Addressing health literacy in schools in the WHO European Region

Paakkari L, Inchley J, Anette S, Weber MW, Okan O. Addressing health literacy in schools in the WHO European Region. Public health panorama. 2019;5(2-3):186-190

The impact of school closure on adolescents’ wellbeing, and steps toward to a new normal: the need for an assessment tool update?

Close to 200 countries have implemented school closures to decrease the spread of the COVID-19 coronavirus. Though the closures have seemed necessary, their effects on the wellbeing of children and adolescents have raised serious concerns. To truly understand the impact of such disruption on young people’s wellbeing, and their views on how to move towards a new normal, we must adopt different approaches to gather the data to secure children’s and adolescents’ rights to be heard in the issues that concern their lives. Current ways to examine the impacts of school closure have been dominated by gathering information concerning the children and adolescents, using mainly existing wellbeing indicators and related questionnaire surveys. Although such sources of information are important, they provide limited understanding of how children and adolescents have experienced school closures, especially if they have been produced using measures developed purely by adults. There is a need for information produced by children and adolescents themselves, which may require going beyond existing and pre-COVID theoretical wellbeing frameworks. By capturing information produced by children and adolescents, we can more effectively guide the development and evaluation of public health policies and identify solutions to mitigate the negative impacts of school closure, or to acknowledge the possible positive effects, and respond accordingly

HBSC 2014 Survey in Scotland National Report

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Do country-level environmental factors explain cross-national variation in adolescent physical activity? A multilevel study in 29 European countries

Background:  Worldwide, roughly 80% of adolescents fail to meet World Health Organization (WHO) recommendations regarding physical activity, though there is substantial variation in adolescent physical activity prevalence across countries. This study explored whether country-level environmental differences explained cross-national variation in adolescent moderate- to vigorous-intensity physical activity (MVPA) and vigorous-intensity activity (VPA). Method:  Using the data of 138,014 11- to 15-year-olds from 29 European countries in the 2013/2014 Health Behaviour in School-aged Children (HBSC) study, multilevel regression models examined the influence of four types of country-level environmental factors (physical, socio-cultural, economic, and political) on self-reported individual-level physical activity (MVPA and VPA). Results:  The environmental variables explained 38% of country-level variance in MVPA and 81% of country-level variance in VPA. Lower annual average national temperature, higher community safety, lower average national household income and a weaker physical education policy were significantly associated with more MVPA. Greater urbanisation, lower annual average national temperature, higher adult physical activity and higher average national household income were significantly associated with more VPA. Conclusions:  The findings showed that national differences in the physical, socio-cultural and economic environment were related to adolescent physical activity. They point to potential avenues for future research looking at interactions between individual and environmental factors.Publisher PDFPeer reviewe

Association of alcohol control policies with adolescent alcohol consumption and with social inequality in adolescent alcohol consumption : a multilevel study in 33 countries and regions

Funding: The Health Behaviour in School-aged Children (HBSC) is an international study carried out in collaboration with WHO Europe. This research is funded by public sources in each member country. Specifically, ELL, CMM, and ISQ are supported by the Ministry de Health, Spain. CMM is supported by the VI Plan Propiode Investigación de la Universidad de Sevilla 2018, under the action “II.5B Contrato de acceso al Sistema Españolde Ciencia, Tecnología e Innovación para el Desarrollo del Programa Propio de I + D + i de la Universidad de Sevilla”. JI is supported by the UK Medical Research Council (MC_UU_12017/12) and the Chief Scientist Office (SPHSU12).Background  Previous research found inconsistent associations between alcohol control policies and socioeconomic inequality with adolescent drinking outcomes. This study expands the focus beyond individual associations to examine whether a combination of policies is related to socioeconomic inequality in adolescent drinking outcomes and whether this relationship varies across survey years. Methods  Multilevel modelling of 4 waves of repeat cross-sectional survey data (2001/02, 2005/06, 2009/10, and 2013/14) from the Health Behaviour in School-aged Children (HBSC) study was carried out. The sample was composed of 671,084 adolescents (51% girls) aged 11, 13, and 15 (mean age=13.58; SD=1.65) from 33 European and North American countries/regions. The dependent variables were lifetime alcohol consumption, weekly alcohol consumption, and lifetime drunkenness. Independent variables were of three types: individual-level variables (age, sex, Family Affluence Scale, and the Perceived Family Wealth), time-level variable (survey year), and context-level variables (minimum legal drinking age, physical availability, advertising restrictions, a total alcohol policy index, and affordability of alcohol). Results  The total alcohol policy index showed a negative relationship with both lifetime and weekly consumption. Higher affordability of alcohol was related to higher lifetime and weekly consumption and higher lifetime drunkenness. Family Affluence Scale was positively related to all three alcohol measures and Perceived Family Wealth was negatively related to lifetime drunkenness, with these associations increasing across survey years. The total alcohol policy index buffered the associations of Family Affluence Scale and Perceived Family Wealth with adolescent drinking outcomes. Conclusion  A combination of alcohol control policies is more effective in reducing adolescent drinking outcomes than single policy measures. Reducing the affordability of alcohol stood out as the most successful single measure. Socioeconomic inequalities (i.e. higher alcohol consumption and drunkenness in adolescents with higher family affluence and higher drunkenness in adolescents perceiving their families to be poor) have persisted and even increased across survey years. A combined alcohol control policy can help in tackling them.PostprintPublisher PDFPeer reviewe

Trends in early alcohol and drunkenness initiation, by gender and subregion

In 2014, around one in four adolescents in the Region first consumed alcohol at age 13 or younger, and just under one in 10 were first drunk at this early age. • Gender differences are not present in all countries and regions, but when present, boys are more likely to report early alcohol initiation and early drunkenness. • Early alcohol initiation has declined in most countries and regions. On average, early alcohol initiation across all countries and regions declined from 46% in 2002 to 28% in 2014. Similarly, early drunkenness more than halved, from 17% to 8%, over this period. • A significant increase in alcohol use at age 13 or younger was reported in Slovenia among both boys and girls and in Greece among girls only. • The biggest changes in early initiation of alcohol and drunkenness were seen in the Nordic and Ireland/Great Britain subregions, which had the highest prevalence in 2002. Less change was seen in the southern Europe/ Mediterranean subregio

Yield and content of biogenic elements in tomato fruit at different NaCl concentrations in nutrient solution

Kakvoću svježih plodova rajčice, osobito sadržaj minerala moguće je poboljšati povećanjem EC-vrijednosti, odnosno koncentracije NaCl-a u hranivoj otopini bez značajnijeg smanjenja prinosa. Istraživanje je provedeno tijekom 2004. i 2005. godine na sorti Belle, u hidroponima na pločama kamene vune s ciljem utvrđivanja utjecaja povećane koncentracije NaCl-a u hranivoj otopini na prinos rajčice i sadržaj biogenih elemenata u plodu. Pokus je postavljen po metodi slučajnog bloknog rasporeda u četiri ponavljanja, a uzorkovanje je provedeno u tri roka berbe. Hraniva otopina EC-vrijednosti 2 dS/m korištena je kao kontrola, a povećane ECvrijednosti su postignute dodavanjem NaCl-a u standardnu hranivu otopinu, 0,05 % pri 3 dS/m, 0,125 % pri 4,5 dS/m i 0,2 % pri 6 dS/m. Najveći prinos zabilježen je pri fertirigaciji standardnom hranivom otopinom i varirao je od 2,06 do 2,60 kg/biljci u 2004. i od 3,41 do 5,19 kg/biljci u 2005. Koncentracije 0,05 i 0,125 % NaCl-a rezultirale su statistički jednakim prinosom i sadržajem biogenih elemenata, a koncentracija 0,2 % NaCl-a signifikantno manjim vrijednostima navedenih parametara. Povećanjem koncentracije NaCl-a ostvareno je značajno povećanje sadržaja suhe tvari koje je proporcionalno povećanju NaCl-a u hranivoj otopini.Quality of fresh tomato fruits, especially mineral content can be improved by increasing the EC value, or the concentration of NaCl in the nutrient solution without a significant reduction in yield. The study was conducted during the years of 2004 and 2005 with Belle tomato variety in hydroponics rock wool slabs in order to determine the impact of increased concentrations of NaCl in the nutrient solution on tomato yield and content of biogenic elements in the fruit compared to the standard solution without added NaCl and the EC-value of 2 dS/m. The experiment was set in a randomized complete block design with four replications and sampling was conducted in three harvests. The nutrient solution with EC-value of 2 dS/m was used as a control and increased EC-values were achieved by adding NaCl in the standard nutrient solution, 0.05% at 3 dS/m, 0.125% at 4.5 dS/m and 0.2% at 6 dS/m. The highest yield was recorded with a standard nutrient solution treatment and ranged from 2.06 to 2.60 kg/plant in 2004 and from 3.41 to 5.19 kg/plant in 2004. In comparison to the standard solution without added NaCl, the concentration of 0.05 and 0.125% NaCl resulted in statistically equivalent yield and content of biogenic elements, and the concentration of 0.2% NaCl with reasonably smaller values of these parameters. Increasing NaCl recorded a significant increase in dry matter content, which is proportional to the increase of NaCl in the nutrient solution

Establishing spirituality as an intermediary determinant of health among 42,843 children from eight countries

The World Health Organization (WHO) Commission on the Social Determinants of Health (CSDH) conceptual framework identifies socio-economic position as a structural determinant of health. Recognized intermediary determinants include biological, behavioural, and psychosocial factors. We examined whether connections afforded by a healthy spirituality potentially act as unrecognized intermediary determinants in adolescent populations, contributing to inequities in mental health. Reports from 42,843 children (21,007 boys, 21,836 girls) from eight countries who participated in the 2017–2018 Health Behaviour in School-aged Children (HBSC) study were used to describe correlations between family affluence and positive levels of mental health, using a cross-sectional design. Based on the CSDH conceptual framework and multivariable regression analyses, we then examined whether these associations were mediated by spiritual health. Connections afforded by a high level of spiritual health were universally correlated with positive mental health status. In three Western European nations (England, Scotland, and Wales) and Canada affluence was correlated with better mental health and this was partially mediated by spiritual health. Among the four Eastern European countries (Latvia, Lithuania, Moldova, Poland), our findings did not support aspects of the CSDH framework that focus on affluence as a direct determinant of health. Spiritual health potentially is an intermediary determinant of children's health in some Western countries, but not in Eastern countries. The universality of social determinants of health models and the measures used in their evaluation require careful assessment across cultures, political contexts, and health outcomes