bluuebunny/crossref_metadata_2025 huggingface dataset:
8.H. Workshop: Policy and practice: the role Real-World Data (RWD) in Health Technology Assessment
Authors:   Organised by: EUPHA-HTA, EUPHA-PHMR, PHIRI, HTAi,   Chair persons: Chiara de Waure (EUPHA-HTA), Elena Petelos (EUPHA-HTA)
Published: October 2021

The European Medicines Agency (EMA) has developed multiple schemes to improve access to medicines. Among them, the Conditional Marketing Authorisation (CMA), namely an approval based on less complete data followed by post-authorisation obligations, can be granted to medicines addressing unmet medical needs, debilitating or life-threatening diseases, rare diseases, or public health threats. In the post-authorisation obligations, real world data (RWD) routinely collected from different sources, such as electronic health records, administrative claims, or product and disease registries, are used for Real World Evidence (RWE) generation. In the context of the COVID-19 pandemic, this effort took the form of establishing an infrastructure and planning for the generation and synthesis of said data. Over the past few years, frameworks have emerged, and the European Union's new Pharmaceutical Strategy, adopted on November 2020, highlighted the need to systematically examine and transform current policies and practices to allow for the use of RWD/RWE to support the development, authorisation and use of medicines. Indeed, regulatory and Health Technology Assessment (HTA) bodies are opening the doors to the use of RWD/RWE in their evaluation frameworks. Nevertheless, currently there is a lack of established infrastructures to facilitate robust EU-wide data collection and transfer. Furthermore, there is a fragmented EU-wide landscape of heterogeneous policies on the acceptance and the appraisal of RWD/RWE. Given the COVID-19 pandemic, we also need to consider comparative effectiveness research and population information. This critically necessitates collaboration and mechanisms of information exchange supported by well-established research infrastructures. Additionally, several challenges need to be overcome, from methodological ones (quality and transferability of data) to governance issues and legislative challenges, including GDRP considerations in terms of data processing and transfer. During the 2019 HTA international (HTAi) Global Policy Forum, a call for actions and guidance to manage RWD/RWE to inform decision-making across the whole lifecycle of health technologies was launched. In fact, there is an urgent need for regulators and payers to make the best use of RWD/RWE also to allow a timely access to innovative health technologies and to reassess them across the lifecycle. This workshop is intended to carry forward the discussion on policies and practices on the use of RWD/RWE by regulatory and HTA bodies.

Key messages

Real world data (RWD) routinely collected from different sources and within different countries can be employed for rapid policy relevant research responses. HTA/Payer should agree on how collect and use data in the assessment and reassessment process of the value of health technologies.
Prescription medication misuse among students in Lithuanian universities
Authors: Guzikaitė B , Astrauskienė A
Published: October 2021

Background

Prescription drug misuse (PDM) is a known problem in Lithuania. However little information is known regarding the characteristics of prescription drug misusers and the extent of this problem among students of Lithuanian universities. This study attempted to further understand PDM by examining prevalence, PDM type, and students' attitudes towards PDM.

Methods

Survey data was collected in December 2020 - January 2021 via an online survey. 974 students from 8 State Universities of Lithuania completed the survey. Results include lifetime, past-year, past-month prevalence of PDM with analysis performed separately for stimulants, sedatives/tranquilizers, and sex, PDM was also analyzed according to stress levels, university year, etc.

Results

Lifetime prevalence of prescription sedative and tranquilizers misuse among students was 21% (CI 95% 18.6- 23.7), of stimulants - 5,4% (CI 95% 4.2- 7.1). Statistically significantly more male students misused prescription stimulants. Prevalence of PDM increased up to the 4th year of university. Primary reasons for PDM are to suppress anxiety and stress -62,4%, ‘to feel good/get high' -31 %, to improve academic performance -18%. 20.5% of the students that participated in PDM reported combining PDM with illicit drug use, 19.5% - with alcohol use and 7.6% used several prescription drugs non medically at once. Most students (61%) receive prescription medication from family members or friends and pay no attention to patient information leaflet.

Conclusions

These results further suggest the importance of assessing PDM risk factors for young adults. Students who often feel stress, anxiety are more likely to participate in PDM. Effective monitoring and prevention strategies should be developed.

Key messages

There is a need to increase public health literacy and to introduce innovative interventions to build mental resilience of young people. Greater availability of mental health services to students is likely to reduce PDM.
9.C. Round table: Digital innovation to fight the pandemic, what is here to stay?
Authors:   Organised by: EUPHA-DH,   Chair persons: Juan Rachadell (Portugal)
Published: October 2021

The COVID-19 pandemic has been a challenge to all Public Health and Healthcare systems around the world. Although strategies and results have varied, there has been a clear investment in digital health tools as part of the response in European Countries. From contact tracing mobile apps to dedicated track and trace information systems, the digital transformation of Public Health practice has been accelerated in this moment of crisis. As countries perfect their digital Public Health tools and reform their information systems, a question comes to mind: which digital transformations might be permanent? What apps, systems or other changes can become the new national norm in each country? How will this affect the European landscape on digital health? Those are the questions we intend to discuss with this workshop, learning from the experience of 3 representatives from 3 different countries and debating those perspectives with the audience. The ultimate goal of the workshop is to explore the digital approaches of European countries in the pandemic fight and to extract best case practices both for future crises and for day-to-day public health activity. There will be one speaker from each of the 3 countries: Malta, Portugal and Switzerland. Each one will have 10 minutes to contextualize the Digital Health Strategy of the country before the pandemic, showcase the digital Public Health tools that were developed during the pandemic and conclude with a prediction of what may permanently change in their respective Public Health systems. The second 30 minutes of the roundtable will be reserved for questions and a debate between the speakers and the audience.

Speakers/Panelists

Stefan Buttigieg Malta Association of Public Health Medicine, St. Paul's Bay, Malta Eduardo Freire Rodrigues ARSLVT ACES Amadora, Amadora, Portugal Marie-Annick Le Pogam Unisanté - Centre Universitaire de Médecine Générale et Santé Publique, Lausanne, Switzerland

Key messages

With “building back better” as a mantra, sharing national level experiences is key to empower informed decision making and better digital innovation. The challenges of the COVID-19 pandemic accelerated the digital transformation in a way that affected how public health information systems are implemented and scaled up.
The application of AMSTAR 2 in overviews of systematic reviews shows a need for improvement
Authors: Matthias K , Lorenz R , De Santis KK
Published: October 2021

Background

Overviews of systematic reviews (SR) summarise and appraise the quality of research relevant for evidence-based decision-making. ‘A Measurement Tool to Assess Systematic Reviews' (AMSTAR 2) is a valid and moderately reliable appraisal instrument with 16 items that can be used to derive the overall confidence rating (OCR). OCR (high, moderate, low or critically low) can be derived based on the original algorithm with 7/9 critical/non-critical items. We aimed to assess the methods for deriving OCR in overviews of SRs of clinical interventions.

Methods

Our cross-sectional study was conducted using 45 overviews of SRs with at least 20 AMSTAR 2 appraisals selected by two authors from a title/abstract search for ‘AMSTAR 2' in Medline, Epistemonikos and CINAHL in 09/2020. One author coded the data. OCR methods and outcomes were compared using descriptive and univariate statistics.

Results

The 45 overviews were published in 2018-2020 by 2-16 authors. The overviews appraised on average 44 SRs (range: 20-158). OCRs of 1.412 SRs were derived in 41 overviews (91%). OCR were derived according to the original algorithm (22; 54%), own algorithm (9; 22%), unspecified algorithm (9; 22%) or AMSTAR 2 website (1; 2%). The OCR were high (190; 13%), moderate (182; 13%), low (267, 19%) or critically low (773; 55%). The original algorithm was more likely to generate the critically low+low ratings than either own algorithms (OR = 2.28, 95% CI [1.66-3.13]) or unclear algorithms (OR = 3.78 [2.81-5.09]).

Conclusions

High quality SRs are needed for making public health decisions. AMSTAR 2 assigns mostly low and critically low OCR to SRs in various clinical areas. These SRs should not be relied on as a source of accurate evidence. Furthermore, our results show that SR reporting guidelines need to be better followed and that AMSTAR 2 users should explicitly report their OCR methods.

Key messages

The methodological quality of the majority of systematic reviews (SRs) in various clinical fields is disappointing, highlighting the requirement for better adherence to reporting guidelines. There is a need for improvement on reporting how AMSTAR 2 is applied in overviews of SRs.
European Union Digital Passenger Locator Form System (EUdPLF) development
Authors: Bitsolas N , Janiec J , Dionisio M , Marotta C , Kairiene B , Raulinaitis A , Ibanez Y , Ripoche R , Bitenc K , Hadjichristodoulou C
Published: October 2021

Introduction

Passenger Locator Forms (PLFs) are used by public health authorities to facilitate international contact tracing. Digital PLFs (dPLF) allows for easier, more rapid data collection and exchange between stakeholders, making international contact tracing more effective and efficient. In response to COVID-19, EU HEALTHY GATEWAYS developed a common European Union digital Passenger Locator Form System (EUdPLF) for all transport sectors (aircrafts, cruise ships/ferries and ground transport).

Methods

A working group was established consisting of 9 EUMS, EASA, EMSA, ECDC, IATA, ERA, CLIA EUROPE. A minimum mandatory dataset was developed. Personal data protection procedures and security measures were implemented. Interconnection of EUdPLF with the EASA exchange platform allowing exchange of data between MS with national dPLF and MS using the EUdPLF was completed. Pilot testing was conducted with four MS for the air and ferry sector.

Results

The EUdPLF system developed consists of a multilingual website being the first point of information for users and the EUdPLF app which is the web app for completion of the dPLF. One dPLF is completed per family/group, a QR code is generated and dPLF is sent to the passenger's email. Pilot testing generated 1013 PLFs submissions and 1450 passenger registrations. Feedback received was positive and used to improve user experience. To date, Italy is officially using the EUdPLF for all arriving passengers for all modes of transport. France, Slovenia, Lithuania and Austria are finalising practicalities before official use and testing of the system is ongoing with other MS.

Conclusions

EUdPLF provides multilingual, user-friendly, secure and GDPR compliant single entry point and database for the collection of PLFs, flexible to be customised to the MS needs and to be connected to external systems e.g. check-in system of transport operators, vaccination/testing/certificate information systems of each MS.
COVID-19: the first Homo Salus syndemic? Lessons of inclusion and social justice in the aftermath of SARS-CoV-2
Authors: Saboga-Nunes L , Bittlingmayer U , Harsch S , Amaral AP
Published: October 2021

Issue

COVID-19 has been considered a pandemic. Nevertheless, following Merrill Singer et al, we could gain new insights if COVID-19 could be considered a syndemic. For too long Homo Sapiens has driven us towards un-sustainable achievements that are strongly reflected in the outbreak of the virus. A new perspective based in salutogenesis would call for the Homo Salus takeover, towards a more inclusive society.

Description

A syndemic perspective addresses biological and social interactions that are relevant for health policy and therefore that may affect prognosis, treatment, prevention and sustainability (sustainability at the environment, social and cultural levels). Analyzing, reducing and ensuring against risks, is a whole-of-society and whole-of-government endeavor. But more is needed than this risk perspective. Promoting health and pro-actively engaging the resilient individual is the sustainable perspective to be triggered. For this, Homo Salus must step in and move humanity forward to a new age.

Results

It is today well documented that policy should not be limited to the harm caused by SARS-CoV-2 addressing a response that only deals with the spread of the virus or curative measures to face the treat. Far more implications are found on NCDs, socioeconomic inequality citizens' susceptibility & health literacy. More than a comorbidity, this syndemic is determined basically by social interactions. In this very sense, the “one health” perspectives, inclusive of health promotion, becomes of utmost importance for future health action and policy.

Lessons

Focus the response to SARS-CoV-2 outbreak in biological characteristics will only deepen inequalities and foster the health gap even further. It is urgent to re-frame and establish a foundation that not only will deal with the scars of the present syndemic but that will help humanity to face next treats. Only then we may insure social justice, inclusion and human dignity.
SGDs, Environmental Health and Gender Equity
Authors: Paixão S
Published: October 2021

According to the literature, the female gender has always been discriminated because it is considered inferior in relation to the male gender. The evolution of women's participation namely in the labor market and the development of studies on women were boosted by social and political changes, specifically in the 1960s and 1980s, in which feminist movements emerged. However, women continue to struggle with the same difficulties as before, and many stereotypes continue to exist in most societies. The 2030 agenda is the result of the joint work of governments and citizens around the world with the aim of reaching a new global model to end poverty, promote prosperity and the well-being of all, protect the environment, fight against climate change and promote gender equality. In this presentation, we intend to reflect on each one of the 17 Sustainable Development Goals, namely how they are related to gender issues, in particular with women and how we can work to achieve equity. Emphasis will be given to the goals most focused on environmental health issues and in particular to goal 6 ‘Clean water and sanitation', since even today it is the woman who, in many regions of the world, has the task of fetching water for the consumption of the house, being exposed to the most diverse dangers. We will also analyze how goal 6 is directly related to goal 3 ‘Good health and well-being'. A reflection will be made on how gender and environmental health issues are reflected in the empowerment of women, using practical examples with what's going on in the world. We will try to verify what there is still to do and how we can involve ourselves in a way to achieve all the goals. The goals for sustainable development that we have to achieve by 2030 are directly related to each other. We only achieve the goal 5 ‘Gender equity' if we manage to achieve most of the other goals, in particular those directly related to Environmental Health.
Nebolus: A location-based game to promote (mental) health literacy of adolescents
Authors: Dadazcynski K , Frankj D , Krah V
Published: October 2021

As a result of international epidemiological findings, health literacy (HL) is seen as an urgent public health issue and should be promoted as early as possible. However, there is a lack of universal interventions addressing young people regardless potential health risks or already existing health problems. Available interventions often focus on the individual level by neglecting the physical and social environment where HL is developed within. Location-based games (LbG) are playful applications in which the course of the game is influenced by constantly changing the geographic position of the player. Despite the limited evidence available so far, study findings indicate that LbGs can have positive effects on physical activity, reduction of sedentary life styles or well-being. Within the project eHLastic (e-based Health Literacy at the intersection of schools and communities), HL is considered in its socio-ecological structure and is embedded in schools and communities as the primary living environments of adolescents aged 13 to 15. The project aims to develop a digital LbG entitled Nebolus, which will enable young people to get in touch with the (mental) health services of their community. The low-threshold and playful contact is intended to strengthen their ability to find, evaluate and apply health information about and from community (mental) health services. Nebolus follows a participatory development logic and is based on the Living Lab method. This method is characterized by its complex multi-stakeholder constellations and is intended to provide a creative space in which many interest groups can actively contribute their ideas for the development. The presentation will introduce the intervention concept of Nebolus and describe its participatory development, piloting and national rollout.
Declining complexity of behavioural sequences in late adulthood: its meaning and implications
Authors: Jarosz E
Published: October 2021

This study looks at the time-use patterns of older adults and examines how complexity of daily behavioural sequences is related to an individual's age. Maintaining complex behavioural sequences in daily lives means that a person is able to lead a relatively rich life, but this becomes increasingly difficult as individuals face growing functional, cognitive or social limitations. The data used in the study came from four nationally representative time-use surveys: German (2012/2013), Polish (2013/2014), Finish (2009/2010), and British (2014/2015). The analyses were carried out on a total sample of 25,495 time-use diaries of respondents aged between 65 and 102. The association between sequence complexity, age, and a set of other covariates was analysed using multivariable regression models fitted independently for each country. The results provide evidence of a significant age-related decline in the complexity of individuals' daily time-use patterns. The steepness of this decline varied across populations. Commonalities in the complexity covariates included the positive net effects of female gender, and tertiary education, and the negative net effect of living in a larger household, which potentially indicated loss of independence. Those effects held in all countries. Decline in complexity was primarily driven by loss of entropy that is decreasing diversity of activities that filled older adults' daily lives. This study concludes that sequence complexity may serve as a behavioural indicator of an individual's general functioning in late adulthood.

Key messages

Declining sequence complexity is driven by loss of diversity of activities - some activities are dropped and not replaced with other. While complexity declines with age, there are important country and socioeconomic differences in complexity of older adults daily time use patterns.
Older adults’ daily activities during lockdown in France, spring 2020: a cross sectional survey
Authors: Engels C , Ségaux L , Lafont C , Canouï-Poitrine F
Published: October 2021

Background

The 2020 COVID-19 pandemic prompted many countries to go into lockdown for varying periods. The French population was limited to 1km around their house, with the need to have a travel declaration when going out. According to the World Federation of Occupational Therapists (2020), “populations around the world have been required to adjust and make compensations to usual routines in order to participate in ongoing or newly acquired activities that are necessary for daily life.” AIMS. In this context, we aimed to describe changes in daily activities, social contacts, and mental health and wellbeing of older adults (i.e. aged 60 or more) living in France.

Methods

We performed an online cross-sectional survey, based on the Canadian Occupational Performance Measure (COPM) for restriction of and satisfaction with daily activities, and the Cantril's ladder for mental health and wellbeing. RESULTS. Of the 512 respondents, 9% did not feel restricted at all in their daily activities, and 13% reported no change. About one third (31%) reported to have less diverse activities than usual but to be satisfied with it. Regarding social contacts, 72% of the respondents reported to have a lot more contacts than usual with their relatives. Concerning the type of activities, 2477 restricted activities could be identified, but also 2190 that were done more often during the lockdown. Most restricted ones concerned leisure (83%), especially active leisure, the most mentioned being walking. The more engaged activities also concerned leisure (73%), especially quiet recreation, the most mentioned reading. The median value of Cantril's ladder was 5 [4;7].

Conclusions

Lockdown measures led to some activity restrictions for older adults, but also offered opportunities for new engagements. Remarkably was the increase in social contacts with relatives, probably related to the use of new technologies.
Introduction to the complex intervention concept and the research perspectives
Authors: Skivington K , Craig P , Moore L , Matthews L , Simpson S
Published: October 2021

Few interventions are truly simple; complexity can arise from various sources, e.g.:

Aspects of the intervention itself, such as the number of intervention components, the number of groups targeted, how dynamic the intervention is permitted to be. The context in which the intervention is developed and delivered, such as the social, political, economic, and geographical context.

Complex intervention research should be approached with an awareness of these sources of complexity. Systems thinking can be helpful to understanding the dynamic interaction between interventions and their context. This presentation will introduce concepts of complex adaptive systems, e.g. feedback loops, adaptation, emergence, that should be considered when developing and evaluating complex interventions. It will then introduce participants to the research perspectives set out in the new framework: efficacy, effectiveness, theory-based, and systems perspectives. Each perspective is associated with a different type of research question, and therefore appropriate in different circumstances. The presentation will provide information to support participants to consider the research perspective(s) most suited to the research challenge that they are aiming to address.

Main messages

There are multiple sources of complexity, each of which can affect how the intervention works or contributes to change. Complex intervention research can take an efficacy, effectiveness, theory-based, or systems perspective, the choice of which is based on what is known already and what further evidence would be most useful.
Persistent symptoms after three months follow-up of in and out-patient COVID-19 cases
Authors: Basoglu E , Emecen AN , Keskin S , Turunc O , Suner AF , Siyve N , Unal B
Published: October 2021

Background and aim

There is limited research on how common the longer-term effects of COVID-19. This study aimed to describe changes in symptoms of COVID-19 patients at the 1st and 3rd months after diagnosis.

Methods

Patients older than 18-years who tested positive for SARS-CoV-2 RNA in Dokuz Eylül University Hospital-Turkey in December 2020 (n = 1434) were included in this prospective cohort study. Overall, 1029 patients (71.8%) completed the 1st month and 3rd-month follow-up. Data on demographic characteristics, chronic disease history, symptom history and hospitalization were collected via telephone interviews. Based on the relapsing nature of the disease, the presence or absence of any COVID-19 related symptoms within a week before the 1st and 3rd-month interview was questioned. Categorical variables (n, %) were compared using the chi-square test.

Results

Of the 1029 patients, 92.8% were symptomatic. The most common initial symptoms were muscle or body aches (58.5%), fatigue (57.8%) and loss of smell (53.1%). Among the symptomatic patients, 40.8% and 27.6% reported at least one symptom in the 1st and 3rd months, respectively. Mean number of symptoms was 4.5±2.6 at diagnosis, 2.3±1.7 at the 1st month and 2.5±2.3 at the 3rd month. The most common persistent symptoms by the 1st month were muscle or body aches (11.1%), heart palpitations (6.4%), and shortness of breath (5.8%). Muscle or body aches (9.5%), shortness of breath (4.2%) and fatigue (4.2%) were reported as persistent by the 3rd month. Persistent symptoms up to the 3rd month were more common in women (33.3% vs 21.3%, p < 0.001), in the patients aged >50 years (32.8% vs 25%, p = 0.01) and in the patients with comorbidities (31.8% vs 25.1%, p = 0.03).

Conclusions

Over a quarter of patients (27.6%) reported persistent symptoms even after 3 months of diagnosis. Rehabilitation and long-term monitoring programs for patients aged >50 years with comorbidities could be useful in responding to this problem.

Key messages

Over a quarter of patients report persisting symptoms even after 3 months of initial diagnosis. Follow-up programs could be useful in appropriately managing any persistent or emerging long-term sequelae.
Public health intelligence monitoring of the COVID-19 epidemiological situation
Authors: Denkel Luisa
Published: October 2021

On a daily basis, the Public Health Intelligence team at the Information Centre for International Health Protection of ZIG monitored epidemiological indicators worldwide with detailed research for of a dynamic list of countries. Countries monitored were selected based on their accelerating or decelerating COVID-19 epidemiological trends, whether in terms of number of new cases, deaths, the emergence and frequency of potentially concerning virus variants, or measures implemented that could be adapted for Germany (lockdown / school closures / open strategy, etc). On a weekly basis and ad hoc, detailed reports on newly emerging potentially concerning virus variants, hospital and ICU capacity and epidemiological situation in certain countries were prepared to support the decision-making process for classification of risk areas by the German Federal Ministry of Health, the Federal Foreign Office and the Federal Ministry of the Interior, Building and Community.
TRANSCOV, a multidisciplinary project to evaluate long distance COVID patients transfers
Authors: Grimaud O , Girault A , Laude L , Sirven N , Cucharero Atienza P , Fermanian C , Elgharabawy Y , Ramanantsoa J , Bayat S , Leray E
Published: October 2021

Background

Faced with an abrupt surge of severe COVID patients in March and April 2020, intensive care units (ICU) from four French regions transferred around 660 patients towards six other regions and four neighbouring countries. The intensity and the diversity of the vectors used (plane, helicopter, train, ambulance), during this wave of medical evacuations make it an unprecedented event. The aim of TRANSCOV is to examine the impact of long distance transfers on patient's health and to understand how actors collaborated to overcome clinical and logistical challenges.

Methods

TRANSCOV is made of three disciplinary components: 1) interviews with clinicians and health authorities staff involved in the organisation and realisation of the transfers as part of the qualitative component; 2) a retrospective cohort collecting clinical parameters and pathway details before during and after transfer; 3) a collection of data regarding human and logistical resources mobilised during transfers as part of an economical evaluation.

Results

Preliminary results indicate that prior experience in medical evacuations proved useful to collaborate effectively in the exceptional circumstances prevailing in spring 2020. Clinicians had to establish quickly eligibility criteria for transfer. Actors' opinions may vary on the appropriateness of vectors to transfer isolated (e.g. via helicopter) or grouped (train) patients. Early epidemiological data suggest that transferred patients were younger and experienced comparable, if not lower, in-hospital mortality compared to other patients. The economic evaluation is in progress.

Conclusions

Initial results indicate that effective collaborations led to the selection of clinically eligible patients and the realisation of safe distant transfers.

Key messages

Healthcare organisations have been able to adapt and create organizational innovations to respond to COVID-19. Multidisciplinary approaches are appropriate to evaluate such complex innovations.
Addressing challenges to cancer control in Ireland due to the Covid-19 pandemic
Authors: McCarthy T , Burns H , Lyng A , Mullen L , O'Toole E
Published: October 2021

The Covid-19 pandemic presented a wide range of challenges to cancer control. People with possible symptoms of cancer were considered less likely to present for investigation. Patients with cancer were concerned about increased risk of illness or death from this novel virus. Cancer services had to ensure continued delivery of time-sensitive care. Public health skills and leadership have been key to Ireland's National Cancer Control Programme's COVID response. The multi-disciplinary skill set within the Programme includes an understanding of health protection principles, experience in rapid service redesign, monitoring of service delivery, patient and public communication, advocacy and guidance development, all of which have been integral to the pandemic response. Specific areas addressed include: rapid turnaround of guidance documents for cancer services, to minimise Covid-19 risk; patient information materials for those on treatment or with a history of cancer; development of novel service delivery mechanisms, such as a virtual national psycho-oncology service; a media campaign to combat decreased presentations with possible cancer and to reassure those currently on treatment; development of pre-surgical cocooning guidance and testing pathway; advocating for prioritisation of time-sensitive cancer diagnosis and treatment, and the wider health & wellbeing needs of those cocooning; advocating for and supporting the implementation of priority vaccination for those undergoing cancer treatment. Cross-sectoral collaboration has been facilitated by existing networks and relationships, allowing rapid responses to be deployed and actioned. The leaner guidance development process employed during the pandemic enabled timely response. A two-way communication system with cancer services allowed swift cascade of information and gathering of intelligence which empowered action. Learning from the cancer setting was transferable to other high-risk groups.

Key messages

The potential impact of the pandemic on non-COVID care was far reaching, including at all stages of the cancer patient journey, from pre-diagnosis to living with or beyond cancer. The programmatic approach to cancer control in Ireland facilitated concerted efforts to respond to the challenges posed by the pandemic.
Effects of partner support on life satisfaction cisgender and transgender adolescents
Authors: Ciria-Barreiro E , Moreno-Maldonado C , Rivera F , Moreno C
Published: October 2021

Background

Among gender minority youth the effect of family, school, peer, and community support are positively associated with emotional well-being, feelings of safety, or improved mental health. However, most research addressing the partner's role in gender minority adolescents have focused on risk behaviors (STI/HIV infection, unplanned pregnancy...) or intimate-partner violence. Because research has seldomly adopted a positive approach, little is known about the effect of partner support on transgender youth health?

Methods

The sample consisted of 170 transgender and 535 cisgender adolescents (selected through a matching process) 15 to 18 years-old who participated in the 2018 HBSC survey in Spain. Emotional Support was measured using the Network of Relationships Inventory (NRI) and Life-Satisfaction with Cantril Ladder. Means comparisons, hierarchical multiple linear regression and interaction tests were performed to contrast differences between the two groups, and to check the possible buffer effect of gender identity on the relationship between partner support and life satisfaction.

Results

Transgender adolescents scored lower in life satisfaction than cisgender peers. No differences were found between groups in the perception of emotional support, however emotional support was positively related to life satisfaction. Lastly, the relationship between partner support and life satisfaction was not moderated by gender identity.

Conclusions

This research showed that cisgender and transgender adolescents do not have differences in partner support, and highlights the overall positive benefit of partner support for health. Using a positive approach to better understand the impact of romantic relationships during adolescence will contribute to build strong network of assets for gender minority youths' positive development.

Key messages

Researching the development of trans adolescents requires the use of approaches that do not pathologize their realities. Individual and contextual assets should be considered to promote empowerment and well-being.
Regional differences in Bulgarian population ageing
Authors: Tsanova D , Yankulovska S , Grancharova G
Published: October 2021

Background

Europeans are living longer than ever, and the age profile of society is rapidly changing. Despite the observed improvement in public health in the European region, for many people old age is accompanied by a high risk of social exclusion and poverty, limited access to quality health and social services, especially in countries with economies in transition. This poses serious challenges for individuals and society. This report aims to analyse the basic regional differences of ageing in Bulgaria.

Methods

Information from the World Bank Open Data was used to calculate the basic indicators: proportion of people 65+ and ageing index for selected European countries. To estimate the rate of change, the growth of ageing index (in %) was calculated on a constant basis in 1970. The regional differences of ageing for Bulgarian population were analysed based on the National Statistical Institute data. The absolute numbers for regions were regrouped and the main indicators for population ageing were calculated. Analysis and calculation procedures were performed by Microsoft Office Excel 2019.

Results

By 2019, in fourteen of sixteen selected European countries, the ageing index exceeded 100%, and in four countries, it was even over 150%: Italy (174.78%), Portugal (168.70%), Greece (157.89%) and Bulgaria (150.07%). In Bulgaria, the proportion of people 65+ was 21.64% with great differences by regions. The highest proportions were found for Vidin and Gabrovo (29,94% and 29.05% respectively) compared to 19.24% for Varna and 17.70% for Sofia. The ageing index varies from 109.40% for the region of Sliven, 126.38% for Varna and 119.91% for Sofia to 248.63% for Vidin, 248.17% for Gabrovo, and 227.98% for Kyustendil, which are the regions with lower availability of health care.

Conclusions

The profound regional differences in population ageing impose permanent monitoring and directing the regional social and public health policies to avoid unfavourable effects of this process.

Key messages

The change of health status with increasing age is a challenge for the capacity of the health systems, especially for provision of long-term care, to cover the needs of the elderly. It is of utmost importance to develop policies and conditions for long-term and palliative care and for improvement of services and living conditions to ensure a better quality of life.
Engaging men and boys in gender equity programs in humanitarian settings: A scoping review
Authors: Dagher M , Abdulrahim S , Witt C
Published: October 2021

Background

Engaging men and boys in interventions designed to achieve gender equity has demonstrated positive impact on reducing gender-based violence (GBV) and improving women's and girls' health. This scoping review describes the content of published gender equity programs that engage men/boys in humanitarian settings.

Methods

We searched five databases for peer-reviewed articles of GBV programs implemented with men/boys in humanitarian settings (published between Jan 2000 and Dec 2019). From each article, we extracted information on program evaluation strategies, theoretical frameworks, and modes of adaptation to the humanitarian setting.

Results

Of 21 published articles of GBV programs with men/boys (implemented in 17 countries), the majority utilized a psychosocial (attitudes) or structural (feminism) theory and only seven were not theoretically based. As to evaluation, nine programs employed quantitative methods whilst the rest employed qualitative or mixed methods; outcome evaluation data were gathered from both men only or men and women. In most articles, authors described how they developed the program taking into account the humanitarian setting and incorporated practical delivery components to overcome contextual barriers.

Conclusions

In describing the content of published GBV interventions that include men/boys in humanitarian settings, this scoping review can guide future efforts to improve women's/girls' health. Such programs can help realize SDG5 to “achieve gender equality and empower all women and girls.”

Key messages

Including men in interventions designed to improve women’s/girls’ health in humanitarian settings is critical. A scoping review of the published literature can identify existing knowledge and guide future programs.
“PNSVEI” - Model of innovation development in health education
Authors: Wrzesinska Magdalena
Published: October 2021

Issue

Health awareness plays an important role in strengthening health potential and determines engagement in health promotion and prevention activities, especially during pandemic. For this reason, an innovative approach to health education is necessary to encourage society to become active in this area.

Description of the problem

The aim of the presentation is to show a model of innovation development in health education called the “PNSVEI” (Problem, Need, Solution, Validation, Implementation). This model has been developed based on the experiences collected during health educational products development and their implementation during regular educational interventions focused on knowledge improvement regarding healthy lifestyle among Polish school students in the last five years.

Results

The model consists of two main phases: development and validation of solution in health education. The development step involves defining the problem and need of the target group, and solution prototype development based on the defined need and co-creation process.

Validation includes experimental prototype testing in cooperation with different stakeholders, final prototype development, possible intellectual property process, than research evaluation and implementation to the society.

Lessons

The “PNSVEI” Model shows that the research evaluation and innovation implementation in health education area should be preceded by multi-directional actions and requires the cooperation of researchers with different stakeholders. Intellectual property certificates increase possibility to acquire business sponsorship what may give the chances of raising funds for future evaluations of solutions by researchers. Defining the needs of the target group, their engagement in the co-creation process and experimental prototype testing increase the chances of implementing health educational solutions to the population.

Key messages

Implementation of innovation in health education should be preceded by multi-directional actions. Need definition of stakeholders increase the chance of implementation in health education.
COVID-19 predictability in Portugal using Google Trends
Authors: Paiva Monteiro G , Barroso Travassos S , Miguel Carvalho J , Marques R , Fernandes D , Portela D
Published: October 2021

Background

Infodemiology is a valuable public health tool which analyses internet sources and real-time data to establish populational trends, thus assisting disease surveillance. Google trends (GT) is a popular infodemiology source widely used in previous reports to study the correlation between internet relative search volume (RSV) and surges in various pathologies. This study aims to explore the association between GT and Covid-19 symptoms and to access the possibility of predicting new surges from internet searches.

Methods

Individual data was extracted from GT RSV on four main Covid-19 related symptoms in the Health category (fever, headache, cough and shortness of breath) in Portugal between 2020/03/02 and 2021/02/15, corresponding to each of the identified surges of daily new cases (DNC) in Portugal, retrieved from GitHub. Pearson's-correlation coefficient was used for assessment. Additionally, a 14 days time-lag correlation analysis between data for the same period of time was performed.

Results

Statistically significant correlations were found between ‘fever' web searches and the DNC in the first (p = 0.02) and third (p = 0.02) wave. No statistically significant correlations were found between any other variables. Through time lag analysis, we found a maximum Pearson association between web searches for ‘cough' and the DNC during the first wave at 14 days (r = 0.55), as well as during the third wave, with a maximum association at 3 days time lag (r = 0.55).

Conclusions

Monitoring behaviour and public interest in health related issues, such as crisis, is necessary and may help in the establishment of better and target oriented health policies. Despite previously stated potential, constraints such as the exclusion of social media platforms or internet users' representativeness, could partly explain our limited results for portuguese predictability of new COVID-19 surges. A better understanding of GT's algorithm may lead to more detailed and precise data.

Key messages

Monitoring behaviour and public interest in health related issues is necessary to establish better and more targeted health policies. Google trends seems to be an helpful infodemiology source, but doesn’t allow for full representation of the population and needs better understanding.
Dutch Public health Foresight Study, in the light of COVID-19
Authors: Hilderink H , Eisinger E
Published: October 2021

Background

The future consequences of the corona pandemic for health are significant but uncertain. The Dutch Public health Foresight Study-2020 (PHFS-2020) analyses future trends in health status, determinants, prevention and care, in the light of COVID-19. The pandemic impacts health directly through COVID-19 and indirectly through changes in lifestyle, reduced regular care and socio-economic developments.

Methods

The Dutch PHFS-2020 applies a scenario approach which explores short- and long-term trends and their possible effect on health and health care. A Trendscenario is used, in combination with three scenarios for the future course of the pandemic and socio-economic developments. Based on these scenarios, societal challenges for the future are identified.

Results

In 2020, COVID-19 was the most important causes of death in 2020, life expectancy was almost a year lower and the disease burden of the first wave was almost five times higher than an average flu season. The increase in overweight and smoking will lead to more health loss in the future, including increased mortality. The negative impacts of reduced health care and mental health are already visible and might worsen in the future. The socio-economic and intergenerational divides might become more prominent.

Conclusions

The PHFS-2020 shows that indirect effects of the crisis might be taken into account when considering future policy interventions targeting COVID-19. Negative impacts on mental health, possible increase of health inequalities and the long term effects of changes in life style are important indirect effects to be considered by policy makers. Next, a further ageing population might increase the vulnerability for possible future outbreaks.

Key messages

The results of this study supports broader consideration of measures and to be better prepared in the future. Public Health foresight help to be better prepared for future possible developments.
Investigation of Epidemiological Characteristics of < 18-Year-Old Patients with Covid-19 ın a City
Authors: Gokce A , Ozer A , Soyiler V , Gundogdu ME
Published: October 2021

Background

After the coronavirus disease 2019 (COVID-19) became a pandemic, the World Health Organization declared it to be a public health emergency. The population aged >of 18 years in Bingol province is 72766 and constitutes 25.8% of the entire population. This study aimed to examine the epidemiological characteristics of < 18-year-old patients with COVID-19 in Bingol Province.

Methods

In this study 1431 people aged <18 who tested positive on reverse transcription polymerase chain reaction for severe acute respiratory syndrome coronavirus 2 in Bingol province between March and December 2020 were studied.The necessary institutional permission and ethics committee approval were obtained to conduct the study. The independent variables of the study were age, gender and place of residence, whereas the dependent variable was the development of pneumonia. Descriptive data were expressed as numbers and percentages, and Chi-Square test was used for statistical analysis. P < 0.05 was considered statistically significant.

Results

The median age of the study patients was 14 (0-17) years. Of the patients, 99.8% did not have any comorbidity and 96% presented with a good clinical condition. Of the patients, 91.1% were home-isolated and 6.9% developed pneumonia. Pneumonia developed at significantly higher rate in the age groups of 0-4 and 5-9 years compared with other age groups (p = 0.004). There was no significant difference in the development of pneumonia according to gender and comorbidity (p > 0.05).

Conclusions

The rate of pneumonia development was low in the study group. The clinical condition of most of the patients was good, and they isolated at home. Pneumonia developed at a higher rate in younger patients.

Key messages

COVID-19 has a milder prognosis in patients aged<18 years. Among the patients aged <18 years, pneumonia develops at a higher rate in younger patients.