Digital Health Training, Attitudes and Intentions to Use It among Romanian Medical Students: A Study Performed during COVID-19 Pandemic.

INTRODUCTION: This study focuses on medical students from the University of Medicine and Pharmacy in Cluj-Napoca, Romania, and has three objectives. First, it evaluates the opinions of medical students regarding their previous training as well as their needs for future training in the field of digital health. Second, it assesses their attitudes regarding digital health and their intention to use digital tools as physicians. Lastly, the interrelationship between these issues as well as the socio-demographic factors which influence them are investigated. MATERIALS AND METHODS: A cross-sectional survey was performed during June-August 2021 among fifth and sixth year students of the Faculty of Medicine from the Iuliu Hațieganu University of Medicine and Pharmacy in Cluj-Napoca, Romania. Anonymous online questionnaires were used which were filled in by 306 students. RESULTS: Less than half of the participating students declared that they benefited from training or different practical examples during medical education regarding the use of digital tools in different medical areas, while the majority said that they would like to receive more training in the field of digital health. A total of 58.2% said that they totally agree with the introduction of a formal training in the medical curricula regarding digital health. Many students declared positive attitudes toward the use of digital tools in different domains within the medical field and intention to use digital tools as physicians; several differences were noted, including gender, year of study, type of domain, and previous training with regard to the use of digital tools in those domains. Moreover, the need for future training and the desire for the introduction of a formal training program into the medical curricula with regard to this field were stronger among those with more positive attitudes and higher intentions to use digital tools in their medical activity. CONCLUSIONS: To the best of our knowledge, this is the first study from Romania which investigated the training, attitudes, and intentions regarding the use of digital health among Romanian medical students, and offers valuable information to guide the education of medical students.

Prognostic Role of Clinical Features of Moderate Forms of COVID-19 Requiring Hospitalization.

INTRODUCTION: We aimed to characterize the clinical features of moderate forms of COVID-19 requiring hospitalization and potentially identify predictors for unfavorable outcomes. METHODS: Pooled anonymized clinical data from 452 COVID-19 patients hospitalized in two regional Romanian respiratory disease centers during the Alpha and Delta variant outbreaks were included in the analysis. RESULTS: Cough and shortness of breath were the most common clinical features; older patients exhibited more fatigue and dyspnea and fewer upper airway-related symptoms such as smell loss or sore throat. The presence of confusion, shortness of breath and age over 60 years were significantly associated with worse outcomes (odds ratios 5.73, 2.08 and 3.29, respectively). CONCLUSION: The clinical picture on admission may have a prognostic role for moderate forms of COVID-19. Clear clinical definitions and developing adequate informational infrastructure allowing complex data sharing and analysis might be useful for fast research response should a similar outbreak occur in the future.

Opinions and Practices Regarding Electronic Cigarette Use among Middle School Students from Rural Areas of Romania.

BACKGROUND: The objectives of the study were to assess awareness, opinions, and practices regarding electronic cigarette (e-cigarette) use, as well as factors associated with their use, among middle-school aged students from rural areas of Romania. METHODS: The study sample included 748 middle-school students aged 13-14 years from 24 schools from rural areas situated in two counties from Romania, after receiving parental consent. A cross-sectional study using confidential questionnaires which assessed smoking-related behaviors, and also opinions and practices related to e-cigarettes use, was performed in 2019 among the participating middle-schoolers. RESULTS: 96.3% of the middle schoolers have heard about e-cigarettes. A percentage of 72.7% of the smokers, 50.8% of the ex-smokers, and 15.4% of the non-smokers had tried e-cigarettes at least once in their life; 20.3% of the smokers, 4.8% of the ex-smokers, and 4.5% of the non-smokers reported using e-cigarettes in the last month. The results of multivariate logistic regression analysis pointed out that e-cigarette use at least once during lifetime was associated with having friends who tried e-cigarettes, having stronger beliefs that they can help quit smoking and that they are less dangerous than traditional cigarettes. The intention to use e-cigarettes in the next year and smoking behavior were also correlated with e-cigarettes experimentation, while no gender differences were found. CONCLUSIONS: The results underline the importance of having prevention programs and interventions concerning e-cigarettes consumption, since e-cigarettes consumption is spread among Romanian adolescents from rural areas.

The Impact of the COVID-19 Pandemic on Research and Volunteering Activities among Medical Students: A Cross-Sectional Study among Romanian and International Students from One Medical Faculty from Romania.

INTRODUCTION: This study focuses on the influence of the COVID-19 pandemic on medical students in their last year of study at the Faculty of Medicine of the University of Medicine and Pharmacy in Cluj-Napoca, Romania. It analyzes the impact of social distance limits on the conduct of research activities required for the development of the graduation thesis, as well as assesses sixth-year students' attitudes and behaviors toward volunteer activities during the COVID-19 pandemic. METHODS: A cross-sectional survey was conducted in June-July 2021 among sixth-year students. It used an anonymous online questionnaire and was sent to all students from the Faculty of Medicine studying in the Romanian, English, or French sections (n = 606). The response rate was 38.28%, resulting in a final sample of 232 students from both Romanian and international sections. RESULTS: The findings demonstrate that two-thirds of the students in the survey agreed that the COVID-19 pandemic had a substantial impact on their research. Some of the students had to choose another subject for their graduation thesis, while about a quarter of the students gave up collecting personal data, 25% of respondents stated that it was difficult to contact research participants, one-third of them linked the difficulty of doing activities at the hospital to the present outbreak, and almost 30% of the students had difficulty communicating with the coordinator. The disturbance of the research activity seems to be higher among international students in comparison with the Romanian students, while there are limited gender differences. One out of five medical students has been involved in volunteer activities during the pandemic. Most have opted to volunteer at hospitals (especially international students) and contribute to health education activities (especially women). CONCLUSIONS: This is the first study from Romania and one of the few from Europe that presents data regarding the influence of the COVID-19 pandemic on research and volunteering activities among medical students.

Assessment of Actual Weight, Perceived Weight and Desired Weight of Romanian School Children-Opinions and Practices of Children and Their Parents.

OBJECTIVE: Children and parental awareness regarding weight is linked to the development and management of overweight and obesity. The aim of this study is to assess the actual weight, perceived weight, and desired weight of Romanian school children. METHODS: A cross-sectional study was conducted in 2019 in seven schools from two counties of Romania and included 880 pupils aged between 10 and 15 years old and 665 parents. We administrated confidential questionnaires to the participants, and we measured children's weight and height during school activities. RESULTS: A total of 61.0% of pupils had normal weight, 7.4% were underweight, and 31.6% were overweight or obese. A total of 66.7% of normal weight children, 56.5% of overweight children, and 40% of underweight children perceived their weight accurately. Regarding parents, a majority correctly appreciated the weight of their normal weight children and only a third appreciated correctly the body weight of their underweight and overweight children. Factors such as body mass index, gender, weight related behaviors, parents' estimation about their children's weight, discussions of weight topics inside family, and bullying, cyberbullying and exclusion from groups were associated with misperceptions. CONCLUSION: The study provides useful information for health education activities targeting both children and their parents regarding appropriate body weight management of children.

Attitudes and Practices Regarding Research among Romanian Medical Undergraduate Students.

OBJECTIVES: This study focuses on the assessment of attitudes and practices regarding research among undergraduate medical students from Cluj-Napoca, Romania. MATERIAL AND METHODS: A cross-sectional study was performed thorough anonymous questionnaires (May-June 2018) among 510 third- and fifth-year students of Iuliu Hatieganu University of Medicine and Pharmacy from Cluj-Napoca, Romania. RESULTS: More than 60% of the third- and fifth-year students declared that they were interested and willing to perform research during medical studies, while more than two-thirds were interested in doing so after graduation. In total, 6% of third-year students and 31% of fifth-year students declared that they had prepared a scientific presentation for a medical congress at least once. Around 9% of the third-year students contributed to the writing of a scientific article and participated in research projects. Among fifth-year students, one-quarter were involved in writing scientific papers, and 21% participated in research projects. CONCLUSIONS: To the best of our knowledge, this study assesses, for the first time in Romania, the perspectives and behaviors of medical undergraduate students with regard to involvement in research activities. The results show that Romanian medical students value opportunities for conducting research, which encourages institutional initiatives that support their involvement in curricular and extracurricular research activities.

Unravelling data for rapid evidence-based response to COVID-19: a summary of the unCoVer protocol.

INTRODUCTION: unCoVer-Unravelling data for rapid evidence-based response to COVID-19-is a Horizon 2020-funded network of 29 partners from 18 countries capable of collecting and using real-world data (RWD) derived from the response and provision of care to patients with COVID-19 by health systems across Europe and elsewhere. unCoVer aims to exploit the full potential of this information to rapidly address clinical and epidemiological research questions arising from the evolving pandemic. METHODS AND ANALYSIS: From the onset of the COVID-19 pandemic, partners are gathering RWD from electronic health records currently including information from over 22 000 hospitalised patients with COVID-19, and national surveillance and screening data, and registries with over 1 900 000 COVID-19 cases across Europe, with continuous updates. These heterogeneous datasets will be described, harmonised and integrated into a multi-user data repository operated through Opal-DataSHIELD, an interoperable open-source server application. Federated data analyses, without sharing or disclosing any individual-level data, will be performed with the objective to reveal patients' baseline characteristics, biomarkers, determinants of COVID-19 prognosis, safety and effectiveness of treatments, and potential strategies against COVID-19, as well as epidemiological patterns. These analyses will complement evidence from efficacy/safety clinical trials, where vulnerable, more complex/heterogeneous populations and those most at risk of severe COVID-19 are often excluded. ETHICS AND DISSEMINATION: After strict ethical considerations, databases will be available through a federated data analysis platform that allows processing of available COVID-19 RWD without disclosing identification information to analysts and limiting output to data aggregates. Dissemination of unCoVer's activities will be related to the access and use of dissimilar RWD, as well as the results generated by the pooled analyses. Dissemination will include training and educational activities, scientific publications and conference communications.

Lifestyle and Cancer Prevention-Opinions and Behaviors Among Romanian University Students.

BACKGROUND: Healthy lifestyle promotion represents an important component of cancer prevention. The aim of this study is the assessment of opinions and behavior related to healthy lifestyle and cancer prevention among Romanian university students. METHODS: A cross-sectional study was performed by anonymous questionnaires in 2017 among 400 university students from the four main universities from Cluj-Napoca, Romania. RESULTS: One out of five students was overweight or obese, but 83% meet the recommendations for performing physical activity. The majority did not meet the recommendations of eating 400 g of fruits and vegetables daily, while almost half declared eating more than 500 g of red meat weekly and more than one third do not respect the recommendations for alcohol consumption. The factor analysis reveals two factors with regard to cancer prevention-related behaviors. The first one consists of those having an appropriate body weight, and having a higher tendency for consumption of fruits and vegetables, performing physical activity, while being more prone not to respect the recommendations regarding the alcohol consumption. The second factor refers to a higher tendency to respect both the recommendations for alcohol and red meat consumption. CONCLUSION: Future educational activities should focus on promoting better nutritional habits, decrease alcohol consumption and offer appropriate services for weight management among Romanian university students.

Actual Weight, Perceived Weight and Desired Weight of Romanian School Children by Parents and Children.

Background and Objectives: The perception of the body weight by children and parents influences the consequent actions undertaken for children's body weight management. This study investigated the correspondence between objective evaluations of Romanian school children (actual weight) and perceptions about weight (perceived weight), preoccupation with body weight management (desired weight) and parents' perceptions on children's weight. Materials and Methods: A cross sectional study was performed among 344 children aged 11 to 14 and 147 parents from Cluj-Napoca, Romania. We made anthropometric measurements of children, and short questionnaires were completed by the children and the parents. Results: The results show that 3.8% of children were underweight, 68.3% had a normal weight and 27.9% were overweight. Of this sample, 61.5% of underweight children, 20% of normal weight children and 43.7% of overweight children had misperceptions about their weight. The percentage of parents who did not estimate their children's weight correctly was 50%, 11.9% and 41.5%, respectively, for each of the three weight groups. The results of the logistic regression analyses showed that several factors were associated with the misclassification of their own body weight by the children, such as body mass index, gender, weight management practices, misclassification by the parents as well as parent-child discussions on these issues. Conclusions: Education for both Romanian parents and children is needed with regard to correctly identifying and managing children' body weight.

Electronic Cigarette Use and Its Relationship with Smoking and Alcohol and Illicit Drug Consumption among Romanian University Students.

Background and objectives: This study assesses electronic cigarette (e-cigarette) use and its relationship with smoking and alcohol and illicit drug consumption among Romanian university students. Materials and methods: A cross sectional study using anonymous questionnaire was performed in 2017 among 400 university students from Cluj-Napoca, Romania. Results: 95.5% of the participants had heard about e-cigarettes and 43.7% of these had tried e-cigarettes during their lifetime, while 8.9% declared using cigarettes in the previous month (one out of five students who had tried them during their lifetime). Half of the students had smoked during their lifetime and one third had smoked in the previous month. Eighty-five percent of participants had experimented alcohol intoxication during their lifetime and 45% had done so in the previous month, while illicit drug use during their lifetime and the previous month was 34% and 9.5%, respectively. The results of the linear regression analyses show a positive correlation between e-cigarette use, smoking, experimentation with alcohol intoxication, and the use of illicit drugs. Conclusions: Future studies as well as educational activities should address the complex relationship between e-cigarette and other substance use among Romanian youth.

Dietary patterns, physical activity, body mass index, weight-related behaviours and their interrelationship among Romanian university students-trends from 2003 to 2016.

INTRODUCTION: promotion of a healthy diet and involvement in physical activity among young people has an important impact on their actual and future lifestyle, health and well being. OBJECTIVES: this study investigates dietary patterns, physical activity, body mass index (BMI) and weight-related behaviours as well as their interrelationship among Romanian university students. METHODS: the study used anonymous questionnaires and was performed in Cluj-Napoca, Romania in 2003 (n = 320) and 2016 (n = 320). RESULTS: the factor analyse revealed three main dietary structures which were similar at both waves. The first one describes a varied diet. The second one shows a diet rich in white meat, dietary fibres and varied sources of carbohydrates. The last one refers to a diet containing red meat, fat, potatoes, sugar. The first dietary structure protects against overweight and it correlates positively with daily physical activity, while has a negative correlation with using several methods for losing weight. The second dietary factor is also protective for overweight, but has a positive correlation with using several methods for losing weight. It has a negative association with eating frequently in fast food restaurants and with daily physical activity. The last dietary structure is negatively associated with daily physical activity, while being positively associated with eating frequently in fast-food restaurants and with a higher BMI. CONCLUSIONS: the study presents trends in dietary patterns, physical activity, BMI and weight related behaviours among Romanian university students between 2003 and 2016 and highlights the existence of several main dietary structures, which seems stable over time.

Gaps in Guidelines for the Management of Diabetes in Low- and Middle-Income Versus High-Income Countries-A Systematic Review.

OBJECTIVE: The extent to which diabetes (DM) practice guidelines, often based on evidence from high-income countries (HIC), can be implemented to improve outcomes in low- and middle-income countries (LMIC) is a critical challenge. We carried out a systematic review to compare type 2 DM guidelines in individual LMIC versus HIC over the past decade to identify aspects that could be improved to facilitate implementation. RESEARCH DESIGN AND METHODS: Eligible guidelines were sought from online databases and websites of diabetes associations and ministries of health. Type 2 DM guidelines published between 2006 and 2016 with accessible full publications were included. Each of the 54 eligible guidelines was assessed for compliance with the Institute of Medicine (IOM) standards, coverage of the cardiovascular quadrangle (epidemiologic surveillance, prevention, acute care, and rehabilitation), translatability, and its target audiences. RESULTS: Most LMIC guidelines were inadequate in terms of applicability, clarity, and dissemination plan as well as socioeconomic and ethical-legal contextualization. LMIC guidelines targeted mainly health care providers, with only a few including patients (7%), payers (11%), and policy makers (18%) as their target audiences. Compared with HIC guidelines, the spectrum of DM clinical care addressed by LMIC guidelines was narrow. Most guidelines from the LMIC complied with less than half of the IOM standards, with 12% of the LMIC guidelines satisfying at least four IOM criteria as opposed to 60% of the HIC guidelines (P < 0.001). CONCLUSIONS: A new approach to the contextualization, content development, and delivery of LMIC guidelines is needed to improve outcomes.

Complex interrelations between self-reported oral health attitudes and behaviors, the oral health status, and oral health-related quality of life.

PURPOSE: The purpose of this study was to develop and test a moderated mediation model that was able to describe the relationships between oral health-related attitudes and behaviors, oral health status (OHS), and oral health-related quality of life. The hypothesized relations corresponded to research questions such as "is a person's oral health predicted by the actions that person takes in order to prevent oral health conditions?" and "do individuals with better oral health also have higher levels of oral health-related quality of life?". MATERIALS AND METHODS: A cross-sectional correlational study with selected predictor variables was conducted in Cluj-Napoca, Romania, among 191 participants, enrolled in the fourth and sixth years of study at the Dentistry School of the Medicine and Pharmacology, University of Cluj-Napoca. Participants completed the Hiroshima University Dental Behavior Inventory (HUDBI) questionnaire targeting specific behavior and attitude with respect to their dental self-care, Oral Health Impact Profile (OHIP) short questionnaire for measuring oral health-related quality of life, and the current OHS was assessed objectively using Decayed, Missing, Filled Teeth/Surfaces (DMFT) index. Statistical analyses were done using structural equation modeling software. RESULTS: Our research showed relevant associations between HUDBI, DMFT, and OHIP. The relationship between HUDBI and OHIP was mediated by DMFT. Furthermore, HUDBI worked as a moderator between DMFT and OHIP. Thus, our study revealed a case for moderated mediation, which is usually ignored in similar research. CONCLUSION: The "straightforward" causality between oral health-related behavior and the actual OHS must be considered with caution, as well as their impact on the oral health-related quality of life. Further research is needed to investigate the interaction between variables, the strength of the interrelations and the magnitude of their interactions, and the confidence that can be placed in these measurements, with respect to the general population and/or those lacking domain-specific education.

Dietary patterns, physical activity, body mass index, weight-related behaviours and their interrelationship among Romanian university students-trends from 2003 to 2016 / Patrones dietéticos, actividad física, índice de masa corporal, conductas relacionadas con el peso y su interrelación entre estudiantes universitarios rumanos entre 2003 y 2016

Introduction: promotion of a healthy diet and involvement in physical activity among young people has an important impact on their actual and future lifestyle, health and well being. Objectives: this study investigates dietary patterns, physical activity, body mass index (BMI) and weight-related behaviours as well as their interrelationship among Romanian university students. Methods: the study used anonymous questionnaires and was performed in Cluj-Napoca, Romania in 2003 (n = 320) and 2016 (n = 320). Results: the factor analyse revealed three main dietary structures which were similar at both waves. The first one describes a varied diet. The second one shows a diet rich in white meat, dietary fibres and varied sources of carbohydrates. The last one refers to a diet containing red meat, fat, potatoes, sugar. The first dietary structure protects against overweight and it correlates positively with daily physical activity, while has a negative correlation with using several methods for losing weight. The second dietary factor is also protective for overweight, but has a positive correlation with using several methods for losing weight. It has a negative association with eating frequently in fast food restaurants and with daily physical activity. The last dietary structure is negatively associated with daily physical activity, while being positively associated with eating frequently in fast-food restaurants and with a higher BMI. Conclusions: the study presents trends in dietary patterns, physical activity, BMI and weight related behaviours among Romanian university students between 2003 and 2016 and highlights the existence of several main dietary structures, which seems stable over time

Introducción: en los jóvenes la promoción de una dieta saludable y la realización de actividad física tienen un importante impacto sobre su estilo de vida, presente y futuro, en su salud y en su bienestar. Objetivos: este estudio investiga los patrones dietéticos, la actividad física, el índice de masa corporal (IMC) y las conductas relacionadas con el peso, así como su interrelación, en los estudiantes universitarios rumanos. Métodos: el estudio utilizó cuestionarios anónimos y fue llevado a cabo en Cluj-Napoca (Rumania), en 2003 (n = 320) y en 2016 (n = 320). Resultados: el análisis de los factores a estudio reveló tres estructuras dietéticas principales que fueron similares en las dos ondas. La primera describe una dieta variada. La segunda muestra una dieta rica en carne blanca, fibra y fuentes variadas de carbohidratos. La última presenta una dieta que contiene carne roja, grasas, patatas y azúcar. La primera estructura dietética protege contra el sobrepeso y se correlaciona positivamente con la actividad física diaria, si bien tiene una correlación negativa con el uso de varios métodos para perder peso. La segunda estructura dietética también protege frente al sobrepeso, aunque tiene una correlación positiva con el uso de varios métodos para perder peso, y negativa con comer con frecuencia en restaurantes de comida rápida y con la actividad física diaria. La última estructura dietética se relaciona negativamente con la actividad física diaria, pero se asocia positivamente con comer con frecuencia en restaurantes de comida rápida y con un mayor IMC. Conclusiones: el estudio describe las tendencias en los patrones dietéticos, la actividad física, el IMC y las conductas relacionadas con el peso en los estudiantes universitarios rumanos entre 2003 y 2016, y resalta la existencia de varias estructuras dietéticas principales que parecen estables en el tiempo

Impact of the Tobacco Treatment Guidelines for High Risk Groups (TOB.g): A pilot study among physicians specializing in CVD, Diabetes and COPD.

INTRODUCTION: The 2017 Tobacco Cessation Guidelines for High-risk Groups (TOB-G) is a comprehensive document on best practices for smoking cessation in clinical practice. The purpose of this pilot study was to assess physician satisfaction and changes in tobacco-related knowledge, self-efficacy and attitudes following exposure to training in the TOB-G guidelines for patients with cardiovascular disease (CVD), chronic obstructive pulmonary disease (COPD), or diabetes. METHODS: A pre-post pilot study was conducted. All participating physicians received an electronic or printed copy of the TOB-G guidelines for patients with CVD, COPD or diabetes. Physicians were also exposed to a one-day training focused on the key clinical practice recommendations from the TOB.g guidelines. Outcome measurement occurred via survey before, immediately following and 6 months after exposure to the training. RESULTS: Fifty physicians participated in the TOB.g training session. High rates of participant satisfaction were documented (exceeded expectations 47.7%; met expectations to a great extent 52.3%). Significant increases in physician knowledge and self-efficacy were documented immediately following and 6 months after exposure to the guideline training session. Exposure to the training was associated with positive changes in some but not all tobacco-related treatment attitudes, however these were no longer significant at the 6-month follow-up. Lower knowledge, confidence and unfavourable attitudes were documented for aspects of treatment related to pharmacotherapy. CONCLUSIONS: Positive changes in previously reported barriers to the delivery of tobacco treatment among physicians were documented following exposure to the TOB.g guidelines and training for patients with CVD, COPD or diabetes.

Choline Intake and Its Food Sources in the Diet of Romanian Kindergarten Children.

The objective of this study is to assess the usual intake and food sources of choline in a group of Romanian kindergarten children. A cross-sectional study was performed among 71 children aged 4-6 years from four kindergartens from Cluj-Napoca, Romania. Dietary intake data were collected by means of three-day food records. The mean (SD) daily intake of choline was 215 (32) mg/day, 22.5% of the participants fulfilling the adequate intake (AI) for children 4-6 years of age of 250 mg of choline per day. The main food sources were meat (mainly poultry), eggs, grains, cereals, and baked products (mainly bread), and dairy products (mainly milk). The results of the logistic regression analyses show that an appropriate consumption of choline/day was statistically significantly associated with the consumption of at least one egg per three days (OR = 7.5, p < 0.05), a minimum of two portions of milk or dairy products per day (500 mL milk or yoghurt, or 60 g of cheese/day) (OR = 4.4, p < 0.05), and at least one portion of meat/day (90 g/day) (OR = 14.4, p < 0.05). The results underline the need for future surveys in this field, as well as actions to encourage an appropriate diet for children, including an appropriate content of choline.

Depression, anxiety and panic disorders in chronic obstructive pulmonary disease patients: correlations with tobacco use, disease severity and quality of life.

BACKGROUND: The objective of this study is to assess anxiety, depression and panic disorders among patients diagnosed with COPD and to investigate their correlation with disease severity, quality of life as well as tobacco use. METHODS: An observational study was performed between January and September 2014 among 60 patients diagnosed with COPD. COPD staging according to GOLD criteria, while anxiety and depression were assessed using Hospital Anxiety and Depression Scale and panic attacks were evaluated based on ICD 10 criteria. RESULTS: Almost 40% of the sample were smokers, the medium packs-years was 34.3 and the medium Fagerstrom score was 7.5. Overall, mean Modified Medical Research Council Dyspnea Scale (mMRC) was 2.86, mean COPD Assessment Test (CAT) score was 21.75 and study participants had 1.93 COPD exacerbations/year. Mean distribution of anxiety and depression symptoms scores among COPD subjects was 10.65 ± 3.5 and 9.93 ± 3.8, respectively. Smokers and ex-smokers had similar scores with regard to anxiety, depression or the presence of panic attacks. The results of the bivariate correlations indicated associations between anxiety, depression, panic attacks and disease severity, as well as poor quality of life of patients with COPD, regardless of their current tobacco use status. CONCLUSIONS: In conclusion, the results of this study indicate that anxiety, depression and panic attacks were constant characteristics among COPD patients- regardless of their current tobacco use.

Opinions and practices regarding electronic cigarette use among Romanian high school students / Opiniones y prácticas en relación con los cigarillos electrónicos en estudiantes rumanos

Objective: The study assessed awareness, opinions, practices regarding electronic cigarettes (e-cigarettes) and factors associated with their use among Romanian high school students. Methods: A cross-sectional study was conducted in 2013 in two major Romanian cities, distributing anonymous questionnaires to 342 high school students aged 16–18. Results: 52.3% of the smokers, 29.2% of the ex-smokers and 7% of the never-smokers had tried e-cigarettes at least once in their life; 7.8% of the smokers and 4.6% of the ex-smokers had used e-cigarettes in the last month. Among smokers, e-cigarette use was associated with lower participation in school health education regarding e-cigarettes and with having parents using e-cigarettes.. Among ex-smokers and never-smokers, e-cigarette use was associated with intention to use e-cigarettes in the next year and with having friends who use e-cigarettes. Conclusion: Health education programmes and regulatory interventions addressing e-cigarettes are needed in Romania. More research is necessary on how to develop effective public health messages (AU)

Objetivo: Este estudio evaluó el conocimiento, las opiniones y las prácticas en relación con los cigarrillos electrónicos (e-cigarrillos), y los factores asociados a su uso, en estudiantes de colegio de Rumanía. Método: Se realizo un estudio transversal mediante cuestionarios anónimos en 2013 en dos grandes ciudades de Rumanía, en 342 estudiantes de colegio de 16 a 18 años de edad. Resultados: El 52,3% de los fumadores, el 29,2% de los ex fumadores y el 7% de los nunca fumadores habían probado los e-cigarrillos al menos una vez en la vida; el 7,8% de los fumadores y el 4,6% de los ex fumadores utilizaron e-cigarrillos en el último mes. Entre los fumadores, la experimentación con e-cigarrillos se asoció a una menor participación en actividades de educación sanitaria escolar al respecto y a tener padres que usan e-cigarrillos. Entre los ex fumadores y los que nunca han fumado, la experimentación con e-cigarillos se asoció con la intención de utilizarlos en el próximo año y con tener amigos que los utilizan. Conclusión: Se necesitan programas de educación para la salud e intervenciones reguladoras que aborden los e-cigarrillos en Rumanía. Es necesaria más investigación sobre cómo desarrollar mensajes eficaces de salud pública (AU)

An Increasing Trend of Illicit Drug use among Romanian University Students from 1999 to 2011.

AIM: The present study investigates the evolution of illicit drug use among Romanian university students from 1999 to 2011. METHODS: The study was performed in Cluj-Napoca, Romania, in three phases: in 1999 (T1), in 2003 (T2) and in 2011 (T3). The study was carried out by means of anonymous questionnaires among university students aged 19-24. RESULTS: The results show that among girls the lifetime illicit drugs use increased statistically significantly from 2.5% in 1999 to 7.5% in 2003 and to 15% in 2011. Among boys the trend was also increasing, the prevalence of illicit drug use was 14.2% at T1, 18.1% at T2, and it increased dramatically to 30.6% at T3. The percentage of students reporting cannabis use was almost identical with the total prevalence of illicit drug use. Ecstasy was the second most frequent drug used by the students; its consumption had also an increasing trend during the examined periods (from 0 to 5.6% among girls and from 0.8% to 11.2% among boys). The results of the bivariate correlation analyses show that lifetime illicit drug use was associated with having friends who experimented with illicit drugs both among boys and girls. Moreover, girls who declared stress management problems and depressive episodes were more likely to try illicit drugs, while among boys illicit drug use was associated with poorer academic performance. CONCLUSIONS: The data pointed out by our study call for comprehensive actions regarding the prevention of illicit drug use among Romanian young people.