bluuebunny/crossref_metadata_2025_split huggingface dataset:
Global comparison of mitigation and vaccine behaviours, motivators, and communication
Authors: Lavoie KL , Stojanovic J , Bacon SL ,   for the iCARE study team
Published: October 2021

Abstract

Issue/problem
In an unprecedented effort to end the pandemic, national mitigations strategies have been implemented and highly effective vaccines have been developed and rolled out in record time. Success of many of these public health endeavors is contingent upon people being willing to engage in proposed behaviours.

Description of the problem
The key to slowing the spread of COVID-19 and ending the pandemic, is public adherence to the rapidly evolving behaviour-based government policies. However, adherence to these policies involves implementing behaviour changes that may come with significant personal, social and economic costs. In addition, public health vaccination campaigns are widely available, and the success of these initiatives is dependent on the behaviour of people getting the vaccine. Understanding the determinants of adherence at each phase of the infection curve around the world is critical for effective policy planning and communication.

Results
The results of the global iCARE study demonstrated a substantial level of national variations, when it comes to engaging in preventive behaviours (social distancing, mask-wearing, hand-washing, self-isolating). Moreover, we observed increasing levels of COVID-19 vaccine hesitancy across several countries. Adherence to these behaviours seems to be driven by socio-demographic (e.g., age, sex, gender, ethnicity, parental status, employment/ student status, built environment, healthcare system factors), psychological (e.g., COVID-19 attitudes, beliefs and concerns), behavioural, physical/mental health, and economic factors.

Lessons
iCARE study offers deeper understanding and continuous assessment of the predictors of behavioural adherence globally. To this end, the study identified possible communication targets, and proposes tailoring the format and the content of the communication, which should be consistent, prioritize equity, foster transparency and trust-building in different communities.
A Tale of Two Pandemics in Three Countries
Authors: Saboga-Nunes L , Peralta-Santos A , Magalhães PC 
Published: October 2021

Abstract

Issue
Italy, Spain, and Portugal's health systems are financed through general taxation, are generally free at the point of care, and provide universal health coverage. The three national health systems emerged in the late 1970s, in Italy as the result of the collapse of the previous social health insurance system and in Spain and Portugal as part of their democratization. They share some standard organizational and performance features that constitute potential strengths and vulnerabilities when facing a pandemic event.

Description
One of the most salient of these features is the impact of a decade of fiscal austerity. During the Great Recession and the Eurozone crisis, the governments of Italy, Spain, and Portugal decreased the budget available for health care, leading to cuts in long-term infrastructure investments and making it even more difficult to deal with the problem of workforce.

Results
Compared with northern European countries, these countries have very efficient healthcare systems. In other words, the return in terms of population health is very good for every Euro invested.

Lessons
However, in what is only apparently a paradox, efficiency is not an advantage during a pandemic. If all the resources are fully optimized, any significant surges in demand, such as those experienced during early March 2020 in Italy and Spain, this favors a collapse of the health system. Portugal seemed especially vulnerable, as it had the lowest number of intensive care unit beds per inhabitant in Europe and one of the lowest levels of investment in public health services in Europe.

Main messages
In 2015, on average, the countries of the Organization for Economic Co-operation and Development (OECD) allocated 2.8 percent of their total healthcare budget to health promotion and disease prevention. More investment in health promotion is a need strategy to drive countries over critical conditions.
Machine learning and COVID-19: a tool for healthcare setting choice by primary care physicians
Authors: Vetrugno G , Foti F , Di Pumpo M , Cicconi M , D'Ambrosio F , La Milia DI , Pastorino R , Boccia S , Damiani G , Laurenti P 
Published: October 2021

Abstract

Background
Primary care physicians have a crucial role in determining the appropriate healthcare setting for their confirmed or suspect COVID-19 patients. Machine learning provides science-based tools that can be used for clinical decision-making which have already been applied to the fight against Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) both in the therapeutic and the prevention area. The aim of this study was to develop a machine learning-based tool to support primary care physicians to decide between home monitoring and hospitalization for their patients before diagnostic test results are available.

Methods
A retrospective cohort study with data from a hospital setting was performed. Patients' medical history and clinical, laboratory and radiological findings were collected and the dataset was used to train a predictive model for COVID-19 severity. The patients were divided between confirmed and suspect cases on the basis of the positivity of the nasopharyngeal RT-PCR test results. A splitting algorithm was recursively used to choose the predictor. A decision tree was built.

Results
A total of 198 subjects were enrolled for the study. Out of them, 28 cases were classified as mild disease, 62 as moderate disease, 64 as severe disease, and 44 as critical disease, according to WHO guidelines. The G2 value was used to determine the contribution of each obtained value to build the decision tree. The tree was, therefore, built choosing values that maximized G2 and LogWorth. SpO2 (cut point = 92%) was chosen for the optimal first split. The correspondence between inputs and outcomes was validated.

Conclusions
Our tool provides accurate clinical severity prediction for both confirmed and suspect COVID-19 patients. We, therefore, propose its implementation in the everyday life challenges of primary care physicians to support their clinical decision-making in providing appropriate and timely care for their patients.

Key messages
Primary care physicians have a crucial role in determining the appropriate healthcare setting for their confirmed or suspect COVID-19 patients. We propose a tool that provides an accurate clinical severity prediction for both confirmed and suspect COVID-19 patients to help choosing the appropriate healthcare setting for them.
Poverty and energy issues as environmental and health challenges in SDGs
Authors: Jevtic M , Matkovic V , Bouland C 
Published: October 2021

Abstract
In 2019, 21.1 % of the EU-27 population were at risk of poverty or social exclusion. Energy poverty is one of many poverty forms and it is a widespread problem across Europe, as between 50 and 125 million people are unable to afford proper indoor thermal comfort. Energy poverty is linked to low household income, high energy costs and energy inefficient homes. These challenges are deeply connected with SDG7 and SDG1, and also produce environmental pollution. The roots of energy poverty are in polluting fuels that are the cheapest and at hand to the population in (risk of) poverty. Biomass heating is the inefficient use in old stoves and the lack of wood drying before use (the loss of up to 50% of the energy and higher energy costs of heating). Biomass and coal is also a major contributor to poor air quality in many European regions, especially in eastern part of the EU and Western Balkans. Biomass smoke contains health-damaging substances (particulate matter, PAHs etc). Studies on indoor air pollution show concentrations of PM10 may extremely exceed standards for ambient air pollution levels and put the people (mostly women and children), at increased risk of health impacts. Biomass burning also leads to the release of black carbon, which is not only a concern for health, but also as short-lived climate change forcer (SDG 13). A conservative estimate of the current contribution of biomass smoke to premature mortality in Europe amounts to at least 40,000 deaths per year. The inefficient use of the biomass means higher costs for already ‘disadvantaged' citizens and those in risk of (energy) poverty. Energy poverty is a distinct form of poverty associated with a range of adverse consequences for people's health and wellbeing (respiratory diseases, CVD, mental health, and stress associated with unaffordable energy bills). Poverty and energy issues as environmental and health challenges should seen through SDG 1 and SDG 7, but also through SDG 8, SDG1 1 and SD G3.
The experience of the Center for Medicare and Medicaid Innovation (USA)
Authors: Bassano Amy 
Published: October 2021

Abstract
Since 2010, the CMMI has been testing new payment and service delivery models, evaluating the results and advancing best practices, and engaging with a broad range of stakeholders to develop additional models for testing. This presentation will showcase over 10 years of experience in managing an innovation funding programme, allowing for an interesting comparison to their European counterparts.
Action Plan on Women's Health' with 40 measures for women's health in Austria (2018) – From reporting to action
Authors: Gaiswinkler S 
Published: October 2021

Abstract

Background
4,5 million women are living in Austria, in different life-phases and living conditions. Women's health situations, health-related behaviour and disease courses differ from men. The Austrian Action Plan on Women's Health addresses the need to increase equal health opportunities for women.

Methods
The Action Plan is developed by a broad, multidimensional, cross-political (HiAP) process with around 50 experts and organizations. A survey at the beginning provided the basis for identifying issues of health that affect “only women, mainly women or women differently”. Goals and measures are based on 8 socio-economic principles and connected to WH&Oacute;s Strategy on Women's Health. The outlined actions are following three life-phases of women (girls/young women, working age, older women) and include one age-spanning focus.

Results
The Action Plan addresses all women in Austria. It includes measures in the fields of research, care, health literacy, women-related diseases (e.g. cervical and breast cancer), sexual-reproductive health or mental health. It is also strongly emphasizing socio-economic determinants that influence health outcomes. Within 17 goals and 40 measures disadvantaged women (e.g. migrant women, women affected by poverty and violence, disabled women) are prioritizes. Measures also target women-related working conditions like the distribution of paid and unpaid work.

Conclusions
The Action Plan was presented by the Austrian Minister of Health in 2017 at the 1st Women's Health Dialogue. The implementation is carried by a triangle of pillars: Focal Points in each federal state as coordination link, Focal Point Meetings for expert exchange and once a year a Women's Health Dialogue. The strategy provides a structure of experts on womeńs health, drives the implementation of measures and supports activities for raising the awareness on sex and gender-related health-issues.
Spectacle wear and refractive errors in Dutch children
Authors: Iyer V , Enthoven CA , van Dommelen P , Samkar A van , Groenewoud JH , Reijneveld SA , Jaddoe VWV , Klaver CCW 
Published: October 2021

Abstract

Background
Myopia is a refractive error that is increasing dramatically all over the world. Early onset is associated with a significant visual burden later in life, but little is known about refractive errors in preschool children. The aim of this study was to assess prevalence of spectacle wear, visual acuity and refractive errors in young Dutch children and to make global comparisons.

Methods
We analyzed data of three prospective population-based studies: 99,660 3- to 5-year-olds undergoing vision screening at preventive child healthcare organizations, 6,934 6-year-olds from the Generation R study, and 2,974 7-year-olds from the RAMSES study. Visual acuity was measured with Landolt-C or LEA charts, spectacle wear was assessed, and refractive errors at age 6 and 7 were measured with cycloplegic refraction. Spectacle wear was compared with international studies.

Results
The prevalence of spectacle wear was 1.5%, 2.3%, 6.6%, 8.2% and 11.8% at 36, 45, 60, 72 and 84 months, respectively, with no major sex differences. Among children with spectacle wear at 72 months (N = 583) and 84 months (N = 351) 29.8% and 34.6% had myopia respectively, of which 21.1% and 21.6% combined with astigmatism, 19.6% and 6.8% had hyperopia, 37.2% and 11.1% hyperopia and astigmatism, and 12.5% and 33.3% astigmatism only. The prevalence of spectacle wear globally varied between 1.5% to 21%.

Conclusions
Spectacle wear in these European children started early in preschool and increased to substantial figures at school age. Among children with spectacle wear, &gt;30% were already myopic, illustrating the urgency to implement myopia prevention strategies in child health centers.

Key messages
Early onset myopia is a public health issue. Of the 6- to 7-year-olds with spectacles 30-34% were already myopic. Monitoring of refractive errors and preventive lifestyle interventions are warranted.
Discrimination impairs cognitive function in ageing men and women
Authors: Lindert J , Paul K , Lachman M , Ritz B , Seeman T 
Published: October 2021

Abstract

Background
We sought to assess changes in episodic memory and executive functioning among men and women in the Midlife in the United States (MIDUS) cohort study; and to delineate variations in episodic memory and executive functioning by gender; and to determine the impact of discrimination on longitudinal changes in episodic memory and executive functioning.

Methods
We used data from the MIDUS study - a national probability sample of non-institutionalized, English speaking respondents aged 25-74 living in the 48 contiguous states of the United States. The initial wave in our study (1995) included 4963 non-institutionalized adults aged 32 to 84 (M = 55, SD = 12.4). Dependent variables are episodic memory and executive functioning, assessed with the Brief Test for Cognition. The independent variables were discrimination (lifetime and daily discrimination) variables. Furthermore, we investigated baseline cognition score, race/ethnicity (White, Hispanic, other), education (some college or more vs high school of less), whether or not living with partner, income (per 100% above Federal Poverty Level), unemployed (vs employed), retired (vs employed), physical health (self-reported), vigorous physical activity, depression (continuous scale), anxiety (continuous scale). To assess cognition changes we estimated adjusted linear regression models.

Results
Cross-sectional, work discrimination was associated with cognition in men and women. Longitudinally, adjusting for baseline cognition score, race/ethnicity, education, living situation, income, (un)employed, (not)retired, physical health, vigorous physical activity, depression, and anxiety, we found an association of family strain with cognition changes in high-income men, and an association of daily discrimination with cognition changes in men (Beta 0.01, P-value: 0.001).

Conclusions
Reducing discrimination might be an important measure to support cognitive function in ageing populations.
11.A. Skills building seminar: A new framework for developing and evaluating complex interventions
Authors:   Organised by: EUPHA-EPI,   Chair persons: Laurence Moore (UK), Kathryn Skivington (UK)
Published: October 2021

Abstract

The new MRC/NIHR Framework for Developing and Evaluating Complex Interventions will be introduced (by the authors) for participants to consider using to support their own complex intervention research. This Framework provides updated recommendations on the key considerations and phases of complex intervention research. Previous versions of the framework have been widely used internationally, but there have been many methodological and theoretical developments since they were published. This workshop will provide an overview of the new framework, with further worked examples. The workshop will include time for questions and discussion and support participants to think about how to approach their own complex intervention research.
The workshop will consist of two 20 minute presentations providing information on a different aspect of our new Framework, and this, alongside questions and discussion, will support attendees to:
Consider what makes interventions complex and how this complexity could usefully be handled in intervention research. Critically evaluate and contrast the utility and role of different research perspectives. Understand the core elements of complex intervention research.
At the end of each presentation, we will pose questions related to our Framework's checklist to the audience for their own consideration. As well as having the chat feature enabled and monitored throughout, we will use interactive software, e.g. mentimeter, to allow engagement beyond the question/answer session.

Key messages
The workshop will enable participants to apply the new MRC/NIHR framework for developing and evaluating complex interventions to their own research. Interactive sessions will explore the concepts underpinning the new framework and the practicalities of applying it to specific cases.
Healthcare use of COVID-19 patients within 3 months of diagnosis and associated factors
Authors: Siyve N , Emecen AN , Keskin S , Basoğlu E , Turunc O , Suner AF , Unal B 
Published: October 2021

Abstract

Background and aim
Healthcare utilization of the population changed by the COVID-19 pandemic. There is limited research on the healthcare use of COVID-19 patients. This study aimed to describe the healthcare use of COVID-19 patients within 3 months after diagnosis and to investigate the associated factors.

Methods
Patients older than 18-years who tested positive for SARS-CoV-2 RNA in Dokuz Eylül University Hospital-Turkey in November and December 2020 (n = 3597) were included in this retrospective cohort study. In total, data from 2978 patients were analyzed. Data were collected through telephone interviews. Dependent variables were patient-reported general healthcare use and COVID-19 related healthcare use within 3 months of follow-up. Age, gender, chronic disease history, number of initial symptoms, and hospitalization status were independent variables. Chi-square was used to compare categorical variables. Univariate and multivariate (backward elimination method) logistic regression models were conducted to identify predictive factors.

Results
In total, 32% of the cases sought healthcare within three months of diagnosis while 11.4% of the visits were due to COVID-19. The most common outpatient visits related to COVID-19 included chest diseases (30.3%), the emergency room (29.1%), and internal medicine (16.2%). Backward stepwise selection identified female gender (OR = 1.23, 1.05-1.44), having more than 3 comorbidities (OR = 2.64, 1.95-3.56), hospitalization (OR = 1.54, 1.16-2.03) for general healthcare use, and having more than 5 symptoms (OR = 1.52, 1.13-2.04), having more than 3 comorbidities (OR = 1.65, 1.09-2.43), hospitalization (OR = 1.77, 1.22-2.51) for COVID-19 related healthcare use.

Conclusions
Having comorbidities, the number of initial symptoms, and the need for hospitalization are the main determinants of general and COVID-19 related health care use in three months of COVID-19 infection.

Key messages
Indicators of severe clinical conditions are the main determinants of general and COVID-19 related healthcare use in the post COVID-19 patients. Healthcare resource planning should consider the needs of post COVID-19 patients.
COVID-19 government response measures: analysis in the European Union
Authors: Pinheiro V 
Published: October 2021

Abstract

Introduction
The global spread of COVID-19 has led to a wide range of responses from governments, including in the European Union (EU). Measures involve travel restrictions, school closings, bans on public gatherings, emergency investments in healthcare, contact tracing and social welfare. However, responses have varied in scope, stringency and timing. The aim of this study was to analyse government response measures in the EU and differences across EU countries, in 2020.

Methods
Using Oxford COVID-19 Government Response Tracker indices (Stringency Index, Containment and Health Index, Economic Support Index, Overall Government Response Index; all scored 1-100), estimates were analysed for the EU and each country, in 2020.

Results
While the Stringency, Overall Government Response and Containment and Health indices were generally in line with COVID-19 incidence progression (peak in April-May, decrease in the summer, new increase in the fall and second peak in November-December), for all EU countries, the Economic Support Index showed heterogeneous patterns between countries. In the EU, the Stringency Index ranged from 1,85 to 96,30 (median:54,63; SD:21,07), the highest median in Ireland and the lowest Croatia. The Containment and Health Index ranged from 1,92 to 84,29 (median:52,88; SD:17,77), again with Ireland showing the highest median, but this time, Estonia the lowest. For the Economic Support Index, ranging from 12,50 to 100 (median:75,00;SD:20,36), Cyprus had the highest median, and Germany the lowest. The Overall Government Response Index ranged from 1,67 to 83,78 (median:55,83; SD:18,36), with the highest median in Cyprus and the lowest in Estonia.

Conclusions
There was wide variation in response measures across the EU countries, in 2020. The Economic Support Index showed quite a different pattern compared to the other ones. Understanding these trends and patterns allows for mutual learning and better preparedness for future pandemics.

Key messages
There was wide variation in response measures across the EU in 2020, especially in economic support. Understanding these patterns allows for better preparedness in future pandemics.