Florence Samkange-Zeeb

Validation of self-reported cellular phone use

Background: In recent years, concern has been raised over possible adverse health effects of cellular telephone use. In epidemiological studies of cancer risk associated with the use of cellular telephones, the validity of self-reported cellular phone use has been problematic. Up to now there is very little information published on this subject. Methods:We conducted a study to validate the questionnaire used in an ongoing international case–control study on cellular phone use, the “Interphone study”. Self-reported cellular phone use from 68 of 104 participants who took part in our study was compared with information derived from the network providers over a period of 3 months (taken as the gold standard). Results:Using Spearmans rank correlation, the correlation between self-reported phone use and information from the network providers for cellular phone use in terms of the number of calls per day was good (r=0.62, 95% CI: 0.45–0.75), while that of the average duration of each call was rather moderate (r=0.34, 95% CI: 0.11–0.54). Similar results were found when Kappa coefficients were estimated. A value of r=0.56 (Spearmans correlation, CI: 0.38–0.70) was found for cumulative cellular phone use. Conclusion:Our study suggests that cellular phone use is easier to recall in terms of number of calls made than in terms of cumulative phone use and should thus be used as the basis for the dose–response analysis.

Assessment of radiofrequency exposure from cellular telephone daily use in an epidemiological study: German Validation study of the international case–control study of cancers of the brain—INTERPHONE-Study

Objective:The objective of the study is to validate self-reported cellular phone use information by comparing it with the cumulative emitted power and duration of calls measured by software-modified cellular phones (SMP). The information was obtained using a questionnaire developed for the international case–control study on the risk of the use of mobile phones in tumours of the brain or salivary gland (INTERPHONE-study). Method: The study was conducted in Bielefeld, Germany. Volunteers were asked to use SMPs instead of their own cellular phones for a period of 1 month. The SMP recorded the power emitted by the mobile phone handset during each base station contact. Information on cellular phone use for the same time period from traffic records of the network providers and from face-to-face interviews with the participants 3 months after the SMP use was assessed. Pearsons correlation coefficients and linear regression models were used to analyse the association between information from the interview and from the SMP. Results: In total, 1757 personal mobile phone calls were recorded for 45 persons by SMP and traffic records. The correlation between the self-reported information about the number and the duration of calls with the cumulative power of calls was 0.50 (P<0.01) and 0.48 (P<0.01), respectively. Almost 23% of the variance of the cumulative power was explained by either the number or the cumulative duration of calls. After inclusion of possible confounding factors in the regression model, the variance increased to 26%. Minor confounding factors were “network provider”, “contract form”, and “cellular phone model”. Discussion: The number of calls alone is a sufficient parameter to estimate the cumulative power emitted by the handset of a cellular telephone. The cumulative power emitted by these phones is only associated with number of calls but not with possible confounding factors. Using the mobile phone while driving, mainly in cities, or mainly in rural areas is not associated with the recorded cumulative power in the SMP.

What works in community-based interventions promoting physical activity and healthy eating? A review of reviews.

Chronic diseases, such as type II diabetes, are on the rise worldwide. There is consistent evidence that physical activity and healthy eating are important lifestyle factors which affect the risk for chronic diseases. Community-based interventions are of particular public health interest as they reach target groups in their natural living environment and may thus achieve high population-level impacts. We conducted a systematic literature search to assess the effectiveness of community-based interventions to promote physical activity and healthy eating. Specifically, we searched for promising intervention strategies in this setting. We narratively summarized the results of 18 systematic reviews. Among children and adolescents, we found moderate evidence for effects on weight change in primary school-aged children for interventions containing a school component. The evidence for interventions aimed at general adult populations was inconclusive. Self-monitoring, group-based components, and motivational signs to encourage stair use were identified as promising strategies to increase physical activity. Among adults at risk for type II diabetes, evidence was found for beneficial effects on weight change and diabetes incidence. However, interventions for this group were not integrated in more comprehensive community-based approaches.

Emerging aspects of mobile phone use.

The mobile phone is a modern-day invention, which has managed to reach many parts of the world enabling telecommunications across areas where it was not possible before. Although these devices have proved to be life saving in certain circumstances (e.g., after accidents) and helped improve the quality of life in some sectors, concerns continue to be raised about potential adverse health impacts associated with their use. These range from cancer and cognitive deficiencies to subjective effects, such as a feeling of warmth around the ear used, headache and fatigue. We provide an overview of the concerns raised and summarise what is known about them. We conducted a literature search in Pubmed/Medline to identify published papers on health effects of mobile phones, and an intensive search on the Internet to collect data on the global use of mobile phones. In the year 2000, there were an estimated 500 million mobile phone users worldwide. Today, there are about 3.3 billion users. The use of mobile phones among young children and adolescents is also increasing. Health-risk research has mainly focused on adults and on a single outcome, brain tumours. No significant relationship has been established between mobile phone use and the incidence or growth of brain tumours. Other research indicates emerging concerns, including hearing problems and self-reported health symptoms, such as tiredness, stress, headache, anxiety, concentration difficulties and sleep disturbances, but results remain inconclusive. Currently, there is little epidemiological evidence indicating that the use of mobile phones causes adverse health effects.

Higher Risk Perception of HIV than of Chlamydia and HPV among Secondary School Students in Two German Cities

Background Chlamydia and genital human papillomavirus (HPV) are the two most common sexually transmitted infections (STIs) among teens and young adults in industrialised countries. The majority of adolescents, however, have limited or no knowledge of these infections. Within the context of a cross-sectional survey on awareness and knowledge of sexually transmitted infections, secondary school students attending the 8th grade and above in Bremen and Bremerhaven, two cities in northern Germany, were asked to rate the risk of peers to get infected with HIV, HPV or chlamydia. Methods Between October and December 2011, students aged 12–20 years completed an anonymous, self-administered questionnaire at their school. In addition to answering questions on awareness and knowledge of sexually transmitted infections, all students were also asked to rate the risk of peers to get infected with HIV, HPV or chlamydia. Furthermore, those reporting ever having sexual intercourse were asked to rate their own risk of getting infected with each of the three infections. Results 1,148 students, 55% female, completed the questionnaire. 27% of the students reported having had sexual intercourse. 68% of all students rated the risk of same-aged students to get infected with HIV/AIDS as high/medium. The corresponding proportions for HPV and chlamydia were 19 and 25% respectively. Those reporting ever having sexual intercourse generally perceived their own risk of getting infected with HIV, chlamydia or HPV as lower than that of their peers. Conclusion Generally, the risk of getting infected with HIV was perceived as being higher than that of getting infected with HPV or chlamydia, most likely due to the fact that the students were more aware of HIV than of the other two infections. Efforts should be made to improve awareness and knowledge of HPV and chlamydia among school going adolescents, and to make them realize that these are common infections that are preventable.

Smokeless Tobacco and Oral Potentially Malignant Disorders in South Asia: A Systematic Review and Meta-analysis.

Implications More than 250 million South and South East Asians use SLT in some form. As cigarettes prices climb up all over the world, more people could potentially take up SLT, particularly in the absence of epidemiological evidence regarding the harmful effects of these products, and SLT being advocated as a means of tobacco harm reduction. Our findings are thus relevant and timely in highlighting the harmful effects of SLT use, with a potential of influencing tobacco control policies in South Asia and beyond.

Populations at Special Health Risk: Migrants

Migration – the movement of people from one country or place of residence to settle in another – is increasing worldwide. Conditions surrounding the migration process can augment the vulnerability for ill health among migrants. Health risks can be related to the conditions before departure, travel conditions, the arrival or transit stage, and the living conditions as well as the level of societal acceptance in the receiving country. Thus, migrants are considered an at-risk population requiring particular public health awareness.

Acculturation and health-related quality of life: results from the German National Cohort migrant feasibility study

ObjectivesWe assessed the association between acculturation and health-related quality of life (HRQoL) among persons with a Turkish migrant background in Germany.Methods1226 adults of Turkish origin were recruited in four German cities. Acculturation was assessed using the Frankfurt Acculturation Scale resulting in four groups (integration, assimilation, separation and marginalization). Short Form-8 physical and mental components were used to assess the HRQoL. Associations were analysed with linear regression models.ResultsOf the respondents, 20% were classified as integrated, 29% assimilated, 29% separated and 19% as marginalized. Separation was associated with poorer physical and mental health (linear regression coefficient (RC) = −2.3, 95% CI −3.9 to −0.8 and RC = −2.4, 95% CI −4.4 to −0.5, respectively; reference: integration). Marginalization was associated with poorer mental health in descendants of migrants (RC = −6.4, 95% CI −12.0 to −0.8; reference: integration).ConclusionsSeparation and marginalization are associated with a poorer HRQoL. Policies should support the integration of migrants, and health promotion interventions should target separated and marginalized migrants to improve their HRQoL.

Prävention bei Menschen mit Migrationshintergrund

Health promotion and prevention can contribute to a long, healthy life in populations both with and without migrant background. This paper provides an overview on migrant participation in prevention programmes in Germany. Furthermore, we describe migrant sensitive prevention strategies and characteristics of prevention programmes for migrants in Germany. With regard to participation in prevention programmes, lower vaccination rates are found among children and adolescents who migrated to Germany after birth. Among adults with a migrant background, we found lower participation in general health check-ups, oral health check-ups, cancer screening programs and influenza vaccination. Migrant sensitive prevention strategies address the visual style of the material, a target group specific risk communication, language requirements, a systematic involvement of the target group, and the recognition of deeply rooted sociocultural practices and beliefs. On analyzing a large database on prevention programs in Germany, we found only a few programmes that were exclusively targeted to migrant groups (0.6%). In 16.6% of the programs migrants were addressed as the target group among others. Compared to general population programs, programs for migrants were more often exclusively directed towards girls or women. Moreover, programs for migrants used community-based approaches more often and addressed different age groups. Although information on migrant participation in prevention programs and utilization of migrant sensitive strategies is still incomplete, we can assume that there is a need for diversity-oriented, migrant sensitive prevention.ZusammenfassungPrävention und Gesundheitsförderung können für Menschen mit und ohne Migrationshintergrund einen wichtigen Beitrag zu einem langen Leben in Gesundheit leisten. Dieser Beitrag liefert einen Überblick zur Teilnahme an Präventionsangeboten in der Bevölkerung mit Migrationshintergrund und beschreibt Strategien zur migrationssensiblen Gestaltung von Präventionsangeboten sowie die Charakteristika der derzeitigen Angebote in Deutschland. Bezüglich der Teilnahme an Prävention sind geringere Impfquoten bei Kindern festzustellen, die nach der Geburt zugewandert sind. Im Erwachsenenalter ist eine deutlich geringere Teilnahme an Gesundheits-Check-ups, Zahn-Vorsorgeuntersuchungen, Krebsfrüherkennungsuntersuchungen und Grippeimpfungen nachweisbar. Migrationssensible Strategien betreffen das äußere Erscheinungsbild der Maßnahmen, die gruppenspezifische Risikokommunikation, die angebotenen Sprachen, die systematische Einbeziehung der Adressatengruppe sowie die Berücksichtigung der soziokulturellen Praktiken und Überzeugungen. Die Auswertung der Datenbank „Gesundheitliche Chancengleichheit“ ergibt eine sehr geringe Anzahl an Angeboten, die sich ausschließlich an Personen mit Migrationshintergrund richten (0,6 %). Bei 16,6 % der Angebote werden Menschen mit Migrationshintergrund als eine der Adressatengruppen genannt. Im Vergleich zu Angeboten für die Allgemeinbevölkerung richten sich Angebote für Menschen mit Migrationshintergrund häufiger ausschließlich an Frauen oder Mädchen. Sie wählen zudem häufiger einen altersgruppenübergreifenden und gemeindebasierten Ansatz. Auch wenn insgesamt noch keine vollständigen Informationen zur Maßnahmengestaltung und Nutzung vorliegen, ist von einem erheblichen Bedarf an diversifizierender, migrationssensibler Ausgestaltung auszugehen.AbstractHealth promotion and prevention can contribute to a long, healthy life in populations both with and without migrant background. This paper provides an overview on migrant participation in prevention programmes in Germany. Furthermore, we describe migrant sensitive prevention strategies and characteristics of prevention programmes for migrants in Germany. With regard to participation in prevention programmes, lower vaccination rates are found among children and adolescents who migrated to Germany after birth. Among adults with a migrant background, we found lower participation in general health check-ups, oral health check-ups, cancer screening programs and influenza vaccination. Migrant sensitive prevention strategies address the visual style of the material, a target group specific risk communication, language requirements, a systematic involvement of the target group, and the recognition of deeply rooted sociocultural practices and beliefs. On analyzing a large database on prevention programs in Germany, we found only a few programmes that were exclusively targeted to migrant groups (0.6 %). In 16.6 % of the programs migrants were addressed as the target group among others. Compared to general population programs, programs for migrants were more often exclusively directed towards girls or women. Moreover, programs for migrants used community-based approaches more often and addressed different age groups. Although information on migrant participation in prevention programs and utilization of migrant sensitive strategies is still incomplete, we can assume that there is a need for diversity-oriented, migrant sensitive prevention.

Comparison of Studies on Mobile Phone Use and Risk of Tumors

published results of ameta-analysis of studies on mobile phone use and risk of tumors. Intheir analysis, the authors included 23 case-control studies, covering abroad spectrum of tumor entities including uveal melanoma, testicu-lar cancer, parotid gland tumors, and brain tumors.However, the authors give no rationale for pooling these hetero-geneous, biologically rather diverse cancer sites, for which the local-ized exposure from the use of mobile phones is completely different.The key difference between this particular meta-analysis com-pared with earlier ones is the use of a quality score. The use of qualityscoreshasbeenreportedtobea“formofsubjectivitymasqueradingasobjectivity”andithasbeensaidto“subjectivelymergeobjectiveinfor-mationwitharbitraryjudgmentsinamannerthatcanobscureimpor-tant sources of heterogeneity among study results.”