bluuebunny/crossref_metadata_2025_split huggingface dataset:
Opportunities and barriers of creating healthy living environments – a Delphi Study
Authors: Leimann J , Kuchler M , Plantz C , Quilling E 
Published: October 2021

Abstract

Comprehensive intersectoral and participatory strategies are required for successful implementation and functioning of local health promotion governance across Europe. 12 experts from 7 European countries took part in the two-stage online Delphi survey. 22 theses on key topics of municipal health promotion, prepared in a participatory process through interviews and a workshop with experts, were rated on a 10-point Likert scale (strongly disagree - strongly agree), and the confidence in answering and comments was queried. This procedure was repeated in the 2nd round. The response behaviour of the participants from the 1st round was made transparent to enable changes in opinion. In the quantitative analysis, the distribution of thesis rating was determined. The extent of consensus building was determined by comparing standard deviations. The comments were evaluated and summarized by content analysis. The outcome of the Delphi survey represents consensus-generated recommendations for the creation of healthy living environments in the municipal context. Consensus was reached on most of the theses. The experts agree on the need for an open structure of networks (mean 9.2; SD 0.6), a common vision in these networks (mean 8.3; SD 0.8), the resources required for organizing participatory processes (mean 9.5; SD 0.9) and the responsibility of all political areas for implementing an overall municipal strategy (mean 9.1; SD 0.8). The qualitative analysis provides indications that certain theses are assessed differently due to country-specific experiences and conditions. The results of the Delphi study provide a clear direction for generating recommendations. Depending on context and country, some contents are evaluated differently, which should be taken into account for the recommendations. In total, the study identified recommendations with cross-national validity that are beneficial for the creation of health promoting structures at local level.
Did You Ever Imagine Yourself?
Authors: Kaade H 
Published: October 2021

Abstract
Moral injuries during wars and crises are likely to happen, especially in the health system. In 2016, the United Nations and Arab League Envoy to Syria put out an estimation that 400,000 that had died in the Syrian conflict, in which many medical personnel were also targeted. By 2016, more than 50% of the Syrian doctors have left the country. These circumstances are reflected in the amount of needs and gaps in the system. In addition the huge increase in the number of injuries has, unfortunately, in the end led to moral injuries. The aim of this talk is to share some of the scenarios that I passed through while working as a medical doctor during the Syrian war, in order to highlight the amount of pressure and the unexpected situations while being under moral pressures. Based on the personal experiences I endured during my clinical work in Aleppo, Syria, as a medical doctor during the war between 2013-2016, I will mention some scenarios that I have faced during my work there. Neither I nor other colleagues would have ever imagined to be in such hard situations or being forced to pass through such cases as a medical doctor. Based on the personal experiences I will identify the impact of wars on health care systems and workers, focusing on Syria as an example.
6.N. Workshop: The politics of credit and blame: centralizing/decentralizing governance in the COVID-19 pandemic
Authors:   Organised by: European Observatory,   Chair persons: Matthias Wismar (European Observatory)
Published: October 2021

Abstract

Objective
The overarching aim of this workshop is to use the theory of credit and blame politics to explain significant and dynamic shifts in power relations through centralization/decentralization within and between governments during the pandemic. Centralization is not just territorial but can also apply within government and change the extend of autonomy and influence ministers, departments and agencies have. To this end we will have a total of five presentations:
Introduction into the theory of politics of blame and credit as a driver for centralization/decentralization; three country case studies including Austria, the Czech Republic and France and a concluding presentation on Credit-taking, blame-avoidance as drivers for power shifts: implications for effective emergency responses

Background
Centralization between governments means an increase in the power of the central government vis-a-vis other ‘subnational' governments such as regions, states, provinces, or municipalities. ‘Command and control' is a common recommendation in public health emergencies (3) and central governments do often take powers over or away from subnational governments in crises. This is most politically contentious in federal states such Spain, Canada, or Germany, but can happen even in countries where there is a history of only local government (such as Ireland, Portugal, or the Nordic states).
This workshop is built on a forthcoming publication. To ensure interactivity, the chair will feed back comments to the speakers between presentations and before the end of the session.

Key messages
In COVID-19 responses credit-taking and blame-avoidance leads to major powershifts within and between governments. Emergency response planning, knowledge broker, media and civil society need to help mitigate the negative effects of credit-taking and blame avoidance for a better pandemic response.
Pandemic response credit-claiming and blame-avoidance in Czechia
Authors: Loblova O 
Published: October 2021

Abstract
Credit claiming led in Czechia during the first wave to centralization and during the summer to decentralization. During the second wave, blame-avoidance led again to centralization. First Wave: Similar to other Central and Eastern European countries, Czechia's number of cases and deaths per capita during the first wave were some of the lowest in Europe. The Czech Prime Minister, Andrej Babiš (of the centrist populist ANO) was in a good position to take credit for these results. While this level of centralization of power attracted some criticism, the unprecedented context as well as the undeniable results of the timely intervention translated into genuine political credit. The government's measures enjoyed overwhelming popular support: an April survey found 76% of respondents saw them as “adequate” (and 16% as too lenient). Summer: The Czech government relaxed measures relatively quickly, precipitated by judicial challenges to the procedural aspects of lockdown measures. Thanks to the low prevalence of COVID-19 in the country, rapid reopening did not lead to dramatic increases in infections. Between June and September, there were virtually no restrictions in Czechia. Second wave: In September, the PM admitted the extent to which restrictions had been eased during the summer was a mistake, but explained his decisions by “societal demand” and prioritizing the economy. Explicit blame avoidance strategy through decentralization of responsibility between governments came only one year into the pandemic. The government obliged and, unconstitutionally, declared a new state of emergency (24). In one weekend, a year after total centralization of responsibility for the pandemic, regional governors (mostly belonging to opposition parties) were co-opted into the government's blame game that crossed party lines, ahead of the October 2021 parliamentary elections.
Credit-taking, blame-avoidance as drivers for power shifts: implications for effective emergency responses
Authors: Greer S 
Published: October 2021

Abstract

In this presentation we summarize the results of the empirical research and draw conclusion for politics in the pandemic.
In the first wave, the ‘honeymoon' period of disaster phases coincided with a poorly understood and dramatic period of sinking cases in many countries. Heads of government saw the risk of massive blame- for failure to respond- and the chance of gaining credit for forceful responses. In the second wave, which hit most of Europe in October and spiked in November and December, blame was easier to find than credit. The honeymoon period of the pandemic was long over and disillusionment was likely to set in. Increasing case counts looked like a policy failure, and reinstated public health restrictions ran a higher risk of looking blameworthy. The result was incentive to take decisions tardily- avoiding blame as long as possible- and to try and shift blame onto others, notably by decentralizing responsibility. In the summer of 2020 case counts across Europe as a whole dropped to very low levels and pressure on health systems eased. As a result, Europe exited both a health care crisis and the solidaristic honeymoon phase in June. The temptation for policymakers was to declare a job well done and lift public health measures despite the ongoing risks. In particular, this could mean heads of government taking credit for lifting restrictions and shifting public health responsibilities back to ministries, agencies, and subnational governments.

Given the empirical evidence on credit taking and blame-avoidance has implications for pandemic preparedness, knowledge-brokering, media coverage and civil society. Policy makers reflex to seek credit and avoid blame needs to be mitigated to allow for adequate pandemic responses.
Impact of COVID-19 on hospital care, employment and mental health of people with Cystic Fibrosis
Authors: Bhatnagar R , Tecklenborg S , Segurado R , Fitzpatrick P 
Published: October 2021

Abstract

Background
The COVID-19 pandemic has been challenging for many but especially for people with pre-existing co-morbidities such as people with cystic fibrosis (PWCF). The aim of this study was to examine the impact of COVID-19 pandemic on hospital services access to essential medication, employment, and mental health of PWCF.

Methods
A cross-sectional survey developed by University College Dublin and Cystic Fibrosis Ireland was uploaded on SmartSurvey UK and advertised by CF Ireland to CF community via CFI website and social media in October 2020. Logistic Regression was used for analysis.

Results
119 PWCF participated. 56 (47.5%) deferred hospital visits for CF care from 1-6 months: (57.4%) to 3 months; 42.6% 4 months-over 6 months), due to hospital closure (11.5%) & fear (69.8%). When adjusted for gender and location, PWCF aged &lt;35 years were twice as likely to defer hospital visits as compared to those &gt;35 years (P = 0.048). Online consultation and prescription via email was new for &gt;50% of PWCF and &gt;80% found it useful. Amongst those who worked (46.2%), 87.2% (n = 48) worked from home during COVID19. More PWCF &lt;35 years (9.6%) worked onsite as compared to those &gt;35 years (1.9%). 95% of employers were sympathetic for PWCF who cocooned while working from home (41.7%), however, overall, approximately 1/3rd of all employers were considered unsympathetic. 24.4% found access to CF medications challenging and 7 (5.9%) had to find alternative. After adjustment for gender and working, PWCF &lt; 35 years were more likely to feel “nervous” (OR: 3.28; P = 0.017), “nothing could cheer them up” (OR: 3.24; P = 0.038) and “tired” (OR: 2.76; P = 0.016) compared to those &gt;35 years.

Conclusions
Fear was a strong reason for essential hospital visit deferrals in COVID19, but hospital closures played an important part also. Prescription by email was novel and popular. There has been a serious impact on the mental health of this vulnerable group.

Key messages
COVID-19 impacted hospital visits due to fear and hospital closures; younger PWCF deferred more and for longer. The negative impact of COVID-19 on mental health was more pronounced in older PWCF.
COVID-19 infection in ethnic minorities: A systematic review of age and gender distribution
Authors: Thompson B , Memon A 
Published: October 2021

Abstract

Background
Currently, there have been 135,646,617 cases of COVID-19 infection and 2,930,732 deaths in the world. Compared with the White populations, members of the ethnic minorities living in Europe and North America are disproportionately diagnosed, hospitalized and dying from COVID-19. The reasons for this relatively increased risk of infection and adverse outcome are poorly understood. The aim of this review is to summarise current epidemiological evidence on age and gender distribution in ethnic minority patients hospitalized with COVID-19 infection.

Methods
Multiple electronic databases were searched. Data from studies, published in any language, reporting the risk factors, incidence and outcomes of COVID-19 infection in hospitalized White and ethnic minorities patients were extracted, reviewed and compiled.

Results
36 studies reporting data on age and 26 on gender were included in the review. Ethnic minority patients hospitalized with COVID-19 were relatively younger than White patients. Within the different minority groups, a greater proportion of Black patients were female, whereas a greater proportion of Asian patients were male.

Conclusions
This review confirms findings from individual studies that with regard to age, the ethnic minority patients hospitalized with COVID-19 infection are relatively younger than the White patients. There is also a disparity with regard to gender within the different minority groups.

Key messages
There is a disparity with regard to age and gender between the different ethnic groups affected with COVID-19 infection in Europe and North America. Potential factors for disparities are genetics, vitamin D deficiency, BCG vaccine, comorbidities, occupation, social gradient, housing, PPE access and understanding/compliance to protection measures.
Introduction and purpose
Authors: Lyshol H , Bogaert P , Tolonen H , Schutte N , Pittet V 
Published: October 2021

Abstract
Dashboards are health information tools, made to illustrate specific indicator sets. They may demonstrate developments over time, geographic distribution, social inequalities or correlations between different factors, use a wide variety of infographics, and are generally updated very frequently. Dashboards can illustrate data for users without statistical knowledge, and are also useful data repositories for more proficient users. Dashboards are a modern approach to an old problem: data visualization. A well-known historical example is John Snow's mapping of cholera cases in London (1854). Current computer technology and the existence of the internet have made it possible to visualize health indicators in close to real time, and dashboards, like Dr Snow's map, are meant to, store, report and illustrate health indicators in order to affect policy. The indicators selected should be the ones amenable to change because their unsurpassed ability to monitor changing conditions and effects of interventions. Indicator selection is vital to set a baseline for such monitoring, and the indicators selected will of necessity be the ones where measures are taken in order to affect change.
Policy will influence the choice of indicators, but indicators will also influence the choice of policies, because these two are intimately intertwined. Dashboards, be they national or regional, open to the public or just open to professional groups, are important implements to reach the policy-making audience and to signal what is defined as important. Dashboards can help to formulate policies that will improve public health for all groups.
Examples and processes from national dashboards: Belgium and Kosovo
Authors: Leroy M 
Published: October 2021

Abstract
The official national COVID-19 dashboard of Belgium was first put online on 31 Dec 2020. 1 year later, it was composed of 12 pages, 35 indicators, 73 charts and 15 tables. Lots of decisions were taken to arrive there: the definition of the indicators, the charts, the pages, the hierarchical order of the information, the colors, the footnotes & annotations... How were all of these decided? Who influenced the decisions and what was the dynamic with the decision makers and the general public? And how did it change over time? What are the particularities of the Belgian dashboard? What makes it different from the dashboard of Kosovo? What are the lessons learned and how would it be different if started from scratch?
Using personalised avatars as an adjunct to a weight loss management programme: A feasibility study
Authors: Horne M , Hardy M , Murrells T , Ugail H , Hill A 
Published: October 2021

Abstract

Background
Obesity is a global public health concern. Interventions rely predominantly on managing dietary intake and/or increasing physical activity but sustained adherence is often poor. A lack motivation, self-efficacy and poor adherence to behavioural regimens are recognized barriers to successful weight loss. Avatar-based interventions have been found to achieve better patient outcomes managing chronic conditions by promoting more active engagement. We aimed to evaluate if a personalized avatar, as an adjunct to a routine weight-loss programme, could increase motivation, sustain engagement and improve health outcomes.

Methods
A feasibility randomised design. Participants were recruited from a community-based, 12-week NHS weight improvement programme. Main outcome measure was weight loss. Quantitative data were subjected to descriptive statistical tests and comparison between intervention/control arms. Acceptability was assessed through interviews and analysed using framework approach.

Results
10 males (7-intervention; 3-routine); 33 females (23-intervention; 10-routine) were recruited. Initial mean weight was greater in intervention than routine arm (126.3 kg vs 122.9 kg); pattern of weight loss was similar across both arms in period T0-T1 but accelerated in period T1-T2 for intervention participants, suggesting that access to the personalized avatar may promote greater engagement with weight-loss initiatives in the short-to-medium term. Quality-of-life and self-efficacy measures demonstrated greater improvement in the intervention arm at both T1 (105.5 routine; 99.7 intervention) and T2 (100.1 routine; 81.2 intervention). N = 13 participants, n = 2 healthcare professionals were interviewed about their experience of using the avatar programme. Overall, participants found the intervention acceptable.

Conclusions
Avatar technology may successfully promote engagement and motivation in a weight-loss programmes, enabling participants to achieve greater weight-loss.

Key messages
The implementation of a personalised avatar as an adjunct to a weight management programme was both feasible and acceptable. Avatar technology may successfully promote engagement and motivation in weight loss programmes.
Digitalizing quality of care control: a Business Intelligence system for COVID-19 inpatients
Authors: Ovchinnikov DA , Potapov IV , Kurapeev DI , Vashenkov VV , Konradi AO 
Published: October 2021

Abstract

Issue
As healthcare systems faced the challenge of the COVID-19, the need for fast and automated quality of care control has grown tremendously. Automatization is widely implemented in the form of Clinical Decision Support Systems (CDS), however, developing such software can take several years of trained IT specialists' work.

Description of the problem
We opted for an analytics and clinical decision support (ACDS) system based on Business Intelligence (BI) software, since it would allow to monitor the necessary clinical data, it was easy to adapt to current tasks and didn't require any special IT-educated specialists to develop and implement. From an individual patient's electronic health record (EHR) was extracted specific clinical data, such as vital signs, laboratory tests and CT scans, respiratory support data; medication prescribed and taken; chronic diseases, etc. Microsoft Power BI software was used to build the ACDS.
The ACDS system consisted of three main elements:
Flat tables (the data from EHR); Data model, connecting tables; Visualizations (tables and charts) depicting patients' condition, which provided the integration of information, the ability to sort data in necessary order, and intuitive marks, such as color indicators for specific parameter values.

Results
Named visualizations were integrated in daily work of the heads of units. Out of 1683 patients admitted with COVID-19, 1415 were undergoing treatment after implementation of ACDS system. It was used to correct the treatment course of 568 patients.
The following corrections were made:
Accuracy of diagnosis (138 cases) and assigned severity (115) Prescribed and delivered medicines (32) Dosage adjustment (25) Transfer to ICU (2) Discharge (412)

Lessons
Thus, engineering analytical and clinical decision support system based on BI appears to be an advantageous way to automate the control of care quality in challenging and time-pressing circumstances.

Key messages
In a situation of unprecedented time pressure and resource shortage, the best option for quality of care control might be a simple BI system, rather than a designated CDS software. The practice of COVID-19 analytics system implementation can become a foundation for designing a bigger transparent analytics system that can be adapted to any patient model or clinical entity.
The public health potential of two popular apps to increase physical activity
Authors: Bondaronek P , Slee A , Hamilton F , Murray E 
Published: October 2021

Abstract

Background
The rise of health apps created novel prospects for public health intervention on a wide scale. Despite the popularity of publicly available physical activity (PA) apps, little is known about their effectiveness. This study aimed to investigate the potential of the apps to increase PA. The objectives were: 1) to determine the feasibility of the trial, 2) explore the effects of the apps on behavioural and psychological outcomes

Methods
Feasibility randomised crossover trial of two popular apps. Inactive adults residing in London (UK) were eligible. The two interventions were: App A - 7 Minute Workout Challenge by Fitness Guide Inc., App B - One You Couch to 5k by Public Health England. After 1-week run-in period, participants were randomly allocated to one of the two assessment sequence (App A, B or App B, A).

Results
Out of 104 participants who were eligible and consented, 63.5% (66/104) were enrolled and randomised. The primary analysis of the accelerometer data showed that there were no significant differences between baseline and the interventions using the continuous variables. Sixteen of 51 participants (31.4%) increased their time in moderate to vigorous PA (MVPA) by 20% from baseline following the introduction of the intervention (95% CI = 19.1% to 45.39). Self-reported PA outcomes showed significant increase and sedentary behaviour decreased. Exercise self-efficacy and intentions increased whilst PA outcome expectancy decreased.

Conclusions
The impact of this two PA apps showed promising results with an impact observed for 20% increase in MVPA, self-reported PA, intentions and exercise self-efficacy. Yet, there was a variability in the outcomes observed.

Key messages
This pragmatic trial with participants classed as inactive showed that physical activity apps can increase physical activity. There was a variability of the physical activity outcome and there is a need to tailor digital tools to the users to impact physical activity on a wide scale.