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Objectives Guidelines recommend colorectal cancer (CRC) screening by fecal occult blood test (FOBT) or colonoscopy. In 2013, Switzerland introduced reimbursement of CRC screening by mandatory health insurance for 50-69-years-olds, after they met their deductible. We hypothesized that the 2013 reimbursement policy increased testing rate. Methods In claims data from a Swiss insurance, we determined yearly CRC testing rate among 50-75-year-olds (2012-2018) and the association with socio-demographic, insurance-, and health-related covariates with multivariate-adjusted logistic regression models. We tested for interaction of age (50-69/70-75) on testing rate over time. Results Among insurees (2012355'683; 2018348'526), yearly CRC testing rate increased from 2012 to 2018 (overall 8.1-9.9%; colonoscopy 5.0-7.6%; FOBT 3.1-2.3%). Odds ratio (OR) were higher for 70-75-year-olds (2012 1.16, 95%CI 1.13-1.20; 2018 1.05, 95%CI 1.02-1.08). Deductible interacted with changes in testing rate over time (p less then 0.001). The increase in testing rate was proportionally higher among 50-69-years-olds than 70-75-year-olds over the years. Conclusions CRC testing rate in Switzerland increased from 2012 to 2018, particularly among 50-69-years-olds, the target population of the 2013 law. Future studies should explore the effect of encouraging FOBT or waiving deductible.Objective Cancer screening rates are suboptimal for disadvantaged populations in France, yet little evidence exists on their cancer-related knowledge and screening barriers. The main objective of this study was to examine cancer-related knowledge, awareness, self-efficacy, and perceptions of screening barriers among low-income, illiterate immigrant women in France following an 8-weeks cancer educational intervention. Methods Semi-structured qualitative interviews were conducted with 164 female participants in the Ain department of France between January 2019 and March 2020. Adopting the Health Belief Model as an intervention and analytic framework, salient themes were identified using qualitative thematic analysis. Results Increased levels of perceived susceptibility to and perceived severity of cancer contributed to higher motivation to get screened. Barriers to screening included low French proficiency, shame surrounding illiteracy, and constant worries due to precarious living conditions. Perceived benefits (e.g., valuing one's health and health-promoting behaviors), cues to action from a trusted source, and greater self-efficacy (e.g., more autonomous in healthcare-seeking) outweighed perceived barriers, including cultural barriers. Conclusions Implications include developing audience-responsive targeted cancer screening communication strategies and educational materials to increase screening rates and reduce cancer and cancer screening inequities.Objectives To assess time trends in the social class inequalities and in total inequality in disability and self-rated health (SRH) in two oldest old populations. Methods The data came from the Finnish Vitality 90+ Study (2001, 2003, 2007, 2010, 2014 and 2018; n = 5,440) and from the Swedish Panel Study of Living Conditions of the Oldest Old (2002, 2004, 2011 and 2014; n = 1,645). Inequalities in mobility and activities of daily living (ADL) disability and SRH were examined cross-sectionally and over time using relative and absolute measures. Results Lower social classes had greater mobility and ADL disability and worse SRH than higher social classes and the inequalities tended to increase over time. Findings were remarkably similar in both studies and with absolute and relative measures. Total inequality, referring to the variance in health outcome in the total population, remained stable or decreased. Conclusion The study suggests that the earlier findings of improved mobility and ADL are largely driven by the positive development in higher social classes while findings of decline in SRH are related to the worsening of SRH in lower social classes.Objectives Young adults are essential to the effective mitigation of the novel coronavirus (SARS-CoV-2/COVID-19) given their tendency toward greater frequency of social interactions. Little is known about vaccine willingness during pandemics in European populations. This study examined young people's attitudes toward COVID-19 vaccines in Fall 2020. Methods Data came from an ongoing longitudinal study's online COVID-19-focused supplement among young adults aged 22 in Zurich, Switzerland (N = 499) in September 2020. Logistic regressions examined young adults' likelihood of participating in COVID-19 immunization programs. Results Approximately half of respondents reported being unlikely to get vaccinated against COVID-19. [https://www.selleckchem.com/Androgen-Receptor.html Androgen Receptor Antagonist] Compared to males, females were more likely to oppose COVID-19 vaccination (p less then 0.05). In multivariate models, Sri Lankan maternal background and higher socioeconomic status were associated with a greater likelihood of getting vaccinated against COVID-19 (p less then 0.05). Respondents were more likely to report a willingness to get vaccinated against COVID-19 when they perceived 1) an effective government response (p less then 0.05) and 2) their information sources to be objective (p less then 0.05). Conclusion This study communicates aspects important to the development of targeted information campaigns to promote engagement in COVID-19 immunization efforts.Objectives To investigate the perspectives and attitudes of people living with human immunodeficiency virus (PLHIV) in Slovakia. Methods A cross-sectional, computer-assisted web survey on health status, emotional support, stigmatisation, communication with physician, treatment, perception, decision-making, concerns, and treatment history. A representative sample of &gt;10% of all PLHIV (N = 895) in Slovakia was invited to participate. Results Mean age of the 117 respondents was 35.4 (±8.9) years, 52.8% had higher education, and 67.0% were in full-time employment. Most (89.4%) were receiving antiretroviral therapy (ART), and 81.8% had undetectable viral load. Most (85.1%) were satisfied with their ART, and side effects were the primary reason for switching therapies. Most (60.8%) had informed only close friends or relatives about their HIV status, only 3 (2.9%) spoke openly about it, and 60.0% hid their ART from others. Of the 31 respondents (31.6%) who experienced stigmatisation, it was primarily from dentists and other physicians who refused to treat them. Conclusion In general, PLHIV in Slovakia receive ART and are satisfied with it. They do not speak openly about their HIV status, and some have experienced discrimination.Objectives An effective vaccine to SARS-CoV-2 cannot be successfully deployed if a significant number of people worldwide are unwilling to accept it. We investigated the relationship between trust in scientists and medical professionals and perceptions of vaccine safety and effectiveness. We also build on past studies by exploring the relationship between confidence in global health organizations and vaccine hesitancy. Methods We conducted an online survey in seventeen countries/territories across five world regions between May -June 2020. We assessed the relationship between COVID19 vaccine hesitancy, confidence in public health organizations, and trust in key experts and leaders. Results Our findings strongly suggest that confidence in the World Health Organization combined with trust in domestic scientists and healthcare professionals is a strong driver of vaccine acceptance across multiple countries/territories. Conclusion We find that hesitancy is widespread, and uptake would be insufficient to achieve herd immunity. There is widespread confidence in how public health organizations have responded to the current pandemic and this is related to vaccine acceptance. Our results also highlight the important role of trust in health care providers and scientists in reducing COVID19 vaccine hesitancy.Objectives We aimed to explore the impact of the Swiss shutdown in spring 2020 on the intensity of health services use in general practice. Methods Based on an electronic medical records database, we built one patient cohort each for January-June 2019 (control, 173,523 patients) and 2020 (179,086 patients). We used linear regression to model weekly consultation counts and blood pressure (BP) and glycated hemoglobin (HbA1c) measurement counts per 100 patients and predicted non-shutdown values. Analyses were repeated for selected at-risk groups and different age groups. Results During the shutdown, weekly consultation counts were lower than predicted by -17.2% (total population), -16.5% (patients with hypertension), -17.5% (diabetes), -17.6% (cardiovascular disease), -15.7% (patients aged 80 years). Weekly BP counts were reduced by -35.3% (total population) and -35.0% (hypertension), and HbA1c counts by -33.2% (total population) and -29.8% (diabetes). p-values less then 0.001 for all reported estimates. Conclusion Our results document consequential decreases in consultation counts and chronic disease monitoring during the shutdown. It is crucial that health systems remain able to meet non-COVID-19-related health care needs.Objectives An inverse relationship between education and cardiovascular risk has been described, however, the combined association of education, income, and neighborhood socioeconomic status with macrovascular disease is less clear. The aim of this study was to evaluate the association of educational level, equivalent household income and area deprivation with macrovascular disease in Germany. Methods Cross-sectional data from two representative German population-based studies, SHIP-TREND (n = 3,731) and KORA-F4 (n = 2,870), were analyzed. Multivariable logistic regression models were applied to estimate odds ratios and 95% confidence intervals for the association between socioeconomic determinants and macrovascular disease (defined as self-reported myocardial infarction or stroke). Results The study showed a higher odds of prevalent macrovascular disease in men with low and middle educational level compared to men with high education. Area deprivation and equivalent income were not related to myocardial infarction or stroke in any of the models. Conclusion Educational level, but not income or area deprivation, is significantly related to the macrovascular disease in men. Effective prevention of macrovascular disease should therefore start with investing in individual education.Objectives Obesity is a risk factor for several chronic conditions, including sleep disorders. We aimed to analyze the relationship between BMI, body fat percentage (FAT%), hip and waist circumference, and weight on the duration of nocturnal sleep. Methods This study was part of the MASHAD cohort study. In all participants BMI and FAT% were measured. BMI was used to categorize individuals as obese, overweight, and normal subjects. FAT% was used to categorize individuals into tertile tertile 1 (low) 8 h. Results There was a significant inverse association between body weight and duration of sleep (p less then 0.05). Obese and overweight participants had 1.152 OR (CI1.083-1.225) and 1.126 OR (CI1.063-1.194) for a short duration of nocturnal sleep, respectively, relative to those with a normal BMI. Conclusion BMI was an independent determinant of nocturnal sleep duration; obesity and overweight may have negative consequences on sleep duration. Weight control should be considered as a factor in adjusting sleep quality.