bluuebunny/crossref_metadata_2025 huggingface dataset:
Artificial Intelligence and Urban health: a step forward to the achievement of SDGs
Authors: Damiani G , Nurchis MC , Sapienza M , Jevtic M
Published: October 2021

The Sustainable Development Goals (SDGs) recognized the transformative power of urbanization with a dedicated goal (SDG11) focused on cities. This represents a pivotal first step to empower cities, also technologically, enabling new levels of intelligence and showing the need to become smarter. Artificial Intelligence (AI) and smart cities bring a multidisciplinary, integrated approach, examining how the digital and physical worlds are converging. The AI-based algorithms are overcoming the provision of urban services entering the realms of urban governance, planning, health, and safety. The aim of this study is to review how digital technologies and AI-based algorithms can influence and transform urban health. A scoping review of the literature was conducted using the Population, Concept, Context (PCC) framework to formulate the research question. A comprehensive search strategy will be implemented according to the PRISMA Extension for Scoping Reviews (PRISMA-ScR). Major electronic databases were queried combining specific keywords. In addition, the search was completed by a snowball-search to identify missing articles. Out of a total of 1150 publications, 8 were identified as relevant to the research question. Among these articles, 43% and 35% reported findings from Europe and North America respectively. Evidence from the literature primarily focuses on the integration of smart city networks (sensor, people, business), based on AI, and urban health with different impacts on the health conditions of urban population over time. Public health plays major roles in urban planning sharing jointly common missions and perspectives. The advent of smart cities supported by AI can have an impact on public health, transforming urban life, with important consequences for physical, mental, and social well-being. AI applications in urban health could support public health activities of prevention and surveillance, and decision-making process, ushering a new era of public health.
Evaluating rapid review provision to inform policy during the COVID-19 pandemic
Authors: Clyne B , Byrne P , Smith SM , O'Neill M , Ryan M
Published: October 2021

Background

Evidence based decision making is central to population health, particularly during a pandemic. Few studies examine the production and use of evidence in decision-making during crisis management. This study describes and evaluates the provision of rapid evidence products by a single agency to support national decision making.

Methods

Semi-structured interviews were conducted with a convenience sample of evidence providers (who gathered and disseminated the required evidence) and service users (policy makers). Interviews were transcribed verbatim and analysed using thematic analysis. Quantitative data of work activity were summarised descriptively.

Results

Three themes were generated from the data: the work, the use and the future, with a fourth theme cross-cutting across these: the team. The work followed clear protocols and was centrally managed. The scope and changing nature of the evidence were highlighted as issues. The service providers reported a strong sense of team work and ‘being in this together', however, the majority of the participants felt that the workload was huge and exhausting and not sustainable long-term. Overall the service users thought the rapid evidence synthesis was indispensable to the decision-making process and had trust and confidence in the work, largely based on existing working relationships with the team. While they recognised that the evidence synthesis support would be an essential component of the continued pandemic response, they did query the sustainability of the process and reflected on the amount of work the team performed.

Conclusions

This evaluation, drawing on qualitative data, has highlighted that, across the services users and evidence providers, the support provided by HIQA was generally perceived as positive. From the service users' perspective, having access to the team was indispensable to the decision making process. However, the sustainability of the work load was identified as a major challenge.
Molecular characterization of A. baumanni isolates causing co-infections in SARS-COV-2 patients
Authors: Ceparano M , Baccolini V , Migliara G , Giannini D , Venditti M , Pugliese F , Tufi D , De Giusti M , Marzuillo C , Villari P
Published: October 2021

Background

Respiratory viral infections, such as COVID-19, predispose patients to co-infections leading to increased morbidity and mortality. A. baumannii poses as a serious threat to hospital facilities because of its ability to persist in the environment and acquire multi-drug resistance. The aim of this study was to quantify the extent of A. baumannii cross-infection and identify any gene clonality between isolates in SARS-CoV-2 patients.

Methods

Bacterial isolates of A. baumannii found in patients with SARS-CoV-2 admitted to the main Intensive Care Unit (ICU) of the Umberto I Teaching Hospital of Rome were collected between March 2020 and February 2021. Isolates were typed by pulsed-field electrophoresis to analyse their homology relationships.

Results

Overall, 196 SARS-CoV-2 patients were admitted to the ICU. They were mainly male (N = 138) and aged 63 years on average. Of these, 122 died, and 74 were discharged. A total of 157 strains of A. baumannii were isolated from 74 patients (38%), who had a higher mean hospital stay than patients in whom the bacterial strain had not been isolated (24.6 vs. 12.2 days). The genotypic analysis of 120 isolates revealed two main patterns (A and F) and a few subtypes, especially A8 (43%), A4 (29%), and A11 (10%). Clone A8 was found mainly between October 2020 and February 2021, clone A4 in April-December 2020 and January-February 2021, and A11 in December 2020 and January 2021. The strains were susceptible to colistin only, were isolated mostly from tracheobronchial aspirates (41%) or rectal swabs (35%) and accounted for 56 healthcare-associated infections (33% of which sustained by A4, 38% by A8, and 9% by A11).

Conclusions

The isolation of A. baumannii from patients with COVID-19 highlighted the importance of monitoring co-infections caused by this pathogen, which frequently shows a multi-drug resistant profile that may lengthen the hospital stay. It is essential to implement preventive measures to contain these infections.

Key messages

A. baumanni is a pathogen that needs to be monitored because it may lengthen the hospital stay of SARS-CoV-2 patients. In critically ill patients, the continued growth of multidrug-resistant organisms shows the importance of preventing these infections.
Competence profile of Regional Health Network Managers
Authors: Kollányi Z , Horváth G
Published: October 2021

Background

Based on the findings of the previous country-level research and interviews conducted by the partner institutions, we aimed at developing an International Core Competence Profile for Regional Health Network Managers (RHNMs), which later may serve as a foundation for the project's final goal: the curriculum development for EU RHNMs.

Core Competence Profile (CCP): The CCP describes in a comprehensive and structured manner what activities a RHNM needs to perform to reach the goals of health promotion and prevention by managing the network of local actors. Two central and one ancillary circle of competences were defined-all three interrelated. The two central, overlapping circles are the Health Content Planning Cycle and the Network Management Cycle, both defined as cycles, emphasizing the importance of repeated feedback and readjustment of the processes.

Relevant competencies' list: Based on the CCP, we ordered knowledge/skill areas to the competences named in the profile. According to the interview results combined with assessment, Health Content Planning Cycle is mostly based on broader health- and policy planning related knowledge (e.g. public health, social epidemiology, interdisciplinary social), and needs a strong basis in data collection and analysis knowledge and skills. Network Management Cycle is based very strongly on a wide range of “people” and communication skills (oral and written, with different stakeholders and in different settings), as well as strategic management. Based on the project team's assessment, RHNMs need advanced level knowledge in the areas of: interdisciplinary knowledge; implementation science; stakeholder analysis; facilitation of process; PR-written and oral communications; people skills, diplomacy, conflict management; strategic management; project management, and fund raising.
10.N. Workshop: Women's health reports in Europe - From data to action
Authors:   Organised by: Robert Koch Institute (Germany),   Chair persons: Anke-Christine Sass (Germany), Franziska Prütz (Germany)
Published: October 2021

The great impact of gender on health is well researched and documented. In addition to the different morbidity rates of women and men, there are differences in the perception and communication of symptoms, in health-related behaviour and in the use of care services. The causes are primarily social and societal in nature. They are closely linked to biological gender differences. A close look at women's health is not only important to achieve improvements in health and well-being for 51% of the population. Evidence shows that healthy women are the cornerstone of healthy societies. In recent decades, women's health reports have been published in many European countries, e.g. ‘Austrian Women's Health Report 2010/2011' or ‘Annual Report of the Chief Medical Officer 2014 - The Health of the 51%: Women' (UK). As the most recent one, the Report on Women's Health in Germany was published in December 2020. It was prepared by Federal Health Reporting at the Robert Koch Institute with the assistance of many external experts. In addition to the differences and similarities in the health of women and men (‘differences between'), particular attention is paid to differences within the group of women (‘differences within'). Reporting on women's health is an important milestone and at the same time a starting point for further steps to improve women's health. In Austria, an ‘Action Plan on Women's Health' with 40 measures for women's health in Austria was published in 2018 by the Federal Ministry of Labour, Social Affairs, Health and Consumer Protection. In the UK, the 2019 report ‘Better for women. Improving the health and wellbeing of girls and women' was published by the Royal College of Obstetricians and Gynaecologists. The authors call for the creation of Women's Health Strategies across the UK. The workshop aims to share experiences and network experts and activists from Europe. The authors of women's health reports will meet colleagues who have prepared action plans and strategies on women's health. They will discuss with participants who want to initiate such reports in their countries. We plan a 60-minute session with 3 presentations (10-15 minutes each) and time for discussion and audience interaction.

The following key questions will be addressed in the 3 presentations:

What women's health issues are of particular concern in your report? What is the data situation on important women's health topics in your country, are there data gaps? Which groups of women did you focus on in more detail in your report/your strategy? How can the findings be translated into policy? What has happened so far?

Key messages

The workshop on women's health in Europe is a networking event for authors and activists who have written reports and strategies or are planning to do so. Mutual learning helps putting women's health on the political agenda and achieving improvements.
Loss of meaning in activities during Covid-19 lockdown and association with low mental health in Belgian adults 50+
Authors: Vriendt P De , Cruyt E , Van de Velde D
Published: October 2021

Introduction

Engagement in meaningful activities (MA) is significantly associated with morbidity, mental health and mortality, regardless age. However, it is known that a gender difference occurs in daily activities: men choose significantly more for leisure activities, work or study, while women opt more for domestic work and social activities. During the covid-19 lockdown, it can be expected that men and women experience the severe restrictions differently. In this study we wanted to identify differences regarding restriction in MA and mental health in particular for men and women 50 y and older.

Methods

In Belgium, strict measures were imposed between March 13 and May 4th. During this lockdown, a large-scale web-survey with more than 2000 Belgian respondents, has been carried out. In total, 420 people 50+ participated (237 women/183 men).

Results

The lockdown had a major impact on the daily activities and mental health of everyone, but slightly more on those of women 50+. They scored significantly lower in engaging in MA as measured by the Engagement in Meaningful Activities Scale (EMAS) (31.36; sd 7.09 versus 33.78; sd 6.35; p.001) and experienced worse mental health measured by the General Health Questionnaire (GHQ) (13.80; sd 6.70 versus 11.59; sd 5.87; p<.000) than men 50+. The correlation between EMAS en GHQ was respectively .510 and .540 (p <.000). The MA women attach more importance to could no longer be continued while the typical male activities still could be practiced (even more). Moreover, the daily caring activities, in which women are already more active anyway, interfered much more with the other activities than usual.

Conclusions

The extent to which activities remained meaningful during the lockdown was crucial. It was obvious that 50-+ women found less meaning in their activities during corona and experienced less mental health. Subsequently, women 50+ turned out to be slightly more vulnerable than men 50+ during the Covid-19 crisis.
Linking Dutch national public services data to estimate the prevalence of intellectual disabilities
Authors: Cuypers M , Tobi H , Naaldenberg J , Leusink GL
Published: October 2021

While people with ID depend on public (health) services more than others, they are difficult to identify within population data. This limits the opportunities to accurately estimate ID prevalence, monitor trends, or to tailor public health interventions according to the needs and characteristics of this groups. By linking relevant databases, this study estimated the prevalence of ID based on public service use, and explored methods to monitor other developments in the ID population. Starting point was the Dutch population register, containing all Dutch adults alive at January 1, 2015. From databases of public services (long-term care, and social benefits) we retrieved information of those individuals who accessed these services with an ID as primary reason. Through this method, 187,149 unique Dutch adults with an ID were identified within a population of almost 12.7 million Dutch adults, giving an ID prevalence estimate of 1.45%. Prevalence of ID was higher among males (1.7%) than among females (1.2%). Most individuals with ID were identified through use of residential care services (n = 91,064; 0.7%). Non-residential ID-related care was utilized by 27,007 individuals (0.2%). Social, employment, or income support due to a (mild) ID was received by 69,078 individuals (0.5%). Mean age in these ID-groups was between 8 and 10 years younger than in the general Dutch population. ID prevalence declined with increasing age across all ID-groups. The ID prevalence in The Netherlands as determined in this study aligned with international estimates. This suggests that national supportive services are well accessible for people with ID. Moreover, it demonstrated that databases from national supportive services can be a useful source to identify individuals with ID at the population level, and it enables structural monitoring of the ID population through linking national databases.
Experiences with acute hospital health care: a cross-sectional study among adult patients in Slovenia
Authors: Murko E , Kralj M , Poldrugovac M , Ropret N
Published: October 2021

Background

Patient-reported experience measures assess patients' experiences with processes in healthcare and hence support a patient-centred orientation of care. The aim of the study was to measure patients' experiences in Slovenian acute hospitals in the fields of internal medicine, surgery, gynaecology and obstetrics, oncology and orthopaedics.

Methods

The survey was based on a 2006 questionnaire already in use in Slovenia, which was updated after a literature and documentary review. The questionnaire included the following domains: admission to the hospital, time from arrival to the hospital to the bed on the ward, attitude of doctors, attitude of nurses, treatment, privacy, hospital environment and discharge from hospital. Mixed-mode study design was used, which involved a combination of traditional paper-and-pencil method and a web survey.

Results

The national survey was conducted in autumn 2019 and included 22 acute hospitals with 49 hospital wards. The questionnaire was validly completed by 3,684 patients, with 91.8% paper and 8.2% online questionnaires. The response rate was estimated to be 32.1%. The mean value for the general assessment of hospital treatment on a scale from 0 to 10 was 9.07. The worst rated indicators were related to hospital food (only 56.9% of patients were satisfied) and doctors' explaining the possible side effects of the newly prescribed medications (65.0% of patients agreed on obtaining such explanation). Qualitative analysis of open questions revealed that patient paid considerable attention to poor infrastructure and needs for hospital renovations.

Conclusions

The surveyed patients in our study rate highly the treatment in acute care hospitals. However, there is room for improvement. Increased attention to hospital environment and infrastructure is warranted in the future, including the amendments of the questionnaire.

Key messages

In autumn 2019, a national survey on patient’s experiences in acute care hospitals in Slovenia was conducted. 76.5% of the surveyed patients rated the medical treatment with a score of 9 or 10. Qualitative analysis of open questions revealed poor infrastructure and needed renovation of the hospitals.
Socio-economic disparities in self-reported, tested, and diagnosed COVID-19 status
Authors: Zhu Y , Duan M , Dijk HH , Freriks RD , Dekker LH , Mierau JO
Published: October 2021

Backgrounds

Studies in clinical settings showed a potential relationship between Socio-Economic Status (SES) and lifestyle factors with COVID-19, but it is still unknown whether this holds in the general population. In this study we investigated the associations of SES with self-reported, tested, and diagnosed COVID-19 status in the general population.

Methods

Participants were 49,474 men and women (46 ± 12 yrs) residing in the Northern Netherlands from the Lifelines cohort study. SES indicators and lifestyle factors (i.e., smoking status, physical activity, alcohol intake, diet quality, sleep time, and TV watching time) were assessed by questionnaire from the Lifelines Biobank. Self-reported, tested, and diagnosed COVID-19 status were obtained from the Lifelines COVID-19 questionnaire.

Results

There were 4,711 participants who self-reported having had a COVID-19 infection, 2,883 participants tested for COVID-19, and 123 positive cases diagnosed in this study population. After adjustment for age, sex, lifestyle factors, BMI, and ethnicity, we found that participants with low education or low income were less likely to self-report a COVID-19 infection (OR [95%CI]: low education 0.78 [0.71-0.86]; low income 0.86 [0.79-0.93]), and be tested for COVID-19 (OR [95%CI]: low education 0.58 [0.52-0.66]; low income 0.86 [0.78-0.95]) compared with high education or high income groups, respectively.

Conclusions

Our findings suggest that the low SES group was the most vulnerable population to COVID-19 infection and self-reported and tested COVID-19 status in the general population was better predicted by SES than by lifestyle factors.

Key messages

This study innovatively included a broader range of COVID-19 status, including self-reported and tested COVID-19 status, to better understand COVID-19 related socio-economic factors. This study added evidence to the socio-economically patterned COVID-19 status in a general population instead of in clinical settings.
Maximising Social Value and Health Impact – what is the role of PHIs?
Authors: Ashton K , Green L , Dyakova M , Bellis M
Published: October 2021

Issue

Public health Institutes (PHIs) need to build on traditional approaches to capture and measure their value and impact. As we transfer into the COVID-19 recovery phase, it is important to maximise the value of the health impact but also the social, economic and environmental impact of PHIs. Exploration is required to understand how the social value and impact of PHIs is, or can be, captured and measured. Existing research has illustrated the potential link between Health Impact Assessment (HIA) which assesses health and well-being through the lens of the determinants of health, and economic methods such as Social Return on Investment (SROI). This research aims to understand the current role which PHIs have, in order to strengthen advocacy for investment in public health and prevention in order to protect and improve population health.

Description of the problem

A scoping survey was designed and distributed digitally to national and regional PHIs via international networks. Semi-structured interviews were also used to add a qualitative value to the research to allow for triangulation of results. The survey data was analysed descriptively and interview data analysed thematically and coded.

Results

The results of the research present an understanding of the meaning of investment, social value and health impact within PHIs including how it is measured using SROI and HIA. It also highlights whether PHIs have considered how capturing social value and health impact can contribute to the recovery from COVID-19, and whether they believe that SROI and HIA have a role in achieving this.

Lessons

This innovative work aims to develop a picture of how PHIs are capturing and measuring the wider social, economic and environmental value of their programmes and services. Survey results will be used to help develop a framework for capturing the wider impact and value of public health at an international level, with an aim to achieving sustainable investment in future public health.

Key messages

Making the case for investing in public health by illustrating its social, economic and environmental value is vital. Understanding how to capture and measure the wider value of public health is imperative to aid the recovery from COVID-19.
Back to school during the COVID-19 pandemic: Does students’ stress differ by socioeconomic status?
Authors: García-Moya I , Díez M , Paniagua C , Prieto-Torrero I
Published: October 2021

Background

With COVID-19 disrupting school life, there is a need to examine whether COVID-related changes in our schools may be creating or exacerbating inequalities among students. The aim of this poster is to examine potential differences associated to socioeconomic status (SES) both in different facets of school stress, and in the overall impact of COVID and specific school COVID-related measures.

Methods

Sample consisted of 2,523 secondary school students (52.3% girls, M age = 13.78) from Spain who had participated in Project EASE from November 2020 to mid-January 2021, i.e. shortly after schools reopened for the new academic year. Using ANOVA and Chi-square analyses, differences associated to SES were examined in: (1) school stress, for which we used 3 subscales of the ASQ-S (school performance, future uncertainty, and school-leisure conflict), and (2) the perceived impact of COVID and specific school COVID-related measures (e.g. hygiene measures, social distancing, increased ICTs use) on stress levels.

Results

We found no significant differences associated to SES in stress of school performance or stress of school-leisure conflict, but low SES was associated with higher stress due to future uncertainty. Regardless of SES, the majority of students reported that their levels of school stress had increased due to COVID-19. As for specific measures, the percentage of students that reported an increase in their level of stress due to the more frequent use of ICTs was higher among low-SES students, who also reported lower levels of stress associated to reduced contact with classmates due to COVID.

Conclusions

Although most students reported an increase in school stress due to COVID-19, low-SES students experienced significantly higher stress due to future uncertainty. Potential differences in the role of specific school COVID-related measures would also deserve further examination.

Key messages

Low-SES students experienced higher levels of stress due to future uncertainty. The majority of students, regardless of SES, reported increases in their stress levels due to COVID-19.
Well-being and depression during the COVID-19 pandemic
Authors: Jericek Klanscek H , Hočevar Grom A , Rehberger M , Lavtar D , Klančič M
Published: October 2021

Background

The COVID-19 pandemic greatly affected the lives of everyone. Some studies suggest that the incidence of mental health problems increased during the pandemic. The purpose of the study was to investigate the characteristics of mental well-being and the risk of developing depression among different age groups during the COVID-19 pandemic in Slovenia.

Methods

Data from eight waves of the Slovenian panel web survey SI PANDA was used, namely the 1st wave: from 4th to 6th December 2020 (n = 1001); 8th wave: from 12th to 15th March 2021 (n = 1002). The sample included adults aged 18 to 74 years. In all eight waves, we used The World Health Organisation-Five Well Being Index (WHO 5), which is a short self-reported scale of current mental well-being and also has appropriate validity for screening for depression. Data were analyzed using the SPSS25, we applied the Mantel Haenszel linear trend test and the chi square test.

Results

The results show that from the 1st to the 8th wave of the study (from December 4th 2020 to March 15th 2021), mental well being in the whole sample improved slightly (M H test for trend, p < 0,001), both in men and women, across all age groups. In addition, there was a declining trend in the risk of developing depression among the population aged between 30 and 64 years. However, this decrease was not observed in the 65-74 and 18-29 age groups in the mentioned time frame. In the youngest age group we could observe substantial fluctuations in the risk for depression between research waves, whereas in the eldest population a favourable decline in the risk for depression was not observed.

Conclusions

Risk of developing depression during the COVID-19 pandemic in Slovenia is different among different age groups. Studies suggest that the occurrence of mental health problems increased during the pandemic, but not necessarily in parallel with the level of mental well being experienced by adults, which was also shown in the Slovenian sample.

Key messages

From December 4th 2020 to March 15th 2021 there was a declining trend in the risk of developing depression among the population aged between 30 and 64 years. The most vulnerable groups for depression symptoms in COVID-19 pandemic in Slovenia were 65–74 and 18-29 age groups.
Life during a pandemic in Australia: wellbeing and social determinants of health
Authors: Lord H , Fernandez R , MacPhail C
Published: October 2021

Background

The COVID-19 pandemic has had effects on populations worldwide. The social determinants of health affect an individual's capacity to cope during a crisis which could potentially impact on their wellbeing. The aim of this study was to examine the relationship between wellbeing and the social determinants of health among Australian adults during the COVID-19 pandemic.

Methods

A cross-sectional study of adults residing in Australia was conducted using SurveyMonkey (an online survey) between August - October 2020. Participants were recruited via social media. Wellbeing was measured using the 10-item Multicultural Quality of Life Index and social determinants of health were measured using validated tools and investigator developed questions. Data were analysed using SPSS version 25. Inferential statistics, including independent t-test and one-way ANOVA were undertaken. Multiple regression analysis was used to investigate the predictors of wellbeing.

Results

In total, 1211 responses were received. Females accounted for 80.7% of the responses, men 16.7% and transgender/non-binary 2.6%. The mean age of the respondents was 43 years (SD 14.5). The mean score for total wellbeing was 62.58 (SD 21.22). Housing insecurity (p = 0.000), food insecurity (p = 0.000, social support (p = 0.000) and access to health care (p = 0.000) were all predictors of poor total wellbeing. Being a male (p = .0380) was the only predictor of higher wellbeing.

Conclusions

This study demonstrates that adults in Australia who had poor social support, had difficultly accessing health care, had insecure housing and food insecurity had significantly poorer wellbeing during the COVID-19 pandemic. This study exposes the social determinants of health that are responsible for health and social inequalities. It shows that the COVID-19 pandemic has exacerbated the social vulnerabilities and highlights the need take action on the social determinants of health and inequalities.

Key messages

The COVID-19 pandemic has further exposed the longstanding health and social inequalities that exist in Australia. Action on social determinants of health is required in a post COVID-19 world to rebuild social protection and safeguard populations from any future public health emergencies.
Mental Health, Wellbeing and Preventive Behaviors in 10 Western Pacific Countries during COVID-19
Authors: Chen DT-H , Wang YJ
Published: October 2021

Background

COVID-19 has shown varying impacts on different populations. In the Western Pacific (WP) Region with a relatively low COVID-19 burden, the variabilities of its impact on mental health, wellbeing and preventive behaviors across countries are unclear.

Methods

We analyzed repeated national-representative, cross-sectional data of 87,787 adults collected via the Imperial College London YouGov COVID-19 behavior tracker in ten WP countries-Australia, China, Singapore, Japan, South Korea, Vietnam, Taiwan, the Philippines, Malaysia and Hong Kong during the pandemic (April-September 2020). Main outcomes were severe depression/anxiety (Patient Health Questionnaire-4 score≥9), wellbeing (Cantril Ladder Scale 0-10), worries of contracting COVID-19 and prevalence of preventive behaviors. Monthly temporal trends were examined.

Results

Percentages of severe depression/anxiety were higher in Australia (12.9%), Hong Kong (11.8%) and lowest in Vietnam (6.8%); increasing trends were noted in the Philippines (5.9% to 12.3%, p < 0.0001) and Malaysia (8.2% to 10.7%, p = 0.019). South Korea, China and Taiwan had the lowest levels of wellbeing (5.0-5.5) compared with their highest counterparts in the Philippines, Australia and Vietnam (6.2-6.5). Worries of COVID-19 remained high in Asia countries (Japan, South Korea, Malaysia, Vietnam and the Philippines: 79.2%-81.6%), compared to that in Australia (41%). 83.5%-97.2% of the Asian respondents persistently wore face masks outside home, while the mean percentages were low in Australia (32.2%) despite the increasing trend observed (24.1% to 48.6%, p < 0.000). Over half of the WP countries have significant decreasing trends (p < 0.000) for avoid going out; Taiwan showed the lowest prevalence (45.7%).

Conclusions

Psychological and behavioral responses to COVID-19 in the WP region varied widely. COVID-19-related negative impact on mental health and wellbeing was universal. A Global effort to tackle the aftermath of the pandemic is crucial.

Key messages

The psychological and behavioral responses to COVID-19 in Western Pacific countries varied widely. Severe depression/anxiety and low levels of wellbeing were prevalent in Western Pacific Region.
Older people’s aspirations for the aftermath of COVID-19: Findings from the WISE study
Authors: Guzman V , Pertl M , Doyle F , Foley R
Published: October 2021

Background

For many older people around the globe, the COVID-19 pandemic has highlighted accessibility issues and pervasive inequalities across multiple social, economic and health dimensions. The aim of the present study is to explore older people's perspectives about what we should learn from this pandemic and how to build a better future.

Methods

The Well-being, Interventions and Support during Epidemics (WISE) study is an exploratory qualitative project that has collected information from 46 individuals aged 65+, who live in Irish community settings. Data collection included in-depth interviews over the phone or videoconference platforms. Analysis is ongoing utilizing NVivo12 to identify themes and linkages within a socio-ecological framework.

Preliminary Results

Findings indicate that at the macrosystems level, several participants expect policymakers and researchers to commit to challenging ageist misconceptions of a homogeneous aging experience- such as the notion that older people are merely recipients of care with a high degree of needs. Upon reflection of their experiences with shelter-in-place restrictions and its consequences, at the exosystem level, many respondents called for older voices to be consulted in public health decisions and included in decision-making bodies. Concerning the microsystem, participants referred policymakers should further develop natural and built environments that enable physical, mental and social well-being for all. Cutting across all levels, participants advised for stronger political will and accountability, as they recognized some of their concerns had been addressed in past policies but were not being implemented.

Conclusions

Our preliminary findings are applicable to the Irish context but also provide relevant insights for those interested in creating inclusive age-friendly societies across the globe. Embracing this shared vision would provide significant opportunities to address present and future public health challenges.

Key messages

Older people are very diverse, so it is necessary to move on from one size fits all approaches. Age-friendly societies are multifaceted endeavours that must include older voices at their core and build upon intergenerational solidarity.
Safety culture in COVID-19 wards during 2020 SARS-COV-2 pandemic
Authors: Bianchet B , Doimo A , Moretti V , Bellomo F , Degan S , Farneti F , Cocconi R
Published: October 2021

Background

Safety of care is an essential aim of a healthcare system, even during a pandemic. Incident reporting (IR) is an important safety tool to identify system failures. This study evaluates the impact of SARS-COV-2 pandemic on IR trend in the COVID-19 wards of an Italian Academic Hospital (AH) in Italy.

Methods

The study analyzed the IR submitted by the wards of Infectious Diseases (ID), Intensive Care Unit (ICU), Pneumology (P) and Emergency Room (ER) of the AH of Udine from 2016 to 2020. For each ward, IR of 2020 were compared to IR of 2016-2019 period, expressed as the mean value. The IR's topics of ER unit, classified according to the International Standards of Patient Safety, were compared between 2019 and 2020. Variation in reporting was assessed using Chi-square tests.

Results

During 2020, 180 incidents were reported, 81.7% of which submitted by ER unit. Three wards showed a decrease in reporting compared to 2016-2019 period: -18% (7vs8,5) for ID unit, -26% (16v21,7) for ICU and -44% (10vs18) for P unit. ER unit, instead, showed a great IR increase (147vs49; +200%). Considering the reporting from 2016 to 2019, 196 out of 389 (50.4%) of IR came from ER unit. Analyzing the difference in reporting in ER unit between 2019 and 2020, the IR topics regarding “Delay in execution and reporting exams” increase from 2 to 21 (p < 0,05), “Lack of human and/or instrumental resources” from 4 to 29 (p < 0,05) and “Prevention and Control of Hospital Infectious” from 0 to 13 (p < 0,05).

Conclusions

ER unit showed a higher attitude in reporting than the other considered wards, especially during the COVID-19 period, recognizing IR as an important tool to highlight critical issues. This aspect may reflect the stronger safety culture already present in this unit. SARS-COV-2 pandemic stressed in ER needs of human resources to cope with reorganization determined by COVID-19, rapid covid-test results for the patient's care path definition, implementation of infection control procedures.

Key messages

A solid safety culture may contribute to maintain high levels of IR even while during challenging times for healthcare systems. Difference in reporting among Covid wards could be explained by a different level of Safety Culture.
Public health as common goal or individual constraint in winter tourism of Tyrol and Vorarlberg
Authors: Kerschbaumer L , Walch S , Sahling F , Reisberger M , Mevenkamp N , Mantel C , Lackner N , Luttinger P , Pejkovic E
Published: October 2021

Background

In February 2020 the alpine village Ischgl, located in the Austrian province Tyrol, reached prominence as a COVID-19 hotspot and starting point for the virus diffusion in Europe. Since then, local authorities, winter tourism and its key stakeholders where under close supervision. The here presented study focusses on how they align their personal and corporate interests with collective interests of mitigating the spread of the virus.

Methods

In summer 2020 a convergent parallel-mixed methods' approach was adopted. It includes 3 focus groups in skiing resorts of Tyrol and Vorarlberg, a quantitative complete online survey, with mayors of municipalities, managing directors of all cable cars companies as tourism associations and 22 qualitative expert interviews with this target groups.

Results

There were 105 out of 375 mayors of municipalities, 57 out of 140 managing directors of all cable cars companies and 37 out of 41 tourism associations of Tyrol and Vorarlberg participating in the online survey. The demand for a standardized risk management in tourism was high, the willingness to compromise low. Inconsistent legal regulations, economic losses, acknowledging risks and taking responsibility for the own area of influence were conflicting topics.

Conclusions

Uncertainty about legal requirements was widespread and therefore mitigating strategies and measures were often classified as a disturbance. Economic concerns where far more prevalent than concerns about public health, blaming other decision-makers was a common strategy. According to the results authorities where advised to:

-reduce complexity and increase transparency within the communication

-demonstrate uniformity without exceptions -show solidarity to facilitate willingness to compromise -provide future perspectives

Key messages

Although demanded a uniform risk management was only possible at a late stage in November 2020 and only in selected fields. COVID-19 promotes reluctance in making decisions.
Social media influencer marketing to build a counter-narrative for promoting sexuality education
Authors: Ahmed F , Ahmad G , Schumacher J , Brand T
Published: October 2021

Background

A recent cross sectional community readiness assessment carried out in Islamabad, Pakistan indicated that the community is at the denial or resistant stage for implementing school-based sexuality education in Pakistan. The resistance was attributed to lack of awareness and prevalent misconceptions regarding sexuality education. This study aims at qualitatively exploring strategies for targeting misconceptions and increase awareness regarding sexuality education with stakeholder involvement.

Methods

35 in-depth interviews and a focus group discussion was conducted to discuss the results of the readiness assessment comprising of community members, researchers, NGO representatives, and social media influencers. Discussion guide included topics on engagement strategies, intervention modes of delivery, target audience, misconceptions, community support, and optimizing sexuality education in local context. Qualitative content analysis was conducted for analyzing the data.

Results

Results indicate that current community support is usually passive in nature and digital or social media platforms are mostly used to talk about sexuality education. Participants believed social media can be used as a platform for disseminating information by involving social media influencers with careful narrative building around sexuality for rebranding the topic, as talking about sexuality is seen as a taboo in the society. Targeting misconceptions through counter narratives and scientific evidence was considered as a way forward for increasing community acceptability and readiness. Violence, staying safe, and age appropriateness were identified as some of the key features of sexuality education that need to be highlighted for garnering community support.

Conclusions

For promoting sexuality education in Pakistan, it is essential to tackle resistance by sensitizing the community and digital social media platforms offer an opportunity to do this through influencer marketing.

Key messages

Digital and social media offer an opportunity for promoting sexuality education in conservative settings like Pakistan. Social media influencer marketing might be useful in building counter narrative and for community engagement.
The impact of Covid-19 on symptomatic back pain – A new surging epidemic?
Authors: Cuschieri S , Grech S
Published: October 2021

Background

The Covid-19 pandemic led to global public health advocacy for a population behavioural and daily routine change. Remote work and social distancing were advocated to curb the community spread. A consequential effect on the physical health of the population is expected. The study aimed to explore whether since the onset of Covid-19 back pain complaints have increased while identifying potential reasons, among the Malta adult population.

Methods

An anonymous online survey was distributed on social media (6th to 20th April 2021). The survey enquired about changes in employment, daily routine, physical activity (PA) patterns and for the presence of back pain before (>6 months duration) and during Covid-19. Data on the socio-demographic status was noted. Descriptive, comparative and multivariant regression analyses were performed.

Results

A total of 388 responded with 30% (CI 95%: 25.55-34.64) reporting chronic back pain pre-Covid-19 while 49% (CI 95%:44.28-54.18) reported back pain since the onset of Covid-19. A significant change in daily routine and physical activity (p < 0.01 respectively) to a more sedentary pattern was observed. Out of those reporting back pain since Covid-19, 51.83% (CI 95%:44.78-58.81) reported a shift to remote working/learning. Indeed, continuously sitting down (OR: 15.53 p = <0.01), no PA (OR:4.22 p = <0.01), once a week PA (OR:5.74 p = <0.01), 2-3 times PA a week (OR:2.58 p = 0.05) and 4-5 PA a week (OR:3.46 p = 0.02) were associated with experiencing back pain since onset of Covid-19, when adjusted for sex, age, education and employment status.

Conclusions

The pandemic led to behavioural changes that have enhanced a sedentary lifestyle with a consequential negative impact on back pain. Those working/learning remotely may be experiencing non-optimal ergonomic conditions intensifying musculoskeletal strain with back pain complaints. Such occurrence is anticipated to increase the burden on the healthcare systems and the disability adjusted-life years.

Key messages

Covid-19 has impacted on behavioural attitudes and daily routines resulting in enhanced sedentary lifestyles with anticipated consequential effects including back pain. Covid-19 is anticipated to increase the burden on healthcare systems with enhanced chronic diseases occurrences including back pain.
Heath literacy, illness perception and NAFLD/NASH awareness in primary care patients in Crete, Greece
Authors: Gergianaki I , Anastasaki M , Papadaki S , Anastasiou F , Koek G , Leen H , Mendive J , Muris J , Lionis C
Published: October 2021

Background and Aims

Patient health literacy (HL), illness perception and awareness are key factors driving health behaviour. This observational study aims to assess the level of HL, illness perception and awareness about non-alcoholic fatty liver disease (NAFLD)/steatohepatitis (NASH) in high-risk primary care (PC) patients in Greece, Spain and the Netherlands.

Methods

Eligibility criteria included: 1) aged ≥50 years, and 2) obesity, and/or metabolic syndrome, and/or diabetes. Patients consecutively visiting PC practices completed a questionnaire assessing socio-demographic characteristics and health habits. HL, illness perception and NAFLD/NASH awareness were assessed using the European Health Literacy Survey Questionnaire, the Brief Illness Perception Questionnaire and the Public Awareness of NAFLD Questionnaire respectively.

Results

Data are available at this moment from the Greek setting. Among the Greek participants (N = 141, 53.2% females, mean age 66 years) 66.7% had diabetes, 78% obesity and 71.6% metabolic syndrome, with 22.7% reporting active smoking. Most (71.6%) had heard about NAFLD by their personal physician. Obesity (78%), excess alcohol intake (45.8%), lack of exercise (38.7%) and diabetes (32.4%) were recognized as the commonest determinants of fatty liver disease, while 78% were aware of ultrasound as the main diagnostic modality and 47% did not know whether there is an available treatment. Only 39% of the participants find information of their treatments easily.

Conclusions

Our preliminary results show that the majority of patients seem to be aware about NAFLD/NASH and their determinants. It's alarming that a lot do not know about treatment, although they are high-risk.

Key messages

Our preliminary results show that the majority of patients seem to be aware about NAFLD/NASH and their determinants. It’s alarming that a lot of patients do not know about their treatment, although they are high-risk.