bluuebunny/crossref_metadata_2025 huggingface dataset:
HAT-field: a cheap, robust and quantitative Point-of-care serological test for Covid-19
Authors: Joly Etienne , Maurel Ribes Agnès
Published: October 2022

The haemagglutination test (HAT)-field protocol described here is an optimization of the recently published HAT, for the detection of antibodies directed against the receptor binding domain (RBD) of the SARS-Cov-2 virus. HAT and HAT-field are both based on haemagglutination triggered by a single reagent, the IH4-RBD recombinant protein. A sample of IH4-RBD sufficient for several thousand tests or a plasmid encoding IH4-RBD can be obtained from the authors of our first paper. Using titration of IH4-RBD, HAT-field now allows a quantitative assessment of antibody levels in a single step, using a few microliters of whole blood, such as can be obtained by finger prick, and requires only very simple disposable equipment. Because it is based on a single soluble reagent, the test can be adapted very simply and rapidly to detect antibodies against variants of the SARS-CoV-2, or conceivably against different pathogens. HAT-field appears well suited to provide quantitative assessments of the serological protection of populations as well as individuals, and given its very low cost, the stability of the IH4-RBD reagent in the adapted buffer and the simplicity of the procedure, could be deployed pretty much anywhere, including in the poorest countries and the most remote corners of the globe.
The International Law Commission and Politics: Taking the Science Out of International Law’s Progressive Development
Authors: Voulgaris Nikolaos
Published: October 2022

The idea that jurists have a vocational duty to progressively develop the law finds its way in international law chiefly via the mission statement of the United Nations’ International Law Commission (ILC). Mandated by states to codify and progressively develop international law, the ILC’s modern practice has merged these two distinct exercises. The Commission utilizes a common working procedure for the elaboration of both and appears to perceive progressive development as an appurtenance of codification. What is more, progressive development has often been equated by the ILC with lex ferenda propositions and policy considerations. It is little wonder then that the ILC has never attempted to meaningfully analyse this aspect of its mandate. This article examines progressive development from a methodological standpoint and maintains that it is an exercise with self-standing importance. It argues that there are two ways to understand the ILC’s mandate to progressively develop the law: either as ‘progressive development stricto sensu’ or as ‘legislation’. The difference between the two is methodological; ‘progressive development stricto sensu’ is elaborated via an inductive methodology and principally justified by legal considerations. On the other side, in the case of ‘legislation’, provisions are principally justified by policy considerations and, hence, imbued with uncertainty regarding their methodological foundations. The article suggests that ‘progressive development stricto sensu’ falls squarely within the ILC’s legal mandate, while this will be the case with respect to ‘legislation’ only when the ILC is conscious of the question it sets out to answer and the requisite methodology that it employs to do so. To this end, the article lays down some basic methodological principles that the ILC should adhere to when engaging with topics of work where political considerations play a significant role in the development of the law. Finally, it calls for a revival of the forgotten discussion regarding the ILC’s capacity to develop international law.
Plenary 3 Health Systems Performance Assessment for Policy: Uses and Abuses
Authors:   Organised by: European Observatory on Health Systems and Policies, European Commission,   Moderators: Isabel de la Mata (European Commission), Dimitra Panteli (European Observatory on Health Systems and Policies)
Published: October 2022

The COVID-19 pandemic constitutes a powerful reminder of the importance of health systems strengthening in protecting and improving the health of our populations. For policy makers ‘to build back better’ systems to face future shocks, they will need to be able to determine which areas work best (in terms of providing access, quality, population health, responsiveness or efficiency) to prioritize and direct resources towards. More than ever, we need now to count with strong health systems monitoring, appraisal and assessment to draw practical policy implications.

This plenary will look at the effective application of Health Systems Performance Assessment (HSPA) to health systems’ improvement as we face key challenges in the sustainability of our health systems. Too often the results of HSPA exercises, particularly when benchmarking is involved, are not well interpreted, and understood. When translating HSPA results into policy changes, we need to address a series of questions not only about the quality and validity of the indicators but, importantly, about the causal attribution and accountability implications and about the kinds of policy interventions required to address the performance failures.

Following an introductory keynote providing practical illustrations of those issues and drawing policy lessons, the panelists will focus on three key HSPA questions particularly relevant in the current policy context. First, how to interpret and attribute overall health system performance outcomes to individual health system functions and strategies in need of reform. Second, how best to benchmark and compare performance between European countries to identify and learn from best practices. Finally, how to measure resilience as core component of systems performance and draw lessons to prepare for future shocks.

Introductory keynote speaker:

Reinhard Busse

European Observatory on Health Systems and Policies and Technical University Berlin, Germany

Panellists:

Kenneth Grech

EU Expert Group Health Systems Performance Assessment & Ministry of Health Malta, Malta

Irini Papanicolas

Department of Health Policy, London School of Economics and Political Science, UK

Marina Karanikolos

Research Fellow, European Observatory on Health Systems and Policies; London School of Economics and Political Science, UK
Food labelling
Authors: Gokani N
Published: October 2022

The Commission has undertaken to regulate the information provided to consumers on food. In particular, it intends to propose mandatory front-of-pack nutrition labelling (FoPNL) for food by the end of 2022. Even though nutrition labelling has been regulated by the EU since 1990, the tactics of industry, with the support of a minority of Member States, have prevented, so far, the adoption of a single, EU-wide, mandatory FoPNL scheme. Questions therefore arise regarding the extent to which the EU may secure agreement for the adoption of an EU-wide scheme which could effectively contribute to a high level of public health protection.
Food marketing
Authors: Garde A
Published: October 2022

The Commission has established a joint action with Member States through the Best ReMaP joint action (2020-2023) to facilitate the effective implementation of the Audiovisual Media Services Directive which, in its revised version, calls on Member States to ensure that codes of conduct protect children from exposure to unhealthy food marketing. This provision itself highlights the tension between, on the one hand, the desire to limit the exposure of children to harmful food marketing and, on the other, the likelihood of achieving this objective through the implementation of codes of conduct.

Speakers/Panellists

Nikolai Pushkarev

Healthy Environments & EPHA Policy, European Public Health Alliance, Brussels, Belgium

Contact: nikolai.pushkarev@epha.org

EPHA will present the perspective of the public health advocacy community, and discuss some of the initiatives civil society are engaged in to help the EU move from rhetoric to practice.
Public health work in Sweden during the COVID-19 pandemic
Authors: Guldbrandsson K , Månsdotter A
Published: October 2022

Background and objectives

This study examines the consequences of the COVID-19 pandemic for public health practice carried out at local and regional levels in Sweden. The work includes, for example, interventions in health care, schools and preschools, social services, and non-profit organisations.

Methods

By means of written questions and interviews in municipalities, regions, county administrative boards, networks, and organisations, we investigated whether public health-related interventions had decreased, increased, or changed as a result of the COVID-19 pandemic. Data were analysed by content analysis.

Results

The results show that a large number of interventions from a variety of local and regional actors aimed at broad target groups were cancelled or paused during the time of our survey. Eventually, many, but not all of the cancelled interventions were replaced with other options, most of which are included in the following themes:

• Digital solutions and support over the phone instead of physical meetings.

• Outdoor activities instead of indoor activities.

• Organisational adaptations, for example, from drop-in visits to booked appointments and from open activities to scheduled visits.

The interviews also revealed that public health issues had been highlighted and that existing collaboration structures were a success factor in managing the consequences of the COVID-19 pandemic. The risk of and concern for the spread of infection and compliance with the authorities’ recommendations were stated to be the main reasons why public health-related interventions had decreased, increased, or changed.

Conclusions

Both general public health practice and targeted interventions in health care and municipal activities have been cancelled or rescheduled according to our survey. Because many public health-related interventions have an equalising effect on health, this can be of great importance for groups that are socially, economically, or health-relatedly vulnerable.
Artificial sweeteners and risk of cardiovascular diseases in the prospective NutriNet-Santé cohort
Authors: Debras C , Chazelas E , Sellem L , Julia C , Kesse-Guyot E , Allès B , Deschasaux-Tanguy M , Huybrechts I , Srour B , Touvier M
Published: October 2022

Background

Artificial sweeteners are widely used today by the food industry as sugar alternatives. Potential adverse effects of these food additives on cardiovascular disease (CVD) have been suggested in experimental studies, but data from studies involving humans remain very limited. Previous cohorts have focused on artificially sweetened beverages. Our objective was to study the associations between artificial sweeteners from all dietary sources, overall and by molecule (aspartame, acesulfame-potassium and sucralose), and risk of CVDs (overall, coronary heart and cerebrovascular).

Methods

The study included 103,388 participants of the web-based NutriNet-Santé cohort (2009-2021). Artificial sweetener intakes were assessed using repeated 24h dietary records including names and brands of industrial products consumed. Multi-adjusted Cox proportional hazard models were performed. Exposure to artificial sweeteners were coded as 3-category variables: non-consumers, lower consumers (artificial sweetener intake below the sex-specific median) and higher consumers (above the sex-specific median).

Results

Compared to non-consumers, higher consumers of total artificial sweeteners had increased risk for CVD (n = 1502 incident cases, HR = 1.17 [1.01-1.35], P-trend=0.04) and more specifically cerebrovascular diseases (n = 777, HR = 1.34 [1.10-1.62], P = 0.004). Higher consumption of aspartame was associated with increased cerebrovascular diseases (HR = 1.29 [1.03-1.60], P = 0.01). Higher consumption of acesulfame-K was associated with a higher risk of CVD (HR = 1.24 [1.04-1.47], P = 0.02) and cerebrovascular diseases (HR = 1.29 [1.02-1.64], P = 0.1). No association was detected for coronary heart diseases (n = 730 incident cases).

Conclusions

These findings suggest a direct association between higher artificial sweetener consumption and increased CVD risk, in particular cerebrovascular. These results provide key novel information for the ongoing re-evaluation of sweeteners by the European Food Safety Authority.

Key messages

• In this large-scale prospective cohort (n = 103,388), artificial sweeteners (especially aspartame and acesulfame-K) were associated with increased risks of cardiovascular and cerebrovascular diseases.

• These results provide key insights to feed EFSA’s expertise for the ongoing risk assessment of artificial sweeteners.
One Health approach for the SDGs achievement
Authors: Viegas S
Published: October 2022

One Health is an approach characterized by the integration of human and animal health, plants, and ecosystems and encourages multisectoral and multidisciplinary efforts to achieve optimal levels of health and collaboration among different sectors and scientific areas to address challenging health problems. Through this approach is possible to obtained better results since the actions taken are normally focused to obtained co-benefits in several of the Sustainable Development Goals, including health for all and cost savings. The dissemination of One Health research and experiences is important to raise awareness for this approach. In this workshop, this will be done with the presentation and discussion of several themes where the One Health approach is of most relevance allowing to identify the most relevant barriers and opportunities for integrating One Health more widely.
1.F. Skills building seminar: Podcast 101 - Lessons learnt and how you can create your own unique experience
Authors:   Organised by: EUPHA-DH,   Chair persons: Stefan Buttigieg (EUPHA-DH), Brian Li Han Wong (UK)
Published: October 2022

Podcasts are one of the fastest growing communication channels globally with more than 850,000 podcasts available globally through all the different podcast distributors. Furthermore, Health-related podcasts are gathering steam on their own front and herein lies the opportunity for public health and digital health professionals to embrace this channel and develop the necessary skills to start communicating their visions in a world that is plagued by misinformation and disinformation. This skills building workshop intends to cover the experience of three public health professionals in their involvement as co-hosts of three different podcasts that have their own voice with differences in their setup and availability of resources. Furthermore, the authors intend to cover the following aspects:

Getting started with your own podcasts

The typical setup for Podcast Recording

Promoting and growing your podcasts

Ensuring sustainability and consistency in your approach

Tips and Tricks for Podcast Success

Key messages

• Podcasts are a unique opportunity to create a meaningful connection with a wide audience in a world plagued by misinformation and disinformation.

• Setting up a Podcast has gotten much less complicated and this workshop will provide the basic knowledge to get you started with tools that you already own.
Reducing health inequalities through general practice in the UK: a realist review (EQUALISE)
Authors: Gkiouleka A , Wong G , Kuhn I , Sowden S , Head F , Bambra C , Harmston R , Manji S , Moseley A , Ford J
Published: October 2022

Background

In the UK, chronic conditions such as cancer, heart disease, stroke, and chronic obstructive pulmonary disease are driving health inequalities in life expectancy and were responsible for two-thirds of premature mortality in 2017. Voices that stress the importance of primary care in reducing health inequalities have been strengthening during the last decade. However, defining the most effective strategies to reduce health inequalities through general practice remains a challenge.

Aims

This study examines the evidence on interventions in primary care that are likely to decrease inequalities in NCDs and especially cancer, diabetes, cardiovascular and chronic obstructive pulmonary disease and will provide healthcare organisations with guiding principles on what should be commissioned.

Methods

The study is a realist review following Pawson's model. Based on a programme theory, we screened systematic reviews of interventions delivered in primary care and through their references, we identified primary studies reporting on inequalities across PROGRESS-Plus criteria. The data were analysed in light of the initial program theory and organised in a model informed by Collins’ Domains of Power framework.

Results

Out of 251 included reviews we retrieved 6,555 primary studies which resulted in 333 studies for data extraction. We found that there are five guiding principles operating simultaneously across four different domains which can reduce health inequalities in General Practice. The principles include flexibility, continuity, inclusivity, intersectionality, and community and operate simultaneously across the domains of structures and policies; narratives and ideas; rules and practices; and relationships and experience.

Conclusions

Flexibility, continuity, inclusivity, intersectionality, and community are the five principles which should guide the design and delivery of General Practice for the reduction of health inequalities.

Key messages

• Flexibility, continuity, inclusivity, intersectionality, and community are the five principles which should guide the design and delivery of General Practice for the reduction of health inequalities.

• Action to reduce health inequalities should be taken simultaneously across the domains of structures and policies; narratives and ideas; rules and practices; and relationships and experience.
Is Ireland ready for tobacco endgame? A national survey of knowledge and attitudes to tobacco endgame
Authors: Cosgrave E , Blake M , Murphy E , Sheridan A , Doyle F , Kavanagh P
Published: October 2022

Background

In 2013 ‘Tobacco-Free Ireland’ (TFI) shifted Irish national policy from tobacco control to “tobacco endgame”: policies, plans and interventions seeking to end the tobacco epidemic completely. Recent trends suggest the current 2025 TFI goal will not be achieved. This cross-sectional study is a timely assessment of public knowledge and attitude to re-focus Irish “tobacco endgame” planning.

Methods

A literature-informed, pre-tested survey instrument was telephone-administered to a representative sample of 1000 members of the Irish public aged ≥15 years recruited via random digit dialling in February 2022. Prevalence of “tobacco endgame” views was measured; logistic regression determined factors associated with key responses.

Results

Response rate was 30% (n = 1,000, post-hoc weighting applied). While TFI goal awareness was low (34%), support was high (75%), albeit most (61%) recognised postponement beyond 2025 was required for achievability. There was majority support for 18/22 endgame measures assessed. Product-focused tactics were popular, while views on targeting users were mixed: e.g. 86% supported a reduction in tobacco-product nicotine content; 40% supported introduction of a tobacco-user license. Phasing-out tobacco sales was highly-supported (83%); however, this was contingent on special supports for those currently addicted. Support for the TFI goal was higher among non-tobacco users (aOR 2.66, 95%CI 1.89-3.76), females (aOR 1.57, 95%CI 1.17-2.11) and those of higher social class (aOR 1.72, 95%CI 1.25-2.35).

Conclusions

While achievement by 2025 is increasingly unrealistic, findings strongly affirm Irish public opinion is ready for “tobacco endgame”. Recognition of the needs of currently addicted tobacco users and focusing on subgroups with lower support levels should be integral to equitable “tobacco endgame” planning and communication. This study should mobilise renewed Irish political commitment to bold actions aimed at ending smoking-related harm.

Key messages

• There is strong support for tobacco endgame measures among the Irish population, which is a supportive factor for bold political leadership to make these radical ideas a reality.

• Public preference for product and non-user-focused measures aligns with tobacco endgame discourse and should aid policy reframing to tackle structures and dynamics sustaining the tobacco epidemic.
1.L. Workshop: Building capacity for a resilient and healthy post-COVID health workforce
Authors:   Organised by: EUPHA-HWR, WHO Europe,   Chair persons: Ellen Kuhlmann (EUPHA-HWR), Tomas Zapata (Denmark)
Published: October 2022

Background

The COVID-19 pandemic added new challenges to health workforce resilience. High workload, increased risk of COVID infection and continuing stress threaten the health and wellbeing of healthcare workers (HCWs) and increase existing (gendered) inequalities, thus reinforcing health labour market problems. Investment in the health workforce and prioritisation of the health and wellbeing needs of healthcare workers in health policy and pandemic recovery plans is therefore called for by the WHO, the European Union and others. However, health systems and policymakers across countries have not sufficiently understood the importance of HCWs.

Objectives

This workshop brings health workforce needs onto the health policy agenda. It seeks to build capacity for a resilient and healthy health workforce, setting the focus on protection and preparedness of HCWs and their individual wellbeing, and reduction of gendered inequalities. The following major questions will be addressed: What do we know about COVID-19 and the health and wellbeing of HCWs? What skills are needed to respond to new demands? What policy approaches are available to improve protection, preparedness and mental health support of HCWs? How to integrate gender equality and the situation of migrant/refugee HCWs in these approaches, and finally build capacity for effective health workforce governance and its implementation.

The workshop introduces novel results drawn from European comparative research and country case studies. It connects policy and practice, as well as health system and individual HCW needs. A number of important policy recommendations are emerging from the research. (1) The health and wellbeing of the health workforce must be addressed systematically across all levels of health policy and governance, including the organisation settings. (2) Health systems must take responsibility and leadership in responding to health workforce needs. (3) Important lessons to be learned from HCWs’ experiences should guide future health workforce policy and pandemic recovery plans. (4) Participatory governance and inclusion of HCWs must be strengthened, including gender equality and diversity.

The workshop will stimulate critical debate and improve knowledge exchange across countries and between researchers. It will contribute to strengthen resilience of the health workforce and health systems, and to build back better after COVID-19 in a fair and equitable manner.

Key messages

• Health workforce needs and mental health support must become policy priorities and addressed as part of health system resilience.

• Action has to be taken to strengthen participatory health workforce governance sensitive to new needs.
Health workforce governance during the COVID-19 pandemic: learning lessons from Europe
Authors: Williams G , Buchan J , Zapata T
Published: October 2022

Background

This study considers some of the effective governance tools that have been utilised to mobilise, redeploy and repurpose the health workforce during the COVID-19 pandemic to create surge capacity, protect workforce health and wellbeing and ensure effective implementation of vaccination programmes.

Methods

Data were systematically extracted from the Observatory/WHO Europe/European Commission Health System and Response Monitor, covering the period from March 2020 to May 2021 with a focus on four dimensions of health workforce governance: national/regional government policies; legislation; regulation; the role and remit of employers and management.

Results

A wide-range of governance actions across all levels were required to ensure the health workforce could provide effective pandemic responses. Creating surge capacity, for example, often required adoption of emergency legislation to facilitate exceptional hiring procedures and the changing of (re-)registration requirements, as well as additional training and development of new competencies among other actions. Putting in place physical and mental health support meanwhile required defining infection control policies, monitoring PPE supply and distribution, ensuring access to free mental health support, and implementation of breaks. Some countries also allowed “new” types of workers to vaccinate; online or in person training; adjustments to payment mechanisms; and creating new supervision requirements.

Conclusions

Pandemic responses have broken up sclerotic governance structures which have hampered past health workforce development and reform, new training programmes have been rapidly developed, leadership roles have been delegated to a wider-range of health professionals than before and monitoring systems that provide more rapid data on staffing levels have been put into place. Learning from and evaluating these changes will be important to help inform future pandemic responses.
Health workforce needs and health policy responses to COVID-19: a European comparative assessment
Authors: Kuhlmann E , Brînzac M-G , Burau V , Correia T , Falkenbach M , Ungureanu M-I
Published: October 2022

Background

The COVID-19 pandemic revealed the importance of the health workforce for health system resilience. This study aims to explore whether and how healthcare system in Europe have responded to new emergent needs and transformed their health workforce policies.

Methods

A qualitative comparative approach is applied, based on multi-level governance theory and a rapid assessment of three areas of health workforce policy: mental health, gender equality, and public health competencies. We consider two years of the pandemic with a focus on recent waves, October 2021-January 2022. Denmark, Germany, Portugal, Romania and Switzerland are selected for comparison, representing different health systems, health workforce conditions and COVID-19 indicators in the European Union and European Economic Area.

Results

Across countries the pandemic has highlighted mental health needs, persisting gender inequalities and demand for public health competencies. Our comparison reveals similar weaknesses and governance gaps. (1) Mental health needs of healthcare workers are increasingly recognised (more strongly in Denmark and less in Romania with the other countries clustering in-between); however, health workers’ perceptions are not used as guidance and effective programmes are lacking. (2) The situation is worst in relation to gender equality goals that are largely ignored in pandemic policy and recovery plans. (3) Public health competences are more advanced and integrated in the NHS systems in Denmark and Portugal, but no country has taken action to innovate health workforce education and strengthen public health.

Conclusions

The comparative assessment highlights that health systems failed to adequately respond to health workforce needs and the COVID-19 challenges. Action has to be taken to implement participatory governance and step up efforts towards more responsive and resilient health workforce policy.
Hospital doctors in Ireland working through COVID-19 pandemic: learning from individual experience
Authors: Humphries N , Byrne J-P , Creese J
Published: October 2022

Background

This study was part of a 5-year, HRB-funded research project about hospital doctor retention and emigration.

Methods

In 2021, we conducted a Mobile Instant Messaging Ethnography (MIME) with 28 hospital doctors in Ireland. This involved interviewing doctors via Zoom and engaging them in a 12-week work-related conversation via WhatsApp.

Results

Our findings illustrate that the pandemic intensified already difficult working conditions. Respondents described working in an under-staffed and under-resourced system, in which they were unable to protect their own wellbeing or achieve a work-life balance. Morale was low and few had hope of health system improvement.

Conclusions

The findings reveal a workforce under strain and raise concerns about health worker wellbeing and health worker attrition, post-pandemic. However, they also highlight the importance (and value) of listening to the voices of frontline health workers and using their insights to inform and enhance retention policies.
Predictors of seropositivity against SARS-COV-2: a population-based seroepidemiological study
Authors: Musheghyan L , Sahakyan S , Sargsyan Z , Muradyan D , Aslanyan L , Gharibyan N , Harutyunyan A , Khachadourian V , Petrosyan V
Published: October 2022

Background

Data on parameters of actual exposure to SARS-CoV-2 is limited, and specific population groups might be at a higher risk of infection. In line with the growing need for large-scale investigations to determine the presence of antibodies against SARS-CoV-2 among different population groups, we conducted a nationwide assessment in Armenia.

Methods

We performed a cross-sectional seroepidemiological study among the adult population in Armenia, in May-September 2021. A multi-stage cluster random sampling was performed to recruit the participants across the capital city and regions. The study had two main components: blood sampling, which took place in primary care facilities and a phone survey on socio-demographic characteristics, comorbidities, and previous history of COVID-19.

Results

The number of participants included in both blood sampling and phone survey was 3483. The nationwide prevalence of SARS-CoV 2 antibodies weighted by age and gender was 66.4% with significantly higher prevalence in urban compared to rural areas (67.3% vs 59.3%, p < 0.001). Only 22.7% (n = 772) of the total sample reported a previous history of PCR confirmed COVID-19, among whom antibodies were detected in 94.2% (n = 727). In the final adjusted model, the seropositivity was associated with being female (OR = 1.60, 95% CI: 1.32; 1.92), employed (OR = 1.41, 95% CI: 1.17; 1.69), and having previous PCR confirmed COVID-19 (OR = 10.6, 95% CI: 7.39; 15.21).

Conclusions

Over 66% of the population were seropositive for antibodies against SARS-CoV 2; and over ⅕ of the sample reported a previous PCR diagnosis. Factors associated with increased odds of seropositivity included gender, employment status, and place of residence. Targeted interventions are recommended to minimize the risk of infection among those groups, including vaccination and infection prevention and control measures.

Key messages

• The prevalence of SARS-CoV 2 antibodies is about three times higher than the rate of infection based on PCR confirmed prevalence of COVID-19.

• Women, people living in urban areas, and those employed are at a higher risk for exposure to SARS-CoV 2.
Review of direct impact health indicators of COVID-19 in the scientific literature published between January 2020 and June 2021
Authors: Garriga C , Valero T , Diaz A , Rodriguez-Blazquez C , Forjaz MJ ,   PHIRI WP5.1collaboration group
Published: October 2022

Background

The Joint Action Population Health Information Research Infrastructure (PHIRI) seeks to create infrastructures to generate quality data on the COVID-19 pandemic between European countries. The aim of this study is to present a synthesis of health indicators used to evaluate the direct impact of COVID-19

Methods

Scoping review using a common search strategy in Pubmed, Embase and WHO Covid-19 databases. Health indicators of direct impact of COVID-19 were obtained from observational studies in the general population, hospitals and long-term care facilities from papers published worldwide in English between 01/01/2020 and 06/31/2021. Titles and abstracts were screened first by 15 reviewers using the Rayyan tool. Any discrepancies were solved by agreement between reviewers. Then, articles containing indicators of direct impact were selected in a full-text reading phase. Of them, a random sample of 35 was drawn and their indicators were described.

Results

After eliminating 262 duplicates 3891 records were reviewed. Screening discarded 3171 abstracts. Of 720 articles sought for retrieval, 445 met inclusion criteria for indicators extraction. In a sample of 35 papers (8.1%), 116 direct impact indicators of COVID-19 were identified. 28 morbidity indicators were found, classified as indicators of prevalence (n = 15), incidence (6), transmissibility (4) and underreported infection (4); 32 of mortality (mortality rate, 9; case fatality rate, 17; time to death, 2); and 54 for severity (complications, 27; mechanical ventilation, 12; hospitalization, 8; requiring ICU admission, 1; time from hospitalization to ICU admission, 1). Two composite indicators of severity and mortality were also identified.

Conclusions

According to the scientific literature, a wide variety of health indicators has been used to measure the direct impact of COVID-19. The systematization of indicators used in the current COVID-19 pandemic could help for future health crises management.
Systematic review on digitals tools used for contact tracing of COVID-19 patients: interim results
Authors: Unim B , Zile-Velika I , Misins J , Pavlovska Z , Lapão L , Peyroteo M , Palmieri L
Published: October 2022

Background

Contact tracing is a public health intervention implemented in synergy with other measures, such as testing, physical distancing, and vaccination, to curb the COVID-19 pandemic. Digital solutions have been developed worldwide to enhance the contact tracing process. The aim of the study was to evaluate the effectiveness and impact of tracking COVID-19 patients using digital tools.

Methods

A systematic literature review was performed on eight online databases to identify observational studies on digital contact tracing, published 2020-2021, in English. Studies identified through the ‘Population Health Information Research Infrastructure’ project were also included. An ad hoc form has been deployed for data extraction of relevant information. Quality assessment of the included studies will be performed using validated tools.

Results

Over 8000 records were identified, of which 27 met the inclusion criteria: 16 modelling and 11 population-based studies. A study was based on GPS technology, four were Bluetooth-based, and others used digital technologies and manual tracing. The uptake rate of the tools ranged 19-100% across the studies. Most studies compared digital contact tracing with other strategies (e.g., no intervention, lockdown). Digital contact tracing was associated with improved identification of contact persons (9 studies), reduction of the effective reproduction number or covid-19 infections (8 studies), and increased effectiveness in combination with other containment measures (9 studies). Security and privacy issues were considered in 8 studies.

Conclusions

Digital contact tracing contributes in reducing further transmission, especially with sufficient population uptake of the applications and in combination with other public health measures. However, its deployment has been limited by security and privacy issues. Further studies are required to investigate the combined impact of digital and conventional contact tracing and enhance privacy and security.
A longitudinal study of how disability has affected survival in Swedish populations across 150 years
Authors: Junkka J , Namatovu F , Häggström Lundevaller E , Karhina K , Vikström L
Published: October 2022

Background

Studies from across the world report that disability jeopardizes people's health and increases the risk of premature death. The trend has been demonstrated in present-day populations but there has been little research about whether disability affected survival in historical populations. Our objective was to identify long-term developments in the relationship between disability and survival.

Methods

We focused on all causes of mortality in ages 25-42 among groups with any type of disability in Swedish populations in the 1800s, 1900s and 2000s. We used Cox proportional regression and longitudinal micro-level data, measuring both relative differences (HRs) and absolute differences (excess LYL) in premature mortality, across time by disability status and sex.

Results

Although the overall mortality declined profoundly in Sweden during the centuries studied, the strong association between disability and premature mortality persisted, generating a significant disability-survival gap that has held since the 1800s. The absolute difference in this gap narrowed only slightly during the 1900s, from excess LYL due to disability for men of 1.67 (CI 0.17-3.44) in the 1800s, to 0.69 (CI 0.54-0.85) in the 2000s, while for women the change was even smaller, from 1.24 (CI -0.46-3.12) to 0.59 (CI 0.43-0.69). However, the relative difference widened, particularly for women, from HR of 2.46 (CI 0.91-6.70) in the 1800s to HR 12.00 (CI 9.88-14.60) in the 2000s. For men we found a change in HR from 2.30 (CI 1.31-4.06) to 8.48 (CI 7.26-9.92).

Conclusions

Our study is unique in providing comprehensive results about how disability has limited survival for more than 150 years. In Sweden, fundamental societal changes and extensive welfare provisions promoting equality in health and social wellbeing of all citizens have not been enough to improve the survival of younger generations with disabilities.

Key messages

• The strong association between disability and premature mortality persisted from the 1800s to the 2000s.

• In Sweden, fundamental societal changes and extensive welfare provisions promoting equality in health have not improved survival of young adults with disabilities.
2.D. Workshop: The challenges of developing population health intervention research in cancer health promotion
Authors:   Organised by: French National Cancer Institute,   Chair persons: Jérôme Foucaud (France)
Published: October 2022

As the leading cause of death in Europe and the second leading cause of death in North America, it is known that about 40% of cancers are preventable. Until recently, it was considered that if we know the risk factor, then we can act on it: experience has shown that this knowledge is necessary but insufficient to know how to act. Population health intervention research (PHIR), a ‘solution’ science, addresses this challenge. It is concerned with the design, implementation, evaluation, adaptation, transferability and durability of interventions aimed at improving the health of populations, in order to produce valid knowledge with a high potential for social and health impacts. This scientific approach apprehends interventions as ‘events in systems’ and challenges the methodological hegemony imposed for many years by the biomedical sciences.

Today, the development of PHIR in health promotion in the domain of cancer faces three major challenges:

– Policy;

– Methodology;

– Transferability.

Three complementary presentations are proposed, each of which will respond directly to these challenges and each of which will be based on concrete examples of implementation in the domain of cancer. The aim of this workshop is to offer a time for exchange and discussion on the challenges to be met in developing PHIR in health promotion, in the domain of cancer and at all stages of the disease, as an innovative model of research within an innovative paradigm shift. It will enable participants to clarify their conceptions of PHIR for the advancement of health promotion in oncology and to evolve these concepts in relation to these three key issues. An interactive format is proposed, including time for discussion based on participants’ perceptions and time for presentations.

Key messages

• PHIR: an effective scientific approach and a relevant tool for thinking about and developing health promotion policies in the field of cancer.

• a new research paradigm for cancer control based on intervention with populations to act on health determinants.
Intervention research in health promotion: methodological issues
Authors: Guillemin A-F
Published: October 2022

Intervention research in population health focuses on actions carried out by researchers in partnership with those involved in the intervention: health professionals, patients, carers, public policy makers and population communities. The diversity of actors shapes PHIR projects, testifies to the richness of this research and gives it a privileged place to analyse and intervene as accurately as possible in different contexts and populations. It also implies the need for a better understanding of how to intervene by considering the determinants of health in these interventions. PHIR in health promotion in the domain of cancer thus proposes a paradigm shift from describing the problem and its causes to intervention. RISP bases its theoretical anchors on the one hand on the contributions and models of public health, health promotion and human and social sciences and on the other hand, on its own contributions to theorise and build its own theoretical and methodological corpus. This presentation will aim to clarify this paradigm shift and five methodological challenges of PHIR: the imperialism of epidemiology as a research model; the evaluation models of PHIR and their polymorphism; the complexity of the objects of study; the partnership dynamics between researchers and field actors without which research cannot be carried out. Finally, the challenges of publication and valorisation of this type of research. Through concrete examples, participants will be invited to understand the challenges of the RISP methodology, and to analyse different concrete perspectives to address them. The first part will focus on identifying the participants’ representations of the methodological difficulties of PHIR. The second part will be an interactive presentation of 12 minutes, the last 2-3 minutes will be devoted to final questions.
Intervention research in health promotion: transferability issues, from project to structuring
Authors: Cousson-Gélie F
Published: October 2022

The work carried out in intervention research has revealed the complexity of health interventions, particularly in health promotion. Even if these interventions are in themselves complex systems interacting with their context or ‘intervention systems’, PHIR is making considerable progress in understanding the mechanisms thus revealed, a key element for their transferability, which is an essential issue in public health.Transferability assesses the extent to which the outcome of a successful intervention, evaluated in one context, can be achieved in another context. It is through the concrete example of the interventional research that has made it possible to evaluate the transferability of the project ‘P2P, peer action for the prevention of smoking among high school students in vocational training”, that the issues presented in the two previous presentations will be analyzed. Using the example of this transferability study, which aimed to assess whether the P2P programme developed and conducted in the south of France is transferable to other regions and under what conditions, participants will be invited to analyse the conditions of this implementation. Thus, the question of the reproducibility of the effectiveness results with a similar population but in a different geographical context, implying differences in the functioning of the intervening structures and the high schools involved, but also in the characteristics of the high school students targeted, will be examined. After the presentation of the project and its transferability in different spaces, an interactive debate will be organised on the challenges of transferability.
(Re)thinking the city of proximity for Salutogenic purposes
Authors: Rebecchi A , Crespi F , Capolongo S
Published: October 2022

As centres of population and human activities, nowadays urban environments are simultaneously the main cause of and solution to a growing number of health-related challenges. In this setting, COVID-19 pandemic has helped reiterate this and serves as a wake-up call and an opportunity to rethink the way we approach cities. Aim of this paper is to research what today seems the most promising urban model for long-term individual and global resilience: the “city of proximity”, namely about inclusive walkable and cycling environments where people can access all basic destinations within reasonable times and distances from home. Therefore, urban proximity dimension, methodological approach and urban features and functions become the main subject of a quanti-qualitative matrix of comparison of five international case studies centred on the topic, by which it is possible to set out general criteria for such model, along with a methodology to measure all cities in its respect. As a result, residential density, functional mix, pedestrian surface, cycle routes, public transport stops, green areas, schools, cultural facilities, sport facilities, retail services and urban gardens make up the fix components of a comprehensive set of 11+n urban features, whose occurrence is investigated through GIS-based analysis within designated distance ranges, creating a comprehensive assessment framework that is adjustable to all urban contexts worldwide. In the end, the application of such framework to the city of Milan finally helps to validate its effectiveness in providing a picture of city-wide accessibility to proximity services, and in highlighting the value of integrated analysis in view of shaping public policies and informed planning choices which put health and sustainability at the centre.
From Personal to Public Health - building Health Data Pipelines
Authors: Buttigieg S
Published: October 2022

The creation of future proof infostructures requires a number of efforts on different levels within a health organisation. One important thing that we need to be genuinely realise and grow aware of is that there is an inherent need to move away from Excel Spreadsheets, Access Databases and legacy data tools (including paper) towards interoperable information systems that are focused on high-quality data coordination mechanisms, robust processes and documentation and most of all design of data flows that enable sustainable data collection and analysis. This hands-on session will inform users on the following elements:

– Doing a thorough situation analysis of your current data situation

– Design your health data pipeline - paper and imagination required

– Resources to help you design the ideal infostructure

– Setting your next steps forward

– Being aware of your organisational culture to ensure maximum success
Data protection and fairness by design
Authors: Rachadell J
Published: October 2022

Building a health data pipeline is an opportunity not only to review the efficiency of data flows and organisational processes but also to guarantee that the resulting data system incorporates data protection and fairness principles by design. This session will cover some key aspects of data protection and the principles of data fairness and ethics:

Transparency, simplicity and fairness

The importance of a diverse team with diverse expertise

Keeping the business objectives in mind and purpose limitation

Compliance with data protection directives (GDPR)