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Self-medication (SM) forms an important part of public health strategy. Nonetheless, little research has been performed to understand the current state of self-medication in the European Union (EU). Utilizing data from the third wave of the European Health Interview Surveys, this study finds an estimated SM prevalence of 34.3% in the EU (95%CI = 34.1-34.5%; n = 255,758). SM prevalence, as well as SM prevalence inequality between men and women, varies substantially between EU member countries. Via multivariable analysis, we also identify a number of variables associated with SM, most notably the substantial impact of health systems on SM behavior (Adjusted Odds Ratio [AOR] = 4.00; 95% Confidence Interval [95%CI] = 3.81–4.21). Several demographics are also associated with greater SM prevalence, including those aged 25–44 (versus ages 75+: AOR = 1.21; 95%CI = 1.12–1.31), women (AOR = 1.74; 95%CI = 1.68–1.81), immigrants born in other EU states (AOR = 1.16; 95%CI = 1.04–1.30), those with higher education (AOR = 1.83; 95%CI = 1.60–2.09), and urban dwellers (AOR = 1.14; 95%CI = 1.04–1.30). Additionally, long-standing health problems (AOR = 1.39; 95%CI = 1.33–1.45), visits to doctors (both general practitioners and specialists) (AOR = 1.21, 95%CIs = 1.15–1.26, 1.17–1.26), and unmet needs for health care due to waiting lists (AOR = 1.38; 95%CI = 1.23–1.55) or inability to afford medical examinations/treatment (AOR = 1.27; 95%CI = 1.12–1.42) serve as conditioners for SM. We also find that smoking (AOR = 1.05; 95%CI = 1.01–1.10), vaping (AOR = 1.19; 95%CI = 1.06–1.32), drinking alcohol (AOR = 1.23; 95%CI = 1.19–1.28), and higher levels of physical activity (AOR = 1.27; 95%CI = 1.22–1.32) are factors associated with SM. Analysis of these variables reveals that though women self-medicate more than men, the patterns that govern their consumption are similar. [ABSTRACT FROM AUTHOR]

Introduction: Diabetes, a key chronic non-communicable disease, poses a substantial public health burden. The role of oral health as a determinant in the epidemiology of diabetes mellitus, particularly in the Central Eastern European region, remains underexplored. This research aims to examine the impact of specific oral health parameters, including gum bleeding, active dental caries, tooth mobility, and tooth loss, on diabetes prevalence. Additionally, it seeks to clarify the moderating effects of socio-demographic and lifestyle variables on this relationship. Materials and methods: Data were extracted from the 2014 and 2019 datasets of the Hungarian European Health Interview Survey, comprising a combined nationally representative sample of 11,429 participants. Descriptive statistics were presented as weighted proportions and unweighted counts, and weighted Pearson's chi-squared tests were employed for assessing associations and goodness-of-fit. Significant predictors were integrated into weighted multiple logistic regression models for analysis. Sensitivity analysis was then conducted to confirm the robustness of the findings. Results: The study identified 'Bad' self-perceived oral health as a diabetes risk (OR=1.35; 95% CI: [1.04-1.75]), with filled teeth being protective (0.65 [0.51-0.84]). Subgroup analysis revealed higher diabetes odds among individuals with primary education (1.41 [1.02-1.96]) and rural residents with tooth loss from decay (3.54 [1.36-9.19]). The bootstrap analysis with 1,000 iterations reaffirmed the model's stability and predictive accuracy for diabetes. Discussion: Enhanced oral health is associated with lower risk factors for diabetes. This research highlights the importance of including oral health measures in comprehensive diabetes management approaches. [ABSTRACT FROM AUTHOR]

IntroductionDiabetes, a key chronic non-communicable disease, poses a substantial public health burden. The role of oral health as a determinant in the epidemiology of diabetes mellitus, particularly in the Central Eastern European region, remains underexplored. This research aims to examine the impact of specific oral health parameters, including gum bleeding, active dental caries, tooth mobility, and tooth loss, on diabetes prevalence. Additionally, it seeks to clarify the moderating effects of socio-demographic and lifestyle variables on this relationship.Materials and methodsData were extracted from the 2014 and 2019 datasets of the Hungarian European Health Interview Survey, comprising a combined nationally representative sample of 11,429 participants. Descriptive statistics were presented as weighted proportions and unweighted counts, and weighted Pearson’s chi-squared tests were employed for assessing associations and goodness-of-fit. Significant predictors were integrated into weighted multiple logistic regression models for analysis. Sensitivity analysis was then conducted to confirm the robustness of the findings.ResultsThe study identified ‘Bad’ self-perceived oral health as a diabetes risk (OR=1.35; 95% CI: [1.04-1.75]), with filled teeth being protective (0.65 [0.51-0.84]). Subgroup analysis revealed higher diabetes odds among individuals with primary education (1.41 [1.02-1.96]) and rural residents with tooth loss from decay (3.54 [1.36-9.19]). The bootstrap analysis with 1,000 iterations reaffirmed the model’s stability and predictive accuracy for diabetes.DiscussionEnhanced oral health is associated with lower risk factors for diabetes. This research highlights the importance of including oral health measures in comprehensive diabetes management approaches.

Abstract Background In 2020, globally 685,000 people died, and 2.3 million women were diagnosed with breast cancer. The main cause of cancer deaths among women is breast cancer, which account for 15.5% of all cancer deaths. Most of these could have been avoided with timely diagnosis. The aim of our study was to determine the proportion of breast screening participation in Hungary, and to identify possible factors that may influence breast screening attendance. Methods Our data were gathered from the cross-sectional European Health Interview Surveys conducted in Hungary in 2009, 2014, and 2019. In terms of categorical characteristics, Pearson’s chi-square test was performed to evaluate the differences between people who have attended breast screening within two years and who have only attended more than two years ago. To determine the factors that may have an impact on the uptake of screening, generalized linear model with logit link function regarding binomial probability distribution was executed. Results The responses of 2626 women between the age 45-65 were included in our study. In 2009 85% (n=741), in 2014 90% (n=851) and in 2019 87% (n=699) of the respondents claimed to have ever attended a breast screening in their life. In 2009 68% (n=594), in 2014 66% (n=630) and in 2019 64% (n=515) said that they have taken part in breast screening within two years (p=0.331). From 2014 to 2019 (AOR=0.72 [0.57-0.89]) the chance of attending breast screening was decreasing. We observed that both secondary (AOR=1.97 [1.60-2.44]) and tertiary educational level (AOR=2.23 [1.67-3.00]), higher perceived income (AOR=1.54 [1.25-1.90]), and more frequent meeting with the doctor (AOR=1.77 [1.39-2.27]) and with the specialist (AOR=1.88 [1.54-2.28]) appeared as protective factors of breast screening attendance. Conclusions Our results show that the lifetime prevalence of breast screening participation is high, however the recommended biennial rate is relatively low. To increase the participation rate, various initiatives would be needed, especially for women in identified risk groups, which are lower educational level, lower perceived income, and less frequent meeting with the doctor and with the specialist.

Background: In 2020, globally 685,000 people died, and 2.3 million women were diagnosed with breast cancer. The main cause of cancer deaths among women is breast cancer, which account for 15.5% of all cancer deaths. Most of these could have been avoided with timely diagnosis. The aim of our study was to determine the proportion of breast screening participation in Hungary, and to identify possible factors that may influence breast screening attendance. Methods: Our data were gathered from the cross-sectional European Health Interview Surveys conducted in Hungary in 2009, 2014, and 2019. In terms of categorical characteristics, Pearson's chi-square test was performed to evaluate the differences between people who have attended breast screening within two years and who have only attended more than two years ago. To determine the factors that may have an impact on the uptake of screening, generalized linear model with logit link function regarding binomial probability distribution was executed. Results: The responses of 2626 women between the age 45-65 were included in our study. In 2009 85% (n=741), in 2014 90% (n=851) and in 2019 87% (n=699) of the respondents claimed to have ever attended a breast screening in their life. In 2009 68% (n=594), in 2014 66% (n=630) and in 2019 64% (n=515) said that they have taken part in breast screening within two years (p=0.331). From 2014 to 2019 (AOR=0.72 [0.57-0.89]) the chance of attending breast screening was decreasing. We observed that both secondary (AOR=1.97 [1.60-2.44]) and tertiary educational level (AOR=2.23 [1.67-3.00]), higher perceived income (AOR=1.54 [1.25-1.90]), and more frequent meeting with the doctor (AOR=1.77 [1.39-2.27]) and with the specialist (AOR=1.88 [1.54-2.28]) appeared as protective factors of breast screening attendance. Conclusions: Our results show that the lifetime prevalence of breast screening participation is high, however the recommended biennial rate is relatively low. To increase the participation rate, various initiatives would be needed, especially for women in identified risk groups, which are lower educational level, lower perceived income, and less frequent meeting with the doctor and with the specialist. [ABSTRACT FROM AUTHOR]

IntroductionOral health, a critical aspect of overall well-being, is influenced by various sociodemographic and lifestyle factors, with poor oral health associated with systemic diseases and diminished quality of life.MethodsThis cross-sectional study leverages data from the Hungarian European Health Interview Survey (EHIS) representative of the Hungarian population, to conduct a comprehensive examination of the intersection between these factors and oral health, aiming to identify potential risk factors and contribute to the development of targeted interventions. The research examined associations between sociodemographic/lifestyle factors and oral health. Statistical techniques included Pearson’s Chi-square test, multivariate and ordinal logistic regression analyses. Weighting was applied to assure the representativeness of the population and enhance the validity of the survey results.ResultsThe study identifies gender, age, education, financial status, smoking, and self-perceived oral health as key factors influencing oral health outcomes. Notably, regular dental visits significantly reduced the risk of poor oral health and caries. Females, non-smokers, university graduates, high-income individuals, and those with good self-perceived health had fewer missing teeth and better self-perceived oral health. Teeth extractions due to decay, especially when not replaced, significantly increased the perception of poor oral health, while regular dental visits improved it.DiscussionThe study highlights the need for personalized oral health interventions considering the different sociodemographic and lifestyle factors, along with promotion of healthy lifestyle, more frequent dental office visits and equitable dental care access. The findings offer the potential to inform regional oral health policies and prevention strategies, improving oral health and overall wellbeing.

Healthcare is the most crucial sector in people's life. Many applications and systems have been proposed to improve the healthcare area. The outbreak of the novel coronavirus Covid19 turns more focus on healthcare applications. To manage medical data, healthcare professionals in developed countries have adopted several electronic healthcare information systems and technologies in recent years. However, these technologies show serious privacy risks and security issues, especially in the transfer of data and the recording of data transactions. Furthermore, the high cost of these technologies acquisition, as well as the complexity of their management, make their application in underdeveloped nations extremely problematic. This article proposes a solution based on a decentralized Blockchain architecture to reinforce the security of health information systems. This solution is particularly recommended for developing countries which lack high-tech infrastructures and suffer from poor interoperability between existing information systems. Various researches and works that implement blockchainbased solutions in the security of electronic health information systems (eHIS) are discussed in this article. A new approach based on a hyperledger fabric, implementing smart contracts and several other components is proposed. The suggested architecture involves many actors who can interact with medical records such as patients, doctors, pharmacists, laboratories and insurance companies. Data privacy is guaranteed because there is minimal risk of unauthorized access entities, and by design, the smart contract is the sole way to manipulate participant data. Various optimization and measurement experiments were carried on. The results covering various key parameters of system performance such as throughput, latency, CPU usage, memory consumption and network usage are presented. [ABSTRACT FROM AUTHOR]

Between April 2019 and September 2020, 23,001 people aged 15 or over responded to questions about their health and living conditions for the German Health Update (GEDA 2019/2020-EHIS). The results are representative of the German resident population aged 15 or above. The response rate was 21.6%. The study used a questionnaire based on the third wave of the European Health Interview Survey (EHIS), which was carried out in all EU member states. EHIS consists of four modules on health status, health care provision, health determinants, and socioeconomic variables. The data are collected in a harmonised manner and therefore have a high degree of international comparability. They constitute an important source of information for European health policy and health reporting and are made available by the Statistical Office of the European Union (Eurostat). They also form the basis of the Federal Health Reporting undertaken in Germany. Data collection began in April 2019, just under a year before the beginning of the SARS-CoV-2 pandemic, and continued into its initial phase, as of March 2020. As such, data from the current GEDA wave can also be used to conduct research into the health impact of the SARS-CoV-2 pandemic.

The state of health of the population is the result of various determinants, but also a barometer of the conditions that affect the formation of the individual's health. In a healthy society, a healthy individual can develop, and healthy individuals can develop from a healthy society. This article deals with the analysis of the impact of selected factors on the health status of the Slovak population. This is based on data from the latest EHIS (The European Health Interview Survey). We worked with the respondent's answer to the question whether he / she suffers from a long-term health problem (variable with variations yes-no). From the variables surveyed, we chose the ones we thought they could have effect on the selected indicator. With respect to the binary dependent variable, we used logistic regression for the analysis, where all calculations have been carried out in the SAS Enterprise Guide statistical program. The results are findings that have to some extent confirmed our assumptions about the impact of selected factors on health, although some of them have not been shown to the extent we expected.

The article considers the issues of formation and maintenance of an integrated information management system in the education sector, as well as the development of e-education on the example of the Republic of Estonia — a regional and one of the world leaders in the field of digital transformation of education. The history and specificity of the information system in the Estonian education sector (EHIS) is analyzed in the context of the development of e-government technologies. The principles for the processes of collecting, processing and analyzing information in the education sector in Estoniaare presented, the expanded analytical capabilities of the information system containing personal data of various categories of participants in the educational process are described. The issues of ensuring confidentiality and integrity of information based on digital signature and blockchain technology are considered. The economic and social effect of the implementation of an integrated information system in the education sector has been revealed. The structure of e-learning services in Estoniaand their role in providing digital transformation of the education system are considered. As a result of the analysis of the Estonian experience in the formation of an integrated information system in the education sector, as well as the development of e-education services, scientifically based recommendations for the modernization of the education system of the Republicof Belarushave been developed.

Abstract Background This methodological paper describes the integration of the ‘European Health Interview Survey wave 2’ (EHIS 2) into the ‘German Health Update’ 2014/2015 (GEDA 2014/2015-EHIS). Methods GEDA 2014/2015-EHIS is a cross-sectional health survey. A two-stage stratified cluster sampling approach was used to recruit persons aged 15 years and older with permanent residence in Germany. Two different modes of data collection were used, self-administered web questionnaire and self-administered paper questionnaire. The survey instrument implemented the EHIS 2 modules on health status, health care use, health determinants and social background variables and additional national questions. Data processing was conducted according to the quality and validation rules specified by Eurostat. Results In total, 24,824 questionnaires were completed. The response rate was 27.6%. The two-stage cluster sample method seems to have been successful in achieving a sample with high representativeness. The final micro data file was inspected, approved and certified by Eurostat. Access to micro data of the EHIS 2 can be provided by Eurostat via research contract and to the GEDA 2014/2015-EHIS public use file by the Research Data Centre of the Robert Koch Institute. First EHIS 2 results are available at the Eurostat website. Conclusions Integrating a multinational health survey into an existing national health monitoring system was a challenge in Germany. The national survey methodology for conducting the survey had to be further developed in order to meet the overarching goal of harmonizing the health information from national statistical offices and public health research institutes across the European Union. The harmonized EHIS 2 data source will profoundly impact international public health research in the near future. The next EHIS wave 3 will be conducted around 2019.

The state of health of the population is the result of various determinants, but also a barometer of the conditions that affect the formation of the individual's health. In a healthy society, a healthy individual can develop, and healthy individuals can develop from a healthy society. This article deals with the analysis of the impact of selected factors on the health status of the Slovak population. This is based on data from the latest EHIS (The European Health Interview Survey). We worked with the respondent's answer to the question whether he / she suffers from a long-term health problem (variable with variations yes-no). From the variables surveyed, we chose the ones we thought they could have effect on the selected indicator. With respect to the binary dependent variable, we used logistic regression for the analysis, where all calculations have been carried out in the SAS Enterprise Guide statistical program. The results are findings that have to some extent confirmed our assumptions about the impact of selected factors on health, although some of them have not been shown to the extent we expected. [ABSTRACT FROM AUTHOR]

The carbon, water, and energy cycles play an important role in the terrestrial ecosystem's functioning. Climate change and hydroclimatic disturbances are primary factors that influence these cycles, yet little is known about the major ecohydrological indicators (EHIs) that characterize these cycles. In addition, it is essential to analyze spatiotemporal variations and driving factors of EHIs to comprehend how well terrestrial ecosystems can preserve their structure and function in the face of hydroclimatic perturbations. We assessed the three important EHIs, namely water use efficiency (WUE e), rain use efficiency (RUE e), and light use efficiency (LUE e), as well as their controlling factors, in India from 2002 to 2017 at various spatial scales (major river basins, climatic zones, and land cover types). In general, high EHI values were found in high productivity ecosystems (e.g., forest ecosystems) compared to low productivity ecosystems (e.g., cropland and grassland ecosystems). WUE e and LUE e have similar characteristics and were higher in mountain, tropical wet, and tropical wet-dry zones, whereas lower in arid zones. RUE e shows distinct spatial characteristics with higher values in semi-arid zones and lower values in arid zones. The drivers investigated in this study include CO 2 concentrations, evapotranspiration (ET), humidity, leaf area index (LAI), normalized difference vegetation index (NDVI), precipitation (PRECIP), soil moisture (SM), solar radiation (SR), temperature (TEMP), vapor pressure deficit (VPD), and wind speed (WS). All three EHIs were found sensitive to TEMP and SR at a national scale, whereas CO 2 was a significant driver in arid ecosystems. Other controlling factors (e.g., VPD, SM, and humidity) also played a significant role at smaller spatial scales. Further, this study finds that undisturbed ecosystems (only climate influenced) have slightly higher values of EHIs compared to disturbed (climate-human influenced) ecosystems. Based on the results, in future, it can be expected that an increase in the incident SR and TEMP will decrease the EHIs in India. This study helps understand the coupling of water, carbon, and energy cycles, and the findings from this research can be a reference for ecosystem conservation and restoration. • Spatiotemporal characterization of three key EHIs was carried out. • Annual WUE e & RUE e showed a decreasing trend, LUE e showed an increasing trend. • Sensitivity of 11 different controlling factors to EHIs were analyzed. • Temperature and solar radiation were major controlling factors of all EHIs. [ABSTRACT FROM AUTHOR]

Although the health status of Poland's population has clearly improved in the last decade, it is still less favourable than in most European countries. The average life expectancy and the average healthy life expectancy in Poland remain considerably shorter than in other EU members. Apart from this, the socio-economic transition in Poland, and accompanying unemployment and social exclusion, are increasing the already considerable income disparities that determine individuals' health investments. This has significantly differentiated the population's health status, both between regions and within particular social groups. The results of the microeconometric research into health status determinants and socio-economic health inequalities, as presented in this article, serve to verify the hypothesis that there is a relationship between the health status of individuals and their socio-economic status. If true, this hypothesis may point to a lack of health security felt by the poorer members of society. The main tool for evaluating the investigated relationship was an econometric model estimated using individual data. Health inequality is understood as an uneven distribution of health status caused by socio-economic status, and is measured by the health inequality index. The research methodology employed in this study is consistent with that used in other countries. The research has demonstrated that health status and socio-economic status in Poland are interrelated. [ABSTRACT FROM AUTHOR]

Diabetes mellitus (DM) is a high-risk non-communicable disease with an emerging burden for the European Union (EU) member states in the past decades. The unfavorable trend of the burden is striking compared to the declining disease burden due to cardiovascular diseases or stagnation of neoplasms. The goal of this study is to describe the temporal changes of diabetes in the adult population of Slovakia through the three European Health Interview Survey (EHIS) waves and to assess the association between DM and socioeconomic and/or lifestyle characteristics. These cross-sectional studies were carried out using microdata derived from Slovakia's EHISs conducted in the years 2009 (n = 4972), 2014 (n = 5490), and 2019 (n = 5527). The DM variable was compared to the independent variables such as sociodemographic and lifestyle characteristics including dietary patterns and physical activity. DM prevalence for the EHIS in 2009, 2014, and 2019 were 6.1%, 8.2%, and 9.8%, respectively. In bivariate analysis, the relationship between DM and age, education level, job status, BMI, walking for at least 10 min, and physical activity was significant in the three EHISs. In 2014 and 2019, there was an inverse association between the risk of DM and walking regularly. There was no association between the frequency of eating fruits or vegetables and DM, with the exception of 2009, where a negative association between eating vegetables one to six times a week and DM was observed. Present health policies and activities in Slovakia were unable to reverse the increasing DM burden, indicating that a more systematic approach is needed. Complex policy strategies and legislative measures must be developed and implemented at both the national and EU levels. [ABSTRACT FROM AUTHOR]

Setting and Objective: In Italy, over the last decades, elderly care has been mostly provided by family members, especially adult offspring, and in particular daughters. This paper investigates the relationship between informal caregiving and mental distress among Italians aged 35-59, with a focus on gender effect and parenthood responsibilities., Data: The dataset is the European Health Interview Survey (EHIS), second wave, year 2015. As far as it is known, the Italian EHIS has not been used for studies on ageing and caregiving., Methods: Using selected subsamples, a Propensity Score Matching between caregivers and non-caregivers aged 35-59 is implemented, with the aim of measuring the difference in level of depression, if any, between the two groups., Results: Findings show that women providing their frail relatives with informal care are less likely to suffer from mental distress compared to non-carers. However, results change radically if they have children aged less than 15 at home, and a higher probability of being depressed is detected for women overwhelmed by the double responsibility of assisting both dependent relatives and their own children. Results are not significant for men., (Copyright © 2020. Published by Elsevier B.V.)