

Decreasing Number of Urodynamics in Urological and Gynaecological Clinics Reflects Decreased Importance for Surgical Indications: German Population-Based Data from 2013 to 2019

<b><i>Introduction:</i></b> The routine use of urodynamic studies (UDS) has been questioned. Additionally, the material and personnel costs are poorly remunerated. We aimed to analyse the UDS utilization in Germany. <b><i>Methods:</i></b> We analysed UDS performed by hospitals based on quality reports from 2013 to 2019. A representative sample of 4 million insured persons was used to estimate outpatient UDS utilization from 2013 to 2018. <b><i>Results:</i></b> There was an overall decrease of 14% in UDS in Germany from 2013 to 2018 (60,980 to 52,319; <i>p</i> = 0.003). In the outpatient sector, there was a slight non-continuous drop of 11% from 34,551 to 30,652 from 2013 to 2018 (<i>p</i> = 0.06). UDS utilization in hospitals decreased by 26% from 26,429 in 2013 to 19,453 in 2019 (<i>p</i> = 0.004). University hospitals showed a smaller decrease (3,007 to 2,685; <i>p</i> = 0.02). In urology, the number of UDS (11,758 to 6,409; <i>p</i> &#x3c; 0.001) and the number of performing departments (328 to 263 clinics; <i>p</i> &#x3c; 0.001) decreased. Gynaecological departments also showed a decrease in UDS (1,861 to 866; <i>p</i> &#x3c; 0.001) and performing departments (159 to 68; <i>p</i> &#x3c; 0.001). However, in paediatrics, there was an increase in UDS (1,564 to 2,192; <i>p</i> = 0.02). By age, the number of children remained constant (1,371 to 1,252; <i>p</i> = 0.2), but there was a strong decrease seen in 60- to 79-year-olds (9,792 to 5,564; <i>p</i> &#x3c; 0.001). <b><i>Conclusion:</i></b> UDS appear to be less important in the indication for surgery. Despite high resource expenditure and low remuneration, the decrease in urodynamics in the outpatient sector is less pronounced, indicating a trend to perform UDS in an outpatient setting.

The Health Status and Healthcare Utilization of Ethnic Germans in Russia

Ethnic German resettlers from the former Soviet Union are one of the largest migrant groups in Germany. In comparison with the majority of the German population, resettlers exhibit worse subjective health and utilize fewer preventive measures. However, there is little evidence on health among ethnic Germans who remained in Russia. Hence, the objective of this study was to determine the differences in subjective health, diabetes, smoking, and utilization of health check-ups between ethnic Germans and the majority population in Russia. We used data from the Russian Longitudinal Monitoring Survey II from 1994 to 2018 (general population of Russia n = 41,675, ethnic Germans n = 158). Multilevel logistic regression was used to calculate odds ratios (ORs) adjusted for age, sex, period, and place of residence. Analyses were furthermore stratified by the periods 1994–2005 and 2006–2018. Ethnic Germans in Russia rated their health less often as good compared with the Russian majority population (OR = 0.67, CI = 0.48–0.92). Furthermore, ethnic Germans were more likely to smoke after 2006 (OR = 1.91, CI = 1.09–3.37). Lower subjective health among ethnic Germans in Russia is in line with findings among minority populations in Europe. Increased odds of smoking after 2006 may indicate the deteriorating risk behavior of ethnic Germans in Russia.

CMV seropositivity is a potential novel risk factor for severe COVID-19 in non-geriatric patients

Background: COVID-19 has so far affected more than 250 million individuals worldwide, causing more than 5 million deaths. Several risk factors for severe disease have been identified, most of which coincide with advanced age. In younger individuals, severe COVID-19 often occurs in the absence of obvious comorbidities. Guided by the finding of cytomegalovirus (CMV)-specific T cells with some cross-reactivity to SARS-CoV-2 in a COVID-19 intensive care unit (ICU) patient, we decided to investigate whether CMV seropositivity is associated with severe or critical COVID-19. Methods: National German COVID-19 bio-sample and data banks were used to retrospectively analyze the CMV serostatus of patients who experienced mild (n=101), moderate (n=130) or severe to critical (n=80) disease by CMV IgG serology. We then investigated the relationship between disease severity and CMV serostatus via statistical models. Results: Non-geriatric patients (< 70 years) with severe COVID-19 were found to have a very high prevalence of CMV-seropositivity, while CMV status distribution in individuals with mild disease was similar to the prevalence in the German population; interestingly, this was not detectable in older patients. Prediction models support the hypothesis that the CMV serostatus might be a strong biomarker in identifying younger individuals with a higher risk of developing severe COVID-19. Conclusions: We identified CMV-seropositivity as a potential novel risk factor for severe COVID-19 in non-geriatric individuals in the studied cohorts. More mechanistic analyses as well as confirmation of similar findings in cohorts representing the currently most relevant SARS-CoV-2 variants should be performed shortly.

External validation of six clinical models for prediction of unknown chronic kidney disease in a German population

Background Chronic kidney disease (CKD) is responsible for large personal health and societal burdens. Screening populations at higher risk for CKD is effective to initiate earlier treatment and decelerate disease progress. We externally validated clinical prediction models for unknown CKD that might be used in population screening. Methods We validated six risk models for prediction of unknown CKD using only non-invasive parameters. Validation data came from 4,185 participants of the German Heinz-Nixdorf-Recall study (HNR), drawn in 2000 from a general population aged 45-75 years. We estimated discrimination and calibration using the full model information, and calculated the diagnostic properties applying the published scoring algorithms of the models using various thresholds for the sum of scores. Results The risk models used four to nine parameters. Age and hypertension were included in all models. Five out of six c-values ranged from 0.71 to 0.73, indicating fair discrimination. Positive predictive values ranged from 15% to 19%, negative predictive values were >93% using score thresholds that resulted in values for sensitivity and specificity above 60%. Conclusions Most of the selected CKD prediction models show fair discrimination in a German general population. The estimated diagnostic properties indicate that the models are suitable for identifying persons at higher risk for unknown CKD without invasive procedures.