bluuebunny/crossref_metadata_2025_split huggingface dataset:
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

Abstract

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

Abstract

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

Abstract

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

Abstract
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

Abstract
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

Abstract

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

Abstract

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

Abstract

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

Abstract

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 &lt; 0.001), in the patients aged &gt;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 &gt;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

Abstract
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

Abstract

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.