Journal of Public Health

Several studies have established the association of various cancers with tobacco consumption. However, hardly any attempt has been made to examine the combined effect of various forms of tobacco consumption. Hence, the present study was undertaken to measure the overall risk of different cancer sites associated with various forms of tobacco used individually or in combination, and to investigate the risk variation within each site by different forms of use. Meta-analysis was carried out on the findings of 22 published studies of samples exposed to tobacco use and control groups that were not exposed to tobacco. The pooled odds ratios (ORs) for each cancer for different combinations of forms of tobacco were calculated using a random effects model. Smoking was found to be associated with a 5-fold higher risk of oropharynx, larynx, and lung, a 3-fold higher risk of hypopharynx, and esophagus, and a 2-fold higher risk of oral cancer. Esophagus (OR = 3.5) and oral cancer were the only sites significantly associated with tobacco chewing. The OR associated with bidi smoking was highest for lung (6-fold) followed by esophagus (3.5-fold) and oral cancer (3-fold). Lung cancer was also significantly associated with cigarette smoking. The present study reported pooled ORs for different tobacco-related cancers associated with various forms of tobacco use, both individually as well as in various combinations. Collecting data on the consumption of tobacco is a complex exercise. Pooled ORs reported in this study will be useful in working out the quantum of diverse tobacco-related cancers attributable to different forms of tobacco consumption, both individually as well as in combination.

This study was carried out to determine the relationship between health literacy and eating attitudes of adolescents. This descriptive and correlational study was conducted with 1519 adolescents. A Personal Information Form, Turkish Health Literacy Scale-32, and Eating Attitudes Test were used to collect data. Data were assessed by using the SPSS 21 statistical package program with Independent samples t test, ANOVA test, and Pearson correlation test. The mean total score of the adolescents on the Turkish Health Literacy Scale-32 was 33.68 ± 10.33 and 31.3% had a sufficient and 28.8% had a problematic-limited level of health literacy. The mean eating attitudes score of the adolescents was calculated as 12.20 ± 12.24 and 20.4% were determined to have a risky eating attitude. In this study, it was found that most of the adolescents had a sufficient level of health literacy and normal eating attitudes.

In Deutschland sind für medizinische Rehabilitationsmaβnahmen die Rentenversicherungsträger bei pflichtversicherten Arbeitern und Angestellten zuständig. Die Maβnahmen sollen Frühberentungen aus gesundheitlichen Gründen vermeiden. Die bedarfsgerechte Selektion der Teilnehmer an Rehabilitationsmaβnahmen wird in Frage gestellt. Expertenschätzungen beziffern den Anted der Überinanspruchname auf 30 %. Wir untersuchten im Rahmen eines Modellversuchs, der sich mit der Entwicklung und Erprobung eines Screenings zur rechtzeitigen Einleitung von Rehabilitationsmaβnahmen bei Versicherten eines Rentenversicherungsträgers befaβte, auch die Frage, ob die behauptete Überinanspruchnahme von Rehabilitationsmaβnahmen empirisch begründet ist. Zu diesem Zweck holten wir bei 53 Versicherten, die im Modellversuch an Rehabilitationsmaβnahmen teilnahmen, ein Zweitgutachten bei Antritt der Rehabilitationsmaβnahme in der Rehabilitationsklinik ein. Das Zweitgutachten der Reha-Ärzte wurde nach denselben Richtlinien wie das Erstgutachten der Hausärzte, auf dem die Bewilligung der Rehabilitationsmaβnahme durch den Rentenversicherungsträgerberuhte, erstellt. Gegenstand des Vergleichs zwischen Erstund Zweitgutachten war en die Diagnosen und die Beurteilung der Minderung/Gefährdung der Erwerbsfähigkeit Die Zweitgutachten bestätigten in 66 % der Fälle die Hauptdiagnose des Hausarztes. Demgegenüber war gemessen an den Zweitgutachten bei 33 % der Versicherten die Rehabilitationsmaβnahme nicht indiziert, well nach den geltenden Bewilligungsbestimmungen wedereine erhebliche Gefährdungnoch Minderung der Erwerbsfähigkeit bestand. Die Untersuchungen bestätigten damit die These von der Überinanspruchnahme von Rehabilitationsmaβnahmen und die vermutete Gröβenordnung. Die Bewilligungskriterien für Rehabilitationsmaβnahmen müβten überprüft werden

Open Source Intelligence (OSINT) and Signals Intelligence (SIGINT) from the clandestine intelligence sector are being increasingly employed in infectious disease outbreaks. The purpose of this article is to explore how such tools might be employed in the detection, reporting, and control of outbreaks designated as a ‘threat’ by the global community. It is also intended to analyse previous use of such tools during the Ebola and SARS epidemics and to discuss key questions regarding the ethics and legality of initiatives that further blur the military and humanitarian spaces. We undertake qualitative analysis of current discussions on OSINT and SIGINT and their intersection with global health. We also review current literature and describe the debates. We built on quantitative and qualitative research done into current health collection capabilities. This article presents an argument for the use of OSINT in the detection of infectious disease outbreaks and how this might occur. We conclude that there is a place for OSINT and SIGINT in the detection and reporting of outbreaks. However, such tools are not sufficient on their own and must be corroborated for the intelligence to be relevant and actionable. Finally, we conclude that further discussion on key ethical issues needs to take place before such research can continue. In particular, this involves questions of jurisdiction, data ownership, and ethical considerations.

In dieser Studie wurde die prädiktive Validität der 20 Items der deutschen Version der Center for Epidemiological Studies-Depression Scale (CES-D, ADS) geschlechterbezogen untersucht. Mit den Antworten von 516 Teilnehmerinnen und Teilnehmern der Berliner Altersstudie (70- bis 103-jährige Frauen und Männer) wurden Itemanalysen durchgeführt. Für Männer waren die meisten Items schwieriger und weniger trennscharf als für Frauen. Darüber hinaus wurden die Itemwerte zu psychiatrischen Depressionsdiagnosen nach DSM-III-R in Beziehung gesetzt, um deren Sensitivität und Spezifität für beide Geschlechter zu ermitteln. Die Itemsensitivitäten fielen eher niedrig aus und unterschieden sich für Frauen und Männer sehr stark. Diese Unterschiede spiegelten sich in der Sensitivität des Gesamtwerts (Cut-Off: 16) wider, die Konfidenzintervalle der Schätzungen überlappten jedoch. Mit Regressionsanalysen wurden die Itemantworten durch das Geschlecht der Person, die Depressionsdiagnose und die Interaktion dieser Prädiktoren vorhergesagt. Die Items 8 und 15 standen in keinem Zusammenhang zur psychiatrischen Depressionsdiagnose. Die Werte von sieben Items wurden signifikant durch die psychiatrische Diagnose und das Geschlecht bzw. die Interaktion von Diagnose und Geschlecht vorhergesagt. Auch wenn auf der Ebene des Gesamtwerts keine statistisch signifikanten Unterschiede in der Validität gefunden wurden, kann es von praktischer Bedeutung sein, dass einzelne CES-D Items nicht die gleiche diagnostische Qualität für Frauen und Männer aufwiesen.

To assess the patterns regarding COVID-19 infection and vaccination, along with the intention and hesitancy towards receiving a booster dose of the COVID-19 vaccine among community pharmacists in Istanbul, Türkiye. This was a cross-sectional, descriptive study conducted using a three-part structured validated questionnaire among community pharmacists. Vaccine hesitancy from a booster dose of the COVID-19 vaccine was assessed using the Vaccine Hesitancy Scale. A total of 145 community pharmacists were included, with a mean age of 43.22 ±13.3 years. Ninety-eight percent of the respondents received the COVID-19 vaccine. Most of the participants reported significant agreement to receiving a booster dose of the vaccine (91.7%, P < 0.0001). There was a statistically significant correlation between the intention to receive a booster vaccine dose and female gender (P = 0.0008), pharmacy education degree (bachelor’s degree; P < 0.0001), and work experience more than 10 years (P < 0.0001). Regardless of side effects from the previous dose, most of pharmacists who received the COVID-19 vaccine reported an intention to receive the booster dose, which generally builds trust in vaccine acceptance and undoubtedly plays a significant role in the control of the COVID-19 pandemic.

The aim of this study was to evaluate the effectiveness of a peer-led HIV/AIDS education program in improving HIV-related health literacy, knowledge, risk perception, preventive self-efficacy and behavioral intention of jailed adolescents. A quasi-experimental study design with pre- and post-intervention measurement was conducted at a juvenile detention center in Tunis, Tunisia. One hundred two adolescents out of 112 answered the validated questionnaires at both baseline and follow-up. The intervention consisted of two sections: a 45-min lecture and a 30-min promotional video. The data on HIV-related health literacy, knowledge, risk perception, preventive self-efficacy and behavioral intention were collected up to 30 days prior to the start of the intervention, November 2017, and 30 days following the end of the intervention period, February 2018. When changes over time, from baseline to follow-up, were compared between the intervention and comparison groups, differences were found for HIV-related health literacy (p = 0.029), knowledge (p = 0.031), risk perception (p = 0.043), preventive self-efficacy (p = 0.031) and behavioral intention (p = 0.019). The peer-led HIV/AIDS education program contributes to the development of HIV-related health literacy of jailed adolescents. It is possible to elaborate aspects of HIV-related health literacy in a non-formal education setting.

To investigate the roles of socio-economic characteristics and lifestyle in obesity and mental health jointly and interaction between the two for adults in France, where in-depth analysis has not existed on the subject. Data are from the 2008 Survey of Health and Disability. The sample comprises individuals who responded to the filter Survey of Daily Life and Health. The Health and Disability component was conducted among 30,000 children and adults face-to-face. Mental health information was collected in self-administered questionnaires. The study sample comprises 13,628 adults age 20 and above. We estimate a simultaneous-equation system of ordinal body weight and continuous mental health. Marginal effects are calculated to exploit the roles of exogenous variables in the two health outcomes. Overweight and obesity contribute to mental health disorders, more notably in men than women. Men with mental health disorders are less likely to be overweight or obese. Education beyond the baccalaureate level decreases the probabilities of overweight and obesity substantially and improves mental health for both men and women. Lifestyle, dietary habit, income, and age play important roles in mental health and obesity. Gender differences are present. Demographic factors play important roles in obesity and mental health. Policy interventions should address obesity and mental health jointly and be gender specific. Promoting a physically active lifestyle and education can have definitive impacts.