Sleep quality in the Croatian adult population during the COVID-19 pandemic

Abstract Background The COVID-19 pandemic as a worldwide public health issue is a traumatic event that has affected both the sleep and mental health of the general population. This study aimed to evaluate the quality of sleep in the Croatian adult population during the COVID-19 pandemic. Methods This cross-sectional questionnaire study was conducted from February to June 2021 period. A validated, anonymous questionnaire that contained questions regarding demographic data, as well as Pittsburgh Sleep Quality Index (PSQI) and Coronavirus Anxiety Scale (CAS) was self-administered to a convenient sample of Croatian adults from central and northwestern Croatia. Results The study sample included 939 subjects with, median age of 42 years (interquartile range 35-48), 35.4% males, and 64.6% females. At the PSQI 22.6% of subjects presented sleep disturbances while at the CAS 0.4% of subjects presented dysfunctional anxiety associated with the COVID-19 pandemic. Sleep disturbances were more frequent among females (p < 0.001), inhabitants of the Croatian capital Zagreb (p = 0.001), subjects who were not infected with COVID-19 virus (p = 0.042), subjects who had fear of coronavirus infection in the workplace (p < 0.001), subjects who had fear of coronavirus infection during daily life activities (p < 0.001), subjects who had fear of coronavirus infection during daily physical activities (p < 0.001), subjects who worked with limited social contact (p = 0.005), and subjects with dysfunctional anxiety associated with the COVID-19 pandemic (p = 0.003). Conclusions Poor sleep quality is common during the COVID-19 pandemic in Croatia. Identifying factors associated with poor sleep would help develop specific intervention programs that enhance mental health and sleep quality during pandemics. Key messages • The COVID-19 pandemic has a significant negative influence on the mental health of the Croatian general population. • Appropriate supportive programs and interventional approaches directed toward the general population are needed to address mental health problems in Croatia during the COVID-19 pandemic.


Background:
Anxiety is widespread among university students. The COVID-19 pandemic af-fected students' mental health negatively. Given the long duration of the pandemic monitoring mental health remains important. This study aims to determine to which extent anxiety is preva-lent among students (1), what factors are associated with it (2) and which student groups are mostly affected (3).

Methods:
The cross-sectional COVID-19 German Student Well-being Study (C19 GSWS) sur-veyed mental health and well-being of students at five universities in Germany from 27.10.-14.11.21. Anxiety was assessed using the GAD-2. Associations between anxiety and sociodem-ographic, socioeconomic/social support factors as well as health-and COVID-19-related factors were determined using multiple binary logistic regression models.

Conclusions:
Concepts for prevention and counselling in terms of mental health problems in students should be developed considering specific stressors due to the pandemic.

Key messages:
This study shows that anxiety is widespread among university students and associated with a variety of stressors. The findings can help to develop specific concepts for prevention and counselling. The COVID-19 pandemic has a significant negative influence on the mental health of the Croatian general population.
Background: COVID-19 as a public mental health emergency has exacerbated existing mental health inequalities. The UK government invited local authorities with areas of high deprivation to apply for a year of funding, in order to address the mental health impacts of COVID-19 and incentivize investment in prevention and promotion interventions for better mental health. South Tyneside Council in North East England made a successful bid to the Better Mental Health Fund (BMHF), and distributed grants to 7 organisations delivering 13 programs. A qualitative evaluation of these programs aimed to answer the following questions: 1. How were the funded programs implemented? 2. What difference did they make to local beneficiaries? 3. How might these programs and their impacts be sustained into the future? 4. Has the BMHF led to any wider impacts on organisations and local communities?

Methods:
In-depth interviews with individuals, pairs and groups were conducted online or in person with service providers and beneficiaries. Non-verbatim transcripts were made from recordings, checked with verbatim transcripts from Teams and Zoom, and analyzed thematically to generate a coding frame. Throughout the analysis, comparisons were made between organizations and programs.

Results:
Fifteen interviews involving 22 participants lasting up to an hour each were conducted. The main themes identified as impactful were 1) community approaches based on supportive and good relationships between the local authority public health lead and participating organizations (mainly voluntary agencies), enabling 2) capacity-building for mental health resilience and 3) community empowerment. This was despite the short turnaround of the grant application process, limited time to deliver on targets, and anxieties about future sustainability.

Conclusions:
Short-term funding can build capacity in mental health resilience in deprived areas if administered by public health leaders who relate well with provider organizations. Key messages: Public health leaders who relate well with provider organizations are key drivers of community health promotion strategies that include mental health capacity building. Qualitative methods used in evaluations can inform public health commissioning by capturing the benefits and challenges of short-term funding for interventions promoting community mental health.

Background:
We are facing a growing popularity of gambling, partly due to the rapid rise of internet related technologies. This growth has been linked to a considerable increase in problem gambling and gambling disorder, which has been an established nonsubstance addiction. The aim of our study was to assess the prevalence rate of gambling disorder among the Slovenian population.

Methods:
National Survey on the Use of Tobacco, Alcohol and Other Drugs was conducted in 2018 on a nationally representative sample (n = 16,000; age: 15-64 years), using mixed-mode data collection (CAWI and CAPI). Responses were obtained from 9,161 respondents, of those 18.4% (n = 1,686) reported to have gambled in the last 12 months (i.e. gamblers). Gambling disorder symptoms were assessed using Berlin Inventory of Gambling Behavior -Screening, consisting of 14 items with a yes/no response option, which measure 9 gambling disorder criteria (DSM-V). Participants who reported at least 5 out of 9 gambling disorder criteria were classified as disordered.
Results: Data shows that 4.3% of Slovenian gamblers met the criteria for gambling disorder. Significantly higher shares were observed among men (5.9%; compared to 1.2% of women) and among younger generations (highest shares among 15-19 year olds (19.4%) and 20-24 year olds (14.5%)). The same goes for money spent for gambling. Namely, males (4.4% of men; compared to 0.6% of women) and younger generations (highest shares among 20-24 year olds (9.2%) and 30-34 year-olds (6.9%)) were more likely to spend more than 100 EUR in a day for gambling.

Conclusions:
Data obtained in the present study indicates the extent of gambling disorder symptomatology and highlights key demographic groups with risk for gambling disorder. These findings are consistent with previous comparable studies and provide a basis for tailored public health measures in Slovenia with an emphasis on early intervention. Key messages: 4.3% of Slovenian residents, who engaged in gambling in the last 12 months met the criteria for gambling disorder. Males and younger generations were more likely to report gambling disorder symptoms and spent more money on gambling. The data shows the need for tailored public health measures.