Background. Smoking is initiated mostly by adolescents and young adults. In Slovenia, we have limited data about this. The purpose of this paper is to show data on age at smoking initiation and differences in age at smoking initiation by gender, age groups, education, social class and geographical region among inhabitants of Slovenia.
Methods. We used data from the cross-sectional survey ‘Health-related behaviour 2012’ in Slovenian population aged from 25 to 74 years.
Results. 4591 ever smokers, aged 25-74, that gave information about the age at smoking initiation were included in the analysis. At the age of 25 or less, smoking was initiated by 96.7% of Slovene ever smokers, at the age of 18 or less by 71.0%. The average age at smoking initiation was 17.7 years. Male ever smokers initiated smoking at an earlier age compared to female ones. Age at smoking initiation was decreasing in both male and female ever smokers, but was more pronounced in females. In male ever smokers, there were no differences in average smoking initiation age by education, self-reported social class and geographical regions, while in female ever smokers, there were significant differences in terms of education and geographical regions.
Conclusion. The initiation of smoking predominantly occurs in adolescents and young adults. Age at smoking initiation has decreased in recent decades. Our study confirms the importance of early and sustained smoking prevention programmes in youth and the importance of national comprehensive tobacco control programme with effective tobacco control measures to ban tobacco products marketing.
Mojca Serdt, Tatjana Lejko Zupanc, Aleš Korošec and Irena Klavs
The second Slovenian national healthcare-associated infections (HAIs) prevalence survey (SNHPS) was conducted in acute-care hospitals in 2011. The objective was to assess the sensitivity and specificity of the method used for the ascertainment of six types of HAIs (bloodstream infections, catheter-associated infections, lower respiratory tract infections, pneumoniae, surgical site infections, and urinary tract infections) in the University Medical Centre Ljubljana (UMCL).
A cross-sectional study was conducted in patients surveyed in the SNHPS in the UMCL using a retrospective medical chart review (RMCR) and European HAIs surveillance definitions. Sensitivity and specificity of the method used in the SNHPS using RMCR as a reference was computed for ascertainment of patients with any of the six selected types of HAIs and for individual types of HAIs. Agreement between the SNHPS and RMCR results was analyzed using Cohen’s kappa coefficient.
1474 of 1742 (84.6%) patients surveyed in the SNHPS were included in RMCR. The sensitivity of the SNHPS method for detecting any of six HAIs was 90% (95% confidence interval (CI): 81%-95%) and specificity 99% (95% CI: 98%-99%). The sensitivity by type of HAI ranged from 63% (lower respiratory tract infections) to 92% (bloodstream infections). Specificity was at least 99% for all types of HAIs. Agreement between the two data collection approaches for HAIs overall was very good (κ=0.83).
The overall sensitivity of SNHPS collection method for ascertaining HAIs overall was high and the specificity was very high. This suggests that the estimated prevalence of HAIs in the SNHPS was credible.
Irena Klavs, Mojca Serdt, Aleš Korošec, Tatjana Lejko Zupanc, Blaž Pečavar and
In the third Slovenian national healthcare-associated infections (HAIs) prevalence survey, conducted within the European point prevalence survey of HAIs and antimicrobial use in acute care hospitals, we estimated the prevalence of all types of HAIs and identified factors associated with them.
Patients were enrolled into a one-day cross-sectional study in November 2017. Descriptive analyses were performed to describe the characteristics of patients, their exposure to invasive procedures and the prevalence of different types of HAIs. Univariate and multivariate analyses of association of having at least one HAI with possible risk factors were performed to identify risk factors.
Among 5,743 patients, 4.4% had at least one HAI and an additional 2.2% were still treated for HAIs on the day of the survey, with a prevalence of HAIs of 6.6%. The prevalence of pneumoniae was the highest (1.8%), followed by surgical site infections (1.5%) and urinary tract infections (1.2%). Prevalence of blood stream infections was 0.3%. In intensive care units (ICUs), the prevalence of patients with at least one HAI was 30.6%. Factors associated with HAIs included central vascular catheter (adjusted odds ratio [aOR] 4.1; 95% confidence intervals [CI]: 3.1–5.4), peripheral vascular catheter (aOR 3.0; 95% CI: 2.3–3.9), urinary catheter (aOR 1.8; 95% CI: 1.4–2.3).
The prevalence of HAIs in Slovenian acute care hospitals in 2017 was substantial, especially in ICUs. HAIs prevention and control is an important public health priority. National surveillance of HAIs in ICUs should be developed to support evidence-based prevention and control.
The behaviour of parents in ensuring car passenger safety for their children is associated with socio-economic (SE) status of the family; however, the influence of parental education has rarely been researched and the findings are contradictory. The aim of the study was to clarify whether parental education influences the use of a child car seat during short rides.
A cross-sectional survey was carried out in outpatient clinics for children’s healthcare across Slovenia. 904 parents of 3-year-old children participated in the study; the response rate was 95.9%. A self-administered questionnaire was used. A binary multiple logistic regression was applied to assess the association between parental unsafe behaviour as dependent variable, and education and other SE factors as independent variables.
14.6% of parents did not use a child car seat during short rides. Families where mother had low or college education had higher odds of the non-use of a child car seat than families where mother had a university education. Single-parent families and those who lived in areas with low or medium SE status also had higher odds of the non-use of a child car seat.
Low educational attainment influences parents’ behaviour regarding the non-use of a child car seat. Low parental education is not the only risk factor since some highly educated parents also have high odds of unsafe behaviour. All parents should therefore be included in individually tailored safety counselling programmes. SE inequalities could be further reduced with provision of free child car seats for eligible families.
Irena Klavs, Jana Kolman, Tatjana Lejko Zupanc, Božena Kotnik Kevorkijan, Aleš Korošec, Mojca Serdt and
In the second Slovenian national healthcare-associated infections (HAIs) prevalence survey, conducted within the European point prevalence survey of HAIs and antimicrobial use in acute-care hospitals, we estimated the prevalence of all types of HAIs and identified risk factors.
Patients from acute-care hospitals were enrolled into a one-day cross-sectional study in October 2011. Descriptive analyses were performed to describe the characteristics of patients, their exposure to invasive procedures and the prevalence of different types of HAIs. Univariate and multivariate analyses of association of having at least one HAI with possible risk factors were performed to identify risk factors.
Among 5628 patients, 3.8% had at least one HAI and additional 2.6% were still being treated for HAIs on the day of the survey; the prevalence of HAIs was 6.4%. The prevalence of urinary tract infections was the highest (1.4%), followed by pneumoniae (1.3%) and surgical site infections (1.2%). In intensive care units (ICUs), the prevalence of patients with at least one HAI was 35.7%. Risk factors for HAIs included central vascular catheter (adjusted odds ratio (aOR) 4.0; 95% confidence intervals (CI): 2.9-5.7), peripheral vascular catheter (aOR 2.0; 95% CI: 1.5-2.6), intubation (aOR 2.3; 95% CI: 1.4-3.5) and rapidly fatal underlying condition (aOR 2.1; 95% CI: 1.4-3.3).
The prevalence of HAIs in Slovenian acute-care hospitals in 2011 was substantial, especially in ICUs. HAIs prevention and control is an important public health priority. National surveillance of HAIs in ICUs should be developed to support evidence-based prevention and control.
Mateja Rok Simon, Sonja Tomšič, Jožica Šelb Šemerl, Petra Nadrag, Barbara Mihevc Ponikvar, Darja Lavtar, Aleš Korošec and Tatjana Kofol Bric
Background: Researchers have found that mortality is decreasing in all socioeconomic population groups but therelative differences in mortality between lower and higher social classes remain unchanged or have even increased.In Slovenia this has not yet been studied.
Methods: The analysis included all women in Slovenia who died in the 2005-2010 period and were recorded in theRegistry of deaths. Cause of death data was linked to data on the educational attainment of the deceased person,which was applied successfully in 98.8% of cases. The rate ratios (RR) for age-standardised death rates werecalculated for women with a low and high educational attainment.
Results: The calculated gap in life expectancy at age 30 between women with low and high educational attainmentstood at 5.5 years. Women aged 0-84 with a low educational attainment had a statistically significant higher riskof death than women with a high educational attainment (RR=1.65; 95% CI: 1.57-1.73). Inequalities in prematuremortality were even greater (1.78; 1.65-1.93). Educational inequalities in premature mortality were revealed in themajority of causes of death, e.g. cervical cancer (1.99; 1.22-3.67), lung cancer (1.70; 1.30-2.26), cardiovasculardiseases (3.02; 2.41-3.91), causes directly attributable to alcohol (7.34; 4.96-12.27), motor vehicle accidents (2.23;1.21-4.45) and suicide (1.68; 1.19-2.41).
Conclusions: Significant socioeconomic gaps in women’s mortality in Slovenia obligate us to more systematicmonitoring of health inequalities in the future. Further research is required in order to clarify specific reasons for themajor gaps in mortality from specific causes of death.
Mojca Gabrijelčič Blenkuš, Metka Mencin Čeplak, Maja Bajt, Aleš Korošec, Janet Klara Djomba, Jožica Maučec Zakotnik, Cirila Hlastan Ribič and Helena Jeriček Klanšček
Background: Numerous studies have found significant gender differences in health-related behaviour, while a lowernumber analyse these differences within the gender. The aim of the article is to analyse the differences in individualhealth-related behaviour indicators among women from different educational groups in Slovenia.
Methods: The analysis is based on the CINDI Health Monitor (2008) survey for Slovenia. The nationally representativesample was chosen using probability sampling and the analysis included 4,237 women aged 25 to 74. The independentvariables are: education, in consideration of age, community type, region of residence, the presence of a partner andchildren and self-perceived social class. The dependent variables are health-related behaviours: nutrition, physicalactivity, sleeping, stress and care for own health. By comparing averages in health-related behaviour with educationand other factors and by classifying participants into homogenous groups, we were able to show differences inhealth-related behaviour in women with different educational attainment.
Results: Individual health-related behaviour indicators show statistically significant differences between groups ofwomen with different educational attainment; however these are neither very distinct nor unambiguous. Womenwith a higher educational attainment evaluate the majority of the indicators more favourably than women in othereducational groups, but differences can also be found within the group of women with a higher educational attainment.The differences in the health-related behaviour of women with a lower educational attainment are relatively blurred.
Conclusion: The relatively small differences in health-related behaviour can be partially explained by existingdifferences within the group of women with a higher educational attainment and the fact that the group of womenwith the lowest educational attainment does not have the worst health-related behaviour indicators, which affects thegreater equality in health-related behaviour. On the other hand, the well-established universal and targeted familyand child care policies, which have been implemented in Slovenia for decades, also affect these results.