bluuebunny/crossref_metadata_2025 huggingface dataset:
COVID-19 prevention and control measures in workplace settings: a rapid review and meta-analysis
Authors: Ingram C , Downey V , Roe M , Chen Y , Cléirigh Büttner F , Buggy C , Perrotta C
Published: October 2021

Workplaces are high-risk environments for SARS-CoV-2 outbreaks and subsequent community transmission. Identifying, understanding, and implementing effective workplace SARS-CoV-2 infection prevention and control (IPC) measures is critical to protect workers, their families, and communities. A rapid review and meta-analysis were conducted to synthesize evidence assessing the effectiveness of COVID-19 IPC measures implemented in global workplace settings through April 2021. Medline, Embase, PubMed, and Cochrane Library were searched for studies that quantitatively assessed the effectiveness of workplace COVID-19 IPC measures. Included studies comprised varying empirical designs and occupational settings. Measures of interest included surveillance measures, outbreak investigations, personal protective equipment (PPE), changes in work arrangements, and worker education. Sixty-three studies from international healthcare, nursing home, meatpacking, manufacturing, and office settings were included, accounting for ∼280,000 employees. Meta-analyses showed that comprehensive measures (0.2% positivity; 95%CI 0-0.4%) were associated with lower post-intervention employee COVID-19 positivity estimates than single measures like asymptomatic PCR testing (1.7%; 95%CI 0.9-2.9%) and universal masking (24%; 95%CI 3.4-55.5%). Modelling studies showed that combinations of (i) timely and widespread contact tracing and case isolation, (ii) facilitating smaller worker cohorts, and (iii) effective use of PPE can reduce workplace transmission. Comprehensive COVID-19 IPC measures incorporating swift contact tracing and case isolation, PPE, and facility zoning, can effectively prevent workplace outbreaks. Masking alone should not be considered as sufficient protection from SARS-CoV-2 outbreaks in workplace environments at high risk of virus transmission.

Key messages

Comprehensive contact tracing, syndromic surveillance, regular testing, PPE, and zoning measures can prevent COVID-19 outbreaks in the workplace. Masking alone should not be considered as sufficient protection from SARS-CoV-2 outbreaks in workplace environments at high risk of virus transmission.
Development of Comorbidities in Type 2 Diabetes: Morbidity Expansion or Dynamic Equilibrium?
Authors: Safieddine B , Sperlich S , Epping J , Lange K , Geyer S
Published: October 2021

Background

Different hypotheses have been proposed about the future development of morbidity associated with the temporal improvement in life expectancy. However, many studies have focused on general morbidity while testing these hypotheses. In type 2 diabetes (T2D), one of the most prevalent chronic diseases, research points towards an increasing prevalence over time with a simultaneous increase in life expectancy among this population. While morbidity compression in T2D can thus be ruled out, it remains unclear whether morbidity expansion or dynamic equilibrium applies, which could be the case with a decrease in personal disease burden despite increasing prevalence. Against this background, this study aims to examine how the prevalence of T2D-related comorbidities is developing over time.

Methods

Using claims data of a large statutory insurance provider in the state of Lower-Saxony, Germany, the period prevalence of nine T2D-related comorbidities was examined for the time periods 2005-2007, 2010-2012, and 2015-2017 in 240241, 295868, and 308134 individuals with T2D, respectively. The temporal development of comorbidities was examined by logistic regression analysis. The change in the number of comorbidities over time was examined by ordered logistic regression. Analyses were stratified by gender and three age groups.

Results

Over the three time periods, age-adjusted predicted probabilities for more severe cardiovascular diseases (CVDs) decreased in men and women with T2D while those for less severe CVDs and other vascular diseases such as retinopathy, polyneuropathy any nephropathy increased significantly in all subgroups. Among all subgroups, the predicted probability of having more comorbidities over time also increased significantly.

Conclusions

Despite differences in the way CVDs are developing, the results are in favour of the morbidity expansion hypothesis for this population. Further research is needed to examine the reasons behind the observed trends.

Key messages

The developement of comorbidities in individuals with type 2 diabetes points towards morbidity expansion among this population. Future studies should examine whether the change is socioeconomic status, medication use and lifestyle risk factors are contributing to these trends.
Distress symptoms in older adults: results from the Survey for Health and Retirement in Europe
Authors: Shahaj O , Ksinan A , Bobak M , Pikhart H
Published: October 2021

The enforced isolation that followed the first wave of SARS-CoV-2 outbreaks led to widespread concern regarding its unintended consequences on the mental well-being of older adults. The onset and severity of the outbreak, as well as the restrictive measures varied widely across countries. We aim to identify both individual and contextual factors that may have affected the presence and worsening of distress symptoms among older adults in 27 European countries. 52,310 non-institutionalised participants were asked about feeling depressed, anxious, lonely, and having trouble sleeping in the 4 weeks preceding the interview. The answers were combined into a count variable measuring distress. Answers regarding worsening of these symptoms during the outbreak were treated as binary variables. Multilevel zero-inflated negative binomial and binary logistic regressions were used to analyse the outcomes. Increasing age is not associated with higher rates of distress (p = 0.12) and compared to those aged <60, those aged 71-80 and 80+ are 33% and 46% less likely to report feeling more depressed than before the pandemic (p < 0.001). Female gender, living alone, poor physical health, low education and reduced social contact were all linked to higher rates of distress (p < 0.001). Living in a country with stronger restrictions is linked to higher distress p < 0.031 while higher Covid-19 deaths/million are associated with worsening of all four symptoms [OR: depressed 1.14(1.01-1.29); nervous 1.15(1.03-1.28); sleep troubles 1.19(1.08-1.32) and loneliness 1.14 (1.02 - 1.28)] Individual factors associated with the presence and worsening of depressive symptoms during the pandemic are similar to the ones reported in the literature before the pandemic. These groups may require additional support and mental health services. The stringency of restrictions and Covid-19 death toll adversely affected mental health, but older adults seem to be more resilient than their younger peers.

Key messages

The negative impact of the outbreak has been stronger on socially disadvantaged older adults. Strong restrictions to contain the outbreaks may lead to increase in distress symptoms in older adults but older adults are more resilient than their younger peers.
The PHIRI Rapid Exchange Forum
Authors: Habl C , Röhrling I
Published: October 2021

Background

The COVID-19 pandemic demanded a quick exchange of those persons and institutions who were aiding the national governments in the crisis response. Thus, devoted members of the Joint Action on Health Information already in April ‘20 started to meet regularly online to foster cross-country exchange. In these meetings partners could approach each other for questions and shared views in a trusted environment on an ad-hoc basis. This initiative became an integral part of PHIRI, allowing a quick exchange of data, indicators, good practices and experiences in the COVID-19 crisis response in a structured and efficient way.

Methods

The bi-weekly 1h online meetings, in a moderated, structured format, have 2 parts: 1 pre-agreed topic (chosen via a survey ex-ante to each meeting) and ad-hoc questions. Answers (backed up by evidence like national reports, guidelines, etc.) are compiled and shared via a devoted platform immediately after the meeting. Every 6 weeks there is a special edition where experts present relevant findings and recent activities in the field. Attendees are project partners, national experts (advisors to ministers and heads of agency), representatives of expert networks (e.g. Healthy Cloud), EU services (ECDC, JRC) and stakeholders (e.g. ELIXIR).

Results

12 meetings took place between Nov ‘20 and April ‘21 with ±25-30 attendees. Topics covered followed a needs assessment in Europe and not surprisingly were in line with public debates at the time: November meetings concentrated around testing options whereas in early ‘21 vaccination strategies of countries were in the focus. A widely recognised outcome was a survey on the (temporary) cancellation of the use of AstraZeneca's vaccine among most EU countries.

Conclusions

The Rapid Exchange Forum offers a structured and highly appreciated platform for regular quick exchange of fellow countries, policy advisors, Commission services and researchers in the joint efforts to manage the COVID-19 pandemic.
Nutrient and energy contribution of ultra-processed foods in the diet of nations: a meta-analysis
Authors: Micek A , Godos J , Grosso G
Published: October 2021

Background

Existing scientific literature indicates that dietary nutritional imbalance is an essential risk factor of many non-communicable diseases. The rapid changes in global food systems worldwide and accompanying it a growth in consumption of ultra-processed foods (UPFs) raised a concern and strengthened the importance of investigating of the extent in which the dietary contribution of these foods determines the overall nutritional quality. A method of production and processing may have detrimental effect on food properties and may disturb a nutritional content of a diet. Moreover, a growing body of literature suggests that the healthy dietary patterns are grossly displaced by UPFs leading to poor nutritional profile. We designed a systematic review and meta-analysis aimed to assess the nutrient profile of the overall diet according to dietary share of UPFs.

Methods

From articles included, the content of individual products (as % of energy) and ingredients in a diet across quintiles of UPFs was extracted; the slopes and intercepts of separately regressed for each food item on the dietary share of UPFs were calculated and pooled in a bivariate meta-analysis.

Results

Out of 13 articles, the mean contribution of UPFs to total energy consumption was 37.22% (95% CI: 27.40, 47.04), with great variation across studies. UPFs consumption was linearly inversely associated with less processed ones (containing fruits, vegetables, eggs, seafood, beans and legumes), whereas positively related to excess in calories from free sugars and unhealthy saturated fats as well as to diet poor in fiber and various micronutrients (potassium, magnesium, vitamin D, zinc, phosphorus, vitamin B12, niacin).

Conclusions

Our results suggests that the UPFs are major drivers of poor nutritional content in the diet, while consumed alternatively to unprocessed or minimally processed foods.

Key messages

Higher intake of ultra-processed foods is associated with unbalanced calories and nutrient intake. There is a need for further evidence to support future policy action on ultra-processed foods in order to inform the consumers or regulate their distribution in the market.
The role of trust in risk communication: the Norwegian experience
Authors: Lyshol H , Rolfheim-Bye C
Published: October 2021

Communication concerns giving and receiving information and ideas. In a public health context, risk communication also includes encouraging people to change their behaviour. During the COVID-19 epidemic, there has been a constant flow of information, but evidence has shown that not all forms of communication have the same effects on the general population.

Risk communication only works well when the communication is based on trust between

Those with the expertise Those with responsibility Those affected

 

Listening to and understanding people's thoughts, worries and experiences is just as important as offering facts and advice. Transparency about what is known and about the unknowns, is essential, as is allowing for interim advice following new knowledge. In the Scandinavian countries, where the cultural context is fairly similar, research has shown the positive effect on trust, when displaying scientific disagreement and being transparent about discussions and debates among health authorities - and between health authorities and other professionals. Inviting the public to know when science does not as yet have an answer, has led to higher confidence in the authorities and higher likelihood of compliance with advice. Showing people why advice has changed and illustrating the scientific processes behind the advice given, make people understand the authorities' reasoning and increases trustworthiness, although it may be argued that this depends on a previous high level of trust in authorities. We draw from the experience of Norway, one of the most successful countries in continental Europe in containing COVID-19 impacts, to outline the importance of trust in developing a successful risk communication strategy.
Pandemic response credit-claiming and blame-avoidance in France
Authors: Rozenblum S
Published: October 2021

Credit claiming led in France during the first wave to centralization and during the summer to decentralization. During the second wave, blame-avoidance led again to centralization. First wave: In the spring, the French government attempted to take credit by centralizing the crisis governance but soon faced mounting criticism from the population, health care professionals and members of the political opposition. These initial missteps prompted legislators to set up two parliamentary inquiry commissions. Complaints were filed against several members of government, including former Prime Minister Edouard Philippe and former Health Minister Agnès Buzyn. In July, Phillipe was replaced by Jean Castex, who was tasked with designing France's reopening strategy with greater attention to regional needs. Summer: The government's response to Covid-19 significantly changed during the summer. The government's failure to put in place a critical triptych of testing, tracing and isolation and to contain the spread of the virus led to a recentralization of the crisis governance and a second national lockdown in late October. Second wave: Although the first lockdown was deemed “necessary” by most French people, implementation of stringent measures was less accepted by the population after a resurgence of cases at the end of the summer. As France entered a third lockdown in late March 2021, Macron's popularity rate fell 4 percentage point from a month earlier. According to an IFOP poll, 37% people said they were satisfied with the president's management of the pandemic.
Citizen initiative: www.covid19data.no
Authors: Hansen T
Published: October 2021

Norway confirmed its first case of Coronavirus on the 26th of February 2020. As the number of infections continued to increase, the Norwegian Institute of Public Health started releasing daily reports on the 9th of March 2020. Public interest peaked with Norway locking down on the 12th of March. Local transmissions and outbreaks generated a growing demand for more granular data than the county-based level reported released by public health officials. The absence of detailed data created a market for some media outlets to release district-level situation reports behind paywalls (Aftenposten). Others implemented daily Corona-trackers on their front page by sourcing information from Norway's 358 municipalities (VG). While public authorities were tracking local infections and media published their results, none of the actors released detailed information in a complete, timely and accessible manner. Covid19data.no was launched as a citizen initiative on the 16th of April 2020 to provide historic and daily updated data for all municipalities and districts in Norway. The launch included daily updated dashboards and the release of all data in a cleaned, granular and machine-readable format. Soon, other citizens began contributing to the project, adding to the already existing list of data sources. The citizen initiative was launched 2 months before the Norwegian Institute of Public Health began releasing similar detailed data.

Citizen dashboards can represent a valuable addition to public reporting, but also represent new challenges:

How can you trust data and dashboards from a non-official actor?

How do you keep data updated when running the dashboard on a voluntary basis?

How are metrics and visualizations decided when creators have no experience with public health and epidemics?

How do multiple collaborators effectively work together when they have never met before?

This presentation will focus on the role of citizen initiatives, their challenges and opportunities.
The city of proximity as an Urban Health strategy for the post pandemic neighborhood’s needs
Authors: Capolongo S , Rebecchi A
Published: October 2021

The lockdown due to the pandemic has prevented travels, forcing many people to work at home and reducing the possibility of accessing services in the territory. This condition has further highlighted the importance of urban living areas capable of satisfying basic needs within a reasonably easy range of accessibility. The concept of the “15 minutes city” is a useful vision to represent the city of proximity, where it is possible to meet the needs for sustainable, fair, quality, and healthy living. However, even if the objectives represented are fundamental, the model it proposes - accessibility within 15 minutes - is not always applicable in all urban contexts, mostly peripheral, peri-urban, or low-density ones. This dimension of proximity - to be defined from time to time according to urban contexts - can be central to formulating strategies to improve the quality of urban life. Still, it can also play a role in constructing forms of intervention to improve public health and in ordinary conditions, both in extraordinary and emergency conditions. From this point of view, a proximity area can be an area to be defined with a variety of tools typical of urban analysis but fed by overlapping layers that also refer to the health dimension. A place of proximity, therefore not only defined based on the physical characteristics and people's uses, but also based on the data collected from a public health perspective in which it is also possible to try to test different types of information and build the conditions to suggest suitable policies and projects. Aim of the authors is to illustrate a survey about several case studies considered virtuous at the international level, analyzed in detail to highlight the main urban and architectural features of those healthy experiences and the related health outcomes, such as sedentary lifestyle reduction, increase of the attractiveness of places, reduction of air and noise pollution.
The European Health Literacy Survey 2019 of M-POHL: a summary of its main results
Authors: Pelikan J , Link T , Straßmayr C
Published: October 2021

Background

The HLS-EU study in 2011 demonstrated that there exists limited comprehensive health literacy (HL) for considerable proportions of the general population, that there is a social gradient for HL and that limited HL has problematic consequences for healthy lifestyles, self-reported health and utilization of health care services. But distributions and associations of HL differed considerably between the 8 included EU-countries. WHO-Europe initiated the Acton Network on Measuring Population and Organizational Health Literacy (M-POHL) to measure HL regularly, starting with the Health Literacy Survey 2019 (HLS19).

Methods

Based on the design and instrument of the HLS-EU, an improved core questionnaire was developed for HLS19 to measure comprehensive HL and its relevant correlates. Optional packages introduced specific instruments and measured digital, communication, navigation and vaccination HL and its most relevant correlates. Cross-sectional data were collected by probability samples of at least 1.000 respondents per country for the general population 18+, in 17 member states of the WHO-Europe region, by personal interviews, telephone interviews, or internet surveys.

Results

Considerable proportions of resident adult populations in participating countries have limited HL and there is a social gradient for HL. HL also has, but to a differing degree, consequences for selected life-style indicators, indicators for self-reported health and use of professional health care services. General trends were found, but also considerable variation by country.

Conclusions

Results demonstrated that main trends of the HLS-EU study concerning HL hold still true for HLS19 and that there are even more pronounced differences between participating countries. Since HL is relevant for health policy in all countries, policy recommendations for improving HL in the European region were drafted by the HLS19 consortium and will be presented in the second presentation.
Adherence to non-pharmaceutical interventions for COVID-19: a national survey
Authors: Kearney PM , Spillane M , Humphreys R , Gannon A , Hoevel P , O’Riordan M , Khashan A , Buckley C , O’Connor L , Perry IJ
Published: October 2021

Background

The global Covid-19 pandemic response depends heavily on non-pharmaceutical interventions to protect population health. This aim of this study was to provide insights into levels and determinants of adherence to travel restrictions and wearing of face coverings during the early phase of the pandemic response in Ireland.

Methods

A series of four cross-sectional surveys were administered through random digit dialling of mobile and landline numbers during May-June 2020. Questions were asked about compliance with local travel restrictions and where relevant, the reasons for travel. A question on mask use was added to the final wave of data collection.

Results

Overall, across the four waves, 73.4% reported adhering to the travel restrictions and these levels were maintained over time (wave 1: 72.1%, wave 2: 73.7%, wave 3: 67.3%, wave 4: 79.7%) and were broadly similar across different socioeconomic groups. Higher proportions reported travelling for non-exempt reasons over time particularly in the final wave of data collection including exercise (from 3% in wave 1, 5% in wave 2 up to 8% in waves 3 and 4) and recreational or social activities (2% in waves 1 and 2, 4% in wave 3, up to 15% by wave 4). Overall, over two-thirds of respondents reported use of masks in the final wave, (72% of women, 65% of men) with shops or supermarkets the most common place of use. Among primary respondents, older age (Age 70+ vs. 18k-44, OR 3.2 [2.4-4.3]), attending higher education (attending vs. completed third level OR 2.2 [ 1.6-3.0]) and female gender (OR 1.2 [1.1-1.4]) were independently associated with compliance with travel restrictions.

Conclusions

The findings demonstrate high levels of adherence to travel restrictions during the early stages of the emerging COVID-19 pandemic, albeit with a modest trend towards reduced compliance over time. There was a high uptake of mask use in advance of relevant national guidance.
Patient journey as tool for measuring effectiveness and cost-effectiveness of community health interventions
Authors: van der Schans J , Stein C
Published: October 2021

Myanmar, Vietnam, and Indonesia aim for a stronger interlinkage between primary and secondary health care as well as between health facilities and communities. The possibility to combine community-based facilities with primary health care will help to reduce costs and provide synergistic effects to interventions that are currently functioning on a standalone level. However, the evidence on (cost-) effectiveness of prevention and treatment targeted at NCDs, such as diabetes and hypertension, is scarce in Southeast Asia. Outside Southeast Asia multiple studies have shown the (cost-) effectiveness and efficiency in LMICs of service delivery of healthcare interventions (e.g., shifting the point of care), improvement of the health workforce (e.g., capacity building of healthcare workers), improvement of health information (e.g., monitoring of patients and people at risk), and health financing (e.g., community-based insurance system). This indicates the potential of adjusting existing interventions or tailoring new interventions to its local context within the field of NCD related supply of prevention and treatment. Matching the chronic care pathway (patient journey) of the country specific demand with possible improvements of the supply side of the health care system in place could help improve the (cost-) effectiveness and efficiency. To get more insight into the demand, services and outcomes of NCDs in Southeast Asia we identified the patient journeys and related methodology to evaluate (cost-)effective interventions for identifying individuals with high risks for developing NCDs, early treatment and lifestyle interventions, which fit in local cultures and health systems.
Media coverage of evidence outputs during the COVID-19 pandemic: findings from one national agency
Authors: Sharp M , Forde Z , McGeown C , O'Murchu E , Smith SM , O'Neill M , Ryan M , Clyne B
Published: October 2021

Background

The COVID-19 Evidence Synthesis Team within the Health Information and Quality Authority (HIQA) in Ireland produced a range of evidence-based reports on a broad range of public health topics related to COVID-19. These evidence outputs (EO) arose directly from questions posed by policy makers and clinicians supporting Ireland's National Public Health Emergency Team (NPHET). Findings from these EOs informed the national response to the COVID-19 pandemic in Ireland and influenced international public health guidance. How research findings are presented through domestic news can influence behaviour and risk perceptions.

Methods

We investigated traditional media coverage of nine COVID-19 EOs and associated press releases, published (April to July 2020) by HIQA. NVivo was used for conceptual content analysis of manifest content. ‘Core messages' from each evidence output were proposed and 488 sources from national and regional broadcast, print, and online media were coded at the phrase level. The presence of political and public health actors in coverage were also coded.

Results

Coverage largely did not distort or misrepresent the results of the EOs, however, there was variability in terms of what content was reported on and to what extent different stakeholders were involved in the contextualization of the findings of the EOs. Coverage appeared to focus more on ‘human-interest' stories as opposed to more technical reports (e.g. focusing on viral load, antibodies, testing, etc.). Selective reporting and the variability in the use of quotes from governmental and public health stakeholders changed and contextualized results in different manners than perhaps originally intended in the press release.

Conclusions

Our findings provide a case-study of European media coverage of evidence reports produced by a national agency. Results highlighted several strengths and weaknesses of current communication efforts.
Prevalence of autism in Europe, North America and Oceania, 2000-2020: A systematic review
Authors: Anorson N , Male I , Farr W , Memon A
Published: October 2021

Background

Since the first study of the prevalence of autism spectrum disorder (ASD) in 1966, several studies from across the world have reported increasing prevalence of ASD in children. This has led to a debate whether childhood ASD cases are increasing in real time or the increase is essentially due to improved accessibility/referral to health services or changes in diagnostic criteria and accuracy.

Methods

MEDLINE and PSYCINFO databases were searched for studies of ASD prevalence estimates in Europe, North America and Oceania published during 2000-2020 (including prevalence data for 1993-2019). Data including age at diagnosis, gender, ethnicity, diagnostic criteria/tools, method(s) of case detection and prevalence per 10,000 population were extracted.

Results

75 studies, reporting a wide range of prevalence estimates, were included in the review. Overall, there was a steady and substantial increase in the prevalence of ASD in Europe, North America and Oceania during the last three decades. For Europe, the median prevalence was 59 per 10,000 population (range, 8 to 420; mean, 80). For North America, the median prevalence was 86 per 10,000 population (range, 11 to 247; mean, 95). For Oceania, the median prevalence was 47 per 10,000 population (range, 10 to 390; mean, 112). Overall, the prevalence was higher in White children compared to other ethnic groups.

Conclusions

It appears that several factors can be attributed to increasing prevalence of ASD in Europe, North America and Oceania. Some of the increase is likely due to increased case ascertainment, but other factors need further investigation to determine the reason(s) for increasing prevalence of ASD.

Key messages

There is a wide variation in the prevalence of ASD in populations of Europe, North America and Oceania. This is partly explained by differences in case ascertainment and sociodemographic factors. The differences in prevalence between ethnic groups need further investigation.
Corporate political activity of the baby food industry in France
Authors: Cossez E , Mialon M
Published: October 2021

Background

There is growing evidence that the ‘corporate political activity' (CPA) of the food industry is a major barrier to the development and implementation of public health policies to promote healthy food environments. The CPA, by targeting the public and health professionals, amongst others, could also promote the consumption of industrial foods, including ultra-processed ones, which is known to lead to ill-health. The purpose of the present study was to map the actors, history and the CPA of the baby food industry in France.

Methods

The study consisted of an analysis of publicly available information for data published between May 2019 and April 2021. Interviews with key informants from academia, civil society and the government served to triangulate that information. For both parts of the study, a qualitative thematic analysis was conducted, using an existing classification of the CPA.

Results

During the study period, Danone and Nestlé used action-based ‘instrumental strategies'. The most prominent strategy was ‘information strategy', used to fund, produce, and disseminate industry-preferred information. Danone and Nestlé were further found to ‘establish relationships with key opinion leaders and health organisations', such as pediatric societies, ‘seek involvement in community', especially during the Covid-19 crisis and used voluntary commitments, a practice that may help avoid the mandatory regulation of their harmful products and practices. The companies also employed argument-based ‘discursive strategies' to frame the debate on diet- and public health-related issues.

Conclusions

These findings can be used to recognize, anticipate, and address CPA practices that may negatively influence infant, child and maternal health, by ensuring that the commercial interests of the industry do not prevail over public health goals.

Key messages

The baby food industry uses a range of political practices in France, which may negatively influence infant, child and maternal health. This study seeks to uncover and describe these practices. This research will serve us both for the political environment, an advocacy work, but also to broaden scientific knowledge on the subject, in France and internationally.
Quantifying uncertainty: the socioeconomic impact of DCCs from an EU and a global health perspective
Authors: Czypionka Thomas
Published: October 2021

The third panelist will provide a brief overview of key scientific issues and discuss how uncertainty is quantified for different parameters, incl. factoring in socioeconomic dimensions and considerations for the European and global economy contributing to decision-making related to the proposal of the Digital COVID Certificate (DCC). The broader macroeconomic perspective given its implementation, as well as potential mitigating measures to assert implementation will not further contribute to exacerbating socioeconomic inequalities will be presented. Special mention will be made to the role of various determinants and on how potential inequities stemming from this measure can be further addressed.
Epidemic dynamics after the DCC introduction: how to best shape COVID-19 evidence-informed policies
Authors: Priesemann Viola
Published: October 2021

The fourth panelist will present tools utilised assess how COVID-19 dynamics evolved upon the introduction of the Digital COVID Certificate (DCC), aspects that ought to be monitored to inform predictive models, forecasting, foresight studies, etc. Key studies correlating various measures related to this measure, e.g., as for example the effect on the perception of risk (compensatory risk, Peltzmann effect) and change in behaviour. Considerations given variants/escape mutants and an elaboration on the implications to low case number will be presented. A brief overview on the trends to look out for in terms of monitoring will be discussed both in terms of moving towards optimistic endemic scenarios or assessing damage and proposing drastic measures and potential withdrawal of this measure.
Effect of smoking on survival following Non-Hodgkin Lymphoma in Ireland
Authors: Havle K , Fitzpatrick P
Published: October 2021

Background

Although Ireland has been to the fore in tobacco control, smoking rates are falling slowly. There is a growing body of evidence that smoking cessation improves outcomes following the diagnosis of several cancers. Notwithstanding the adverse outcomes, a significant number of people who have been diagnosed with cancer continue to smoke. The aim of this study was to determine the role of smoking in overall and 5-year survival in patients diagnosed with Non-Hodgkin Lymphoma (NHL) between 1996 to 2016 (inclusive) in Ireland.

Methods

Data relating to 12,693 patients diagnosed with NHL was obtained from the National Cancer Registry of Ireland. Kaplan Meier survival analysis with log-rank test was conducted to determine the overall and 5-year survival. Multivariate Cox regression adjusted for age and gender was performed.

Results

Tobacco smoking has a significant influence on survival following NHL (p = 0.001). Young patients and non-smokers had superior 5-year survival at 87.5% and 59% respectively. On univariate analysis, current and ex-smoking were each significantly associated with increased mortality. After adjustment for age and gender, current smoking remained significant with increased mortality risk (HR-1.47, 95% CI = 1.23-1.76).

Conclusions

Smoking status is significantly associated with survival from NHL. Smoking cessation in cancer patients is a key component in the improvement of survival. Targeted smoking cessation services for cancer patients are needed; research on the best approach is currently being conducted by this research group.

Key messages

Current smoking impairs survival from Non-Hodgkin lymphoma. Targeted smoking cessation services for cancer patients are required.
Classification of original deprivation indices used in public health
Authors: Zelenina A , Shalnova S , Maksimov S , Drapkina O
Published: October 2021

Background

Many studies around the world have been carried out to establish the association between deprivation and health outcomes. Both separate deprivation indicators (income, education) and indices that include several ones are used. Deprivation indices have been actively used in public health since the mid-80s of the last century. Nowadays, there is no clear classification of deprivation indices.

Methods

In order to create a taxonomy of deprivation indices, scientific publications related to the development and application of indices have been combined, analyzed, and systematized. The search was carried out in two bibliographic databases (PubMed and Google Sholar). After conducting a full-text review and searching and adding relevant papers from the bibliography, and adding papers that were already known to the authors, 61 documents were included in the study. These documents referred to 61 original deprivation indices. Original index is defined as “an index that includes a combination of deprivation indicators that is unique and not repeated in other indices”.

Results

Four key characteristics of the indices included in the classification were determined: type of deprivation, spatial scale, data source and weighting method. To create the taxonomy, an integrative approach was used that allows you to add new classes and subclasses when new information appears. In accordance with the type of deprivation 72% (44 \ 61) socio-economic, 7% (4 \ 61) material deprivation, 5% (3 \ 61) environmental deprivation and 16% (10 \ 61) multidimensional indices were identified.

Conclusions

The terms and definitions introduced during the review are aimed at ensuring uniformity in the taxonomy and finding a common language among researchers and specialists who develop and use indices. We also hope that the data from the study will stimulate the use of a competent approach and will help in resolving conflicts or inconsistencies that arise during the construction and use of indices.

Key messages

Development of the first classification of deprivation indices. Stimulation of the use of competent approach and thus help researchers and public health professionals resolve conflicts or inconsistencies in the construction and use of indices.
Potential alcohol use disorder (AUD) among men who have sex with men (MSM) in Ireland
Authors: Daly FP , O'Donnell K , Davoren MP , Noone C , Weatherburn P , Quinlan M , Foley B , Igoe D , Barrett PM
Published: October 2021

Background

Alcohol consumption is a major public health concern in Ireland. Alcohol use disorder (AUD) appears to disproportionately affect men who have sex with men (MSM). However, little is known about the prevalence of AUD in this group in Ireland specifically, and the characteristics of MSM who may struggle with this.

Methods

The European MSM Internet Survey 2017 was an online, self-completed, anonymous questionnaire among MSM residing in Ireland. Standardised questions were used to explore a variety of topics. The validated CAGE-4 questionnaire was used to screen for potential AUD, defined as a CAGE-4 score of ≥ 2 out of 4. Multivariable-adjusted logistic regression analysis was used to identify factors associated with potential AUD.

Results

In total, 1,793 MSM met inclusion criteria, and 31% screened positive for AUD. We observed higher odds of possible AUD among MSM who were bisexual (vs. gay/homosexual) (aOR 1.48 95%CI 1.01-2.18), native to Ireland (vs. non-native) (aOR 1.49 95%CI 1.12-1.96), unemployed (vs. employed) (aOR 1.80 95%CI 1.02-3.16), had used illicit drugs in the previous year (vs. none) (cannabis only, aOR 1.74 95%CI 1.14-2.63) (other illicit drugs, aOR 2.28 95%CI 1.67-3.09), reported anxiety/depression (vs. none) (aOR 1.73 95%CI 1.12-2.66), and MSM who experienced homophobic abuse (vs. never) (aOR 1.55 95%CI 1.09-2.22). Student MSM were less likely to screen positive for AUD (vs. employed) (aOR 0.65 95%CI 0.46-0.93).

Conclusions

The prevalence of AUD appears to be higher in the MSM population compared to the general male population in Ireland. Targeted interventions may be warranted to reduce the burden of AUD among MSM.

Key messages

The prevalence of AUD appears to be higher in the MSM population compared to the general male population in Ireland. Targeted interventions may be warranted to reduce the burden of AUD among MSM.
Body image and weight control in sexual minority and non-minority youth in Ireland
Authors: Költő A , Kelly C , Nic Gabhainn S
Published: October 2021

Background

Sexual minority young people have higher rates of eating disorders and disordered eating behaviours than their heterosexual peers. However, research in this area is rare in Europe, and the existing studies rarely disaggregate youth exclusively attracted to the same-gender (lesbian/gay) or both-gender partners (bisexual).

Methods

In this study we compared happiness with self, satisfaction with one's body and weight control attempts among 4,816 opposite-, same-, both-gender attracted and non-attracted young people, aged 14-18 (mean age: 15.74±1.09, percentage girls: 55.4), participating in the 2018 data collection round of the Health Behaviour in School-aged Children study in Ireland. These groups were compared across the outcome variables using Chi-square tests and binary logistic regression, adjusted for gender and social class.

Results

Both-gender attracted youth were less likely than the other groups to be happy with the way they are (adjusted odds ratio [aOR] = 0.33, 95% confidence interval [CI]: 0.25-0.45). Both- (aOR = 0.55, CI: 0.43-0.70) and same-gender attracted (aOR = 0.68, CI: 0.48-0.96) youth were less likely than their heterosexual peers to feel their body is about the right size, which was mostly attributable to feeling too fat. Both minority groups were more likely than heterosexual youth to try to reduce their weight (aOR = 1.75, CI: 1.12-2.75 for same-gender attracted and aOR = 1.44, CI: 1.05-1.98 for both-gender attracted youth, respectively). All effects were significant (p < .05).

Conclusions

Sexual minority youth in Ireland, especially those attracted to both-gender partners, are more likely to report body dissatisfaction and weight control behaviours than their same-gender attracted or non-minority peers. This calls for interventions which increase self-acceptance and body positivity among sexual minority young people and promote healthy ways of maintaining a healthy weight such as physical activity.

Key messages

Sexual minority young people are disproportionately affected by body dissatisfaction and restrictive weight control, compared to their heterosexual peers. Interventions that increase self-acceptance and body positivity among sexual minority youth should be a priority for public health.
Design, implementation and assessment of a drive-through flu mass-vaccination program in Italy
Authors: Pompili E , Catozzi D , Cigliano F , Siliquini R
Published: October 2021

Problem

The SARS-CoV-2 pandemic has completely changed health systems around the world.

As part of a mass immunization campaign with COVID-19 vaccines, it was necessary to study new methods to vaccinate a large number of people in a short time and in complete safety.

Description of the problem

To ensure the requirements of speed, safety and low cost, we therefore designed an EBM model of drive-through flu-vaccination, built in the city of Rivalta di Torino (about 20,000 inhabitants), in Northern Italy, on two Saturdays in November 2020. The project was created by Public Health Residents with the collaboration of the Municipality, a team of Family Doctors and Civil Protection.

Results

We measured driving time for each vehicle from the check-in station to the parking zone designed for the 15min post-vaccination follow-up. We calculated the mean length of stay time (LOS) and the mean time per person based on the number of individual vaccinations given per vehicle. In two days, 1539 vaccines were administered. Flows were only timed on the first day (417 vehicles and 672 vaccines). The highest percentage of cars (47%) received only one vaccination per vehicle, followed by 2 (45.8%), 3 (6.2%), and 4 (1%) vaccines per vehicle. The optimal number of vaccinations per vehicle to maximize efficiency was 4: the average LOS per vaccination decreased from 2.54 minutes per person (1 vehicle=1 person) to 0.34 seconds per person (1 vehicle=4 people). The mean LOS time was 3.06min (SD1.11).

Lessons

This model appeared as a real possibility to start a rapid, effective, safe and low-cost mass-vaccination program in the Italian setting. It also seems to be appreciated by the population, not only in terms of novelty but also for the sense of security and speed of the process. For this reason, in April 2021, the same model was successfully applied in the same area for COVID-19 vaccination.

Key messages

The drive-through model appeared as a real possibility to start a rapid, effective, safe and low-cost mass-vaccination program in the Italian setting. The Pandemic has changed the needs and methods of carrying out common health practices: the drive-through model has proved to be a valuable resource for mass vaccination.
Attitudes and beliefs regarding current vaccines among Tunisian cancer patients
Authors: Cherif I , Khiari H , M’ghirbi F , Mallekh R , Mezlini A , Hsairi M
Published: October 2021

Background

Vaccines constitute a successful and cost-effective public health tool. Whereas, skepticism regarding their safety and efficacy remains prevalent. We aimed in this study to assess attitudes and beliefs regarding current vaccines among cancer patients in a national Tunisian center for cancer care.

Methods

A cross sectional study was conducted, during the month of February 2021, among hospitalized patients in the oncology unit of the Salah Azaiez Institute of cancer. We included patients who were aged 18 years and over and who were able to respond to the questionnaire. A standardized questionnaire was administered to patients to assess their attitudes and beliefs regarding current vaccines. Chi square test was used for comparing percentages and a p value <0.05 was considered as statistically significant.

Results

A total of 200 patients were included with a mean age of 54.4±12.7 years. The willingness to receive influenza and COVID-19 vaccine were respectively of 39.0% and 35.0%. A higher proportion of 69.0% was observed for the willingness to receive vaccines against other infectious diseases. Among surveyed patients, the high majority (81.0%) agreed with the fact that there is no need to be vaccinated because native immunity exits and or because vaccines are unsafe. This belief was significantly associated to patients' unacceptance of COVID-19 (91.3% vs 63.8%, p < 0.001), influenza (86.8% vs 72.7%, p = 0.013) and other infectious diseases vaccines (93.5% vs 75.9%, p = 0.003).

Conclusions

This study reported low acceptance proportions of influenza and COVID-19 vaccines and that false beliefs constitute a threat to vaccine acceptance. Healthcare professionals should educate and encourage cancer patients to be vaccinated, especially against COVID-19, influenza and pneumococcal infections.

Key messages

Low acceptance proportions of influenza and COVID-19 vaccines, were found in this study. Improving communication strategies in order to redress false beliefs and increase vaccine acceptance is recommended.