Differences Regarding Knowledge of Sexually Transmitted Infections, Sexual Habits, and Behavior Between University Students of Medical and Nonmedical Professions in Serbia

Aim: The aim of this study is to assess the knowledge of sexually transmitted infections (STIs), sexual habits, and behavior among students of medical and nonmedical students in Serbia.Methodology: The cross-sectional study of 1,273 university students of four undergraduate institutions in Serbia, two of medical and two of nonmedical orientation. A standardized questionnaire, prepared in line with the questionnaire of the European health research—the second wave (European Health Interview Survey—EHIS wave 2), according to defined internationally accepted indicators, was used as a survey instrument.Results: Statistically significant difference (p < 0.001) between medical and nonmedical student groups was determined for the following parameters: naming four of five STIs (29.1 vs. 13.4%), knowledge about vaccines against some STIs (26.0 vs. 17.0%), relationship between HPV infection and cervical malignancy (48.2 vs. 16.7%) engaged in the sexual relations (87.9 vs. 76.4%), never used a condom (15.2 vs. 10.4%), underwent gynecological or urological examination (66.7 vs. 44.1%), and tested to one of STIs (10.5 vs. 4.9%).Conclusion: Both student groups have limited knowledge on possible consequences that risky sexual behavior has for reproductive health. Promotion of knowledge about STIs, awareness of all complications, and consequences of these infections certainly affect the reduction of risky behavior.

Cross-national data on informal caregivers of older people with long-term care needs in the European population: time for a more coordinated and comparable approach

To promote long-term care policies for older adults, accurate mapping of the often invisible and insufficiently recognized role of their informal caregivers is needed. This paper measures the prevalence of informal caregivers in the European population, illustrates current difficulties in gathering unequivocal information on this topic and deals with the scientific and policy implications of the problem. Using the European Health Interview Survey (EHIS), the European Quality of Life Survey (EQLS) and the Study on Health and Ageing in Europe (SHARE), the current difficulties in gathering unequivocal information on this topic are illustrated. In most countries, the share of informal caregivers varies, sometimes markedly, among the three surveys. As for the sex of caregivers, while confirming the well-known higher prevalence of caregivers among women than among men, large variations emerge across the three surveys in most countries in respect of the two sexes. The takeaway message of the paper is that it is urgent to promote international concerted action in gathering comprehensive informal caregiving information and/or exploring in greater depth the different intercultural understandings of informal care itself.

Reliability and Validity of Slovenian Versions of IPAQ-SF, GPAQ and EHIS-PAQ for Assessing Physical Activity and Sedentarism of Adults

Health policies rely on physical activity (PA) and sedentary behavior data collected through PA questionnaires (PAQs). Validity of international PAQs varies among countries. Therefore, it is important to know the validity of the national versions of the PAQs to properly evaluate the results. We conducted a validation study of the Slovenian versions of the International PAQ Short Form (IPAQ-SF), the Global PAQ (GPAQ), and the PAQ used in the European Health Interview Survey (EHIS-PAQ) on 306 healthy adults. The most valid and reliable constructs in all tested were sedentary behavior and vigorous PA (VPA), however the criterion validity of these constructs was low (Spearman’s ρ 0.38–0.45 for sedentary behavior and 0.34–0.42 for VPA). Moderate to vigorous PA (MVPA) had low validity (0.26–0.29) despite being used as a standard measure of PA behavior. Participants over-reported MVPA for 17 to 156 min and underreported the sedentary behavior for more than two hours. The test-retest study found high reliability for sedentary behavior (0.69–0.81) and low to moderate reliability for PA behavior (0.42–0.76). The Slovenian versions of the observed PAQs are a useful tool for national PA surveillance, but for qualitative assessment of individual health-related PA behavior they should be combined with accelerometer-based devices.

A short-form suggestion for the Turkish version of the European Health Literacy Survey Questionnaire: a development and validation study in university students

The European Health Literacy Survey Questionnaire was translated into Turkish following a validity and reliability study, but there is no comprehensive short form available. We aimed to suggest a short form of the 47-item Turkish version of European Health Literacy Survey Questionnaire in this study. Data were obtained from a cross-sectional study that included a total of 686 students, 345 male and 341 female, conducted in nine different faculties of a university using the Turkish version of European Health Literacy Survey Questionnaire. The development process of the short form was conducted using principal component analysis with exploratory factor analysis, and correlation and regression analyses. The validation process was done using confirmatory factor analysis and regression analysis. Based on the results, a 12-item short form was developed, retaining the conceptual framework of the European Health Literacy Survey Questionnaire. The short form was shown to have adequate psychometric properties with high reliability, good validity, a high and moderate level of correlation, and a good model fit with the independent dataset in this cross-sectional study. The short form developed in this study was demonstrated to be a valid and reliable tool to measure health literacy easily and rapidly in Turkey.

Covid-19 Case Statistics in Europe Show Moderate Negative Correlation with Vaccination Level

Based on the statistics of Covid-19 cases and vaccination level in the last quarter of 2021, a moderate negative correlation was detected between the level of vaccination and current and peak case numbers in a number of European health jurisdictions. Statistically significant correlation was detected after taking into account differences in the local phase of the cases curve, by comparing statistics at the similar phase such as near the top of a local wave rather than current. These results may indicate a certain level of effectiveness of vaccines in preventing Covid-19 spread in the population, though analysis of other factors is still needed for a confident conclusion.

The European Health Union: European Union’s Concern about Health for All. Concepts, Definition, and Scenarios

The COVID-19 pandemic brought visibility and intensified the discussions on the European Union’s (EU) health mandate. The proposals of the European Commission (EC) to move towards a European Health Union (EHU) can be seen as a starting point towards more integration in health. However, the definition of what the EHU will look like is not clear. This paper searches to find a common definition, and/or features for this EHU through a systematic literature review performed in May 2021. “European Union’s concern about health for all” is suggested as a definition. The main drivers identified to develop an EHU are: surveillance and monitoring, crisis preparedness, funding, political will, vision of public health expenditures, population’s awareness and interest, and global health. Based on these findings, five scenarios were developed: making a full move towards supranational action; improving efficiency in the actual framework; more coordination but no real change; in a full intergovernmentalism direction; and fragmentation of the EU. The scenarios show that the development of a EHU is possible inside the current legal framework. However, it will rely on increased coordination and has a focus on cross-border health threats. Any development will be strongly linked to political choices from Member States.

Health expectancy indicators: what do they measure?

Background Health expectancy indicators aim at capturing the quality dimension of total life expectancy.; however, the underlying approach, definition of health, and information source differ considerably among the indicators available. Objective (1) Review the main concepts and approaches used to estimate health expectancy focusing on two widely used European health indicators: Health-Adjusted Life Expectancy (HALE) and Healthy Life Years (HLY); (2) identify underlying differences between the results yielded by these two indicators. Method Statistical differences between the HALE and HLY indicators by sex at ages 50, 60, and 70 were tested using pairwise and global Student´s t-tests and z-scores based on standard deviation. Data for 29 European countries were collected from the European Health Expectancy Monitoring Unit (EHEMU) information system and the World Health Organization (WHO) Global Burden of Disease Study 2016 (GBD 2016). Results The HALE indicator estimates were smoother across European countries compared with those of the HLY indicator, present a narrower sex gap in morbidity, higher z-scores compared with the average distribution across Europe, and results less sensitive to cross-national variations. Conclusion The HALE estimates indicate that morbidity is more compressed for both sexes, whereas the HLY estimates suggest that morbidity is more compressed for males but more expanded for females. These contrasting results demonstrate that health expectancy indicators should be interpreted with caution.

Does the global activity limitation indicator measure participation restriction? Data from the European Health and Social Integration Survey in Spain

Purpose The global activity limitation indicator (GALI) is the only internationally agreed and harmonised participation restriction measure. We examine if GALI, as intended, is a reflective measure of the domains of participation; furthermore, we determine the relative importance of these domains. Also, we investigated the consistency of response to GALI by age and gender and compared the performance of GALI with that of self-rated health (SRH). Methods We used Spanish data from the European Health and Social Integration Survey and selected adults aged 18 and over (N = 13,568). Data analysis, based on logistic regression models and Shapley value decomposition, were also stratified by age. The predictors of the models were demographic variables and restrictions in participation domains: studies, work, mobility, leisure and social activities, domestic life, and self-care. The GALI and SRH were the response variables. Results GALI was strongly associated with all participation domains (e.g. for domestic life, adjusted OR 24.34 (95% CI 18.53–31.97) in adult under 65) and performed differentially with age (e.g. for domestic life, adjusted OR 13.33 (95% CI 10.42–17.03) in adults over 64), but not with gender. The relative importance of domains varied with age (e.g. work was the most important domain for younger and domestic life for older adults). The results with SRH were parallel to those of GALI, but the association of SRH with participation domains was lowest. Conclusions GALI reflects well restrictions in multiple participation domains and performs differently with age, probably because older people lower their standard of good functioning.

Literacia em Saúde nos Doentes Hospitalizados num Serviço de Medicina Interna

Introdução: Literacia em saúde é um tema de popularidade crescente face à relevância e impacto que tem nos re- sultados clínicos. Existem diversas ferramentas de avaliação de literacia em saúde sendo o European Health Literacy Sur- vey Questionnaire (HLS-EU) o mais recentemente aplicado e validado. Graus de literacia consideradas problemáticas ou insuficientes estão associadas a incidência e gravidade pior de doenças, taxas de hospitalização e morbi-mortalidade superior. O objetivo foi aferir o grau de literacia em saúde relativamente aos cuidados de saúde.Material e Métodos: Aplicação da versão portuguesa do questionário HLS-EU (HLS-PT) aos doentes internados ao cuidado da medicina interna. Incluídos todos os doentes internados ao cuidado da medicina interna, tendo-se excluído de doentes cognitivamente e clinicamente incapazes de responder ao questionário. Resultados: Foram inquiridos 64 doentes. A amostra era maioritariamente do sexo masculino (57%) com média de idade 71 anos, reformado (71,8%) e com grau de escolaridade baixa (56,2% com formação académica até 1o ciclo). A maioria (68,7%) tinha grau de literacia em saúde problemática ou insuficiente quanto aos cuidados de saúde. Conclusão: Apesar de se reconhecer que, tanto o ambiente da aplicação do questionário como as características demográficas deste estudo serem diferentes do estudo nacional e europeu, revela-se um resultado preocupante da literacia em saúde de indivíduos hospitalizados com doenças crónicas.

The role of European health system characteristics in affecting Covid 19 lethality during the early days of the pandemic

This article examines the main factors affecting COVID-19 lethality across 16 European Countries with a focus on the role of health system characteristics during the first phase of the diffusion of the virus. Specifically, we investigate the leading causes of lethality at 10, 20, 30, 40 days in the first hit of the pandemic. Using a random forest regression (ML), with lethality as outcome variable, we show that the percentage of people older than 65 years (with two or more chronic diseases) is the main predictor variable of lethality by COVID-19, followed by the number of hospital intensive care unit beds, investments in healthcare spending compared to GDP, number of nurses and doctors. Moreover, the variable of general practitioners has little but significant predicting quality. These findings contribute to provide evidence for the prediction of lethality caused by COVID-19 in Europe and open the discussion on health policy and management of health care and ICU beds during a severe epidemic.