bluuebunny/crossref_metadata_2025_split huggingface dataset:
Shaping health together: practice from the project I-CARE-SMART
Authors: Loeffler K , Pettinger V 
Published: October 2021

Abstract

Issue
In Austria 28% of the total population are over 60 years. In 2050 this number will increase up to 34%. Considering the growth of the elderly population, their needs should be include in the development of products and services from the beginning using co-creation methods. In the ongoing EU-funded project I-CARE-SMART the aim is an implementation of co-creation in product and service development for elderly people. Therefore a service should be built in the region to support start-ups, companies and service providers using co-creation. This service will be validated collecting patterns of seniors needs that are the basis of regional pilot actions.

Description
The project worked with a mixed approach of qualitative and quantitative methods. The results from a literature research were used as a basis for a co-creation approach with seniors discussing their needs for a self-determined life by using the Value Proposition Canvas. Additionally, journal entries were used describing their daily challenges in living self-determined at home. All results were resumed in a Design Thinking Workshop with experts to define 4 use cases/personas describing specific needs of seniors for the regional pilot actions.

Results
The 4 use cases were used in a regional and international call for proposals for businesses, start-ups and service providers. The winners of the call are offered a platform to work on social innovation for and with elderly people in a ongoing co-creation process for several months from 04/2021 to 09/2021 to develop customer-oriented solutions.

Lessons
Effects that can be achieved by means of co-creation in public health should not be underestimated. Not only the promotion of self-determination and satisfaction, but also cost savings for the health care system have already been demonstrated. Co-creation should be part of public health, the development of assistive technologies for patients and seniors as well as in the further development of health services.

Key messages
Co-Creation services should be part of research, design and development of solutions for elderly people. The idea of co-creation in health care is by no means new, but it is definitely forward-looking and has experienced a new upswing with the movements around co-creation of health.
Food business operator risk categorization
Authors: Colarusso G , Mazzone P , Peirce E , Pellicanò R , Della Rotonda M , Di Loria G , Baldi L , Mandato D 
Published: October 2021

Abstract

Issue
EU Reg 625/2017 establishes that all Food Business Operator FBO needs to be categorised based on risk. The risk rating is obtained by summing the scores of the non-conformities and risk factors checked.

Description of the problem
In the past, various categorisation systems have been used but due to many FBO present in the regional territory, a new system of categorisation rapid and efficient is required.

Results
The system classifies the risk of FBO in two phases: the first, based on static criteria (type and volume of production, market areas), in which a default category is established; the second, based on dynamic and technical criteria (provisions and scores of official control, structural and productive features), in which a definitive category is established. When a FBO is set up, it presents a declaration of start-up that included the static criteria: a preliminary risk category is determined. The authorities assign a definitive rating by a complex inspection, during which specific check-lists of the dynamic and technical criteria are completed. Each element is assigned a percentage weight, which contributes to the risk assessment, and so to the frequency of controls. A value &gt;70% means high risk and 1 control per year; a value of 69.9-50% means medium risk and 1 control every 2 year; a value of 59.9-30% means low risk and 1 control every 3 years, and a value &lt;29.9% indicates a negligible risk and controls on demand. In the period between 2 inspections, the score will be updated by the outcomes of any other official controls. The rating is updated according to favourable or unfavourable outcome.

Lessons
In addition to being efficacious and efficient, this new system of categorisation optimises the work of the authorities.

Key messages
This new categorisation system makes risk-based controls simpler and more efficacious. The project involves various Italian regions and the OECD, thereby enabling official controls to be standardised at the European level.
The most challenging COVID19 phases and the skills healthcare leaders need to face the pandemic
Authors: Scarpis E , Bravo G , Cocconi R , Brunelli L 
Published: October 2021

Abstract

Introduction
Coronavirus disease 2019 (COVID19) pandemic is the most significant public health threat of the century, a crisis that have been challenging healthcare systems around the world. Assessment of leadership skills is needed in order to identify attributes of successful leadership during public health emergencies. This study aims to highlight the critical role played by healthcare leaders during this pandemic, assessing the most challenging and demanding phases of the health crisis and the characteristics required for a healthcare leader.

Methods
A cross-sectional survey was carried out between October and November 2020, using online questionnaires, involving medical and nursing leaders working in the healthcare organizations of the Friuli-Venezia Giulia Region (Northeast of Italy). Professionals from hospital, community setting and regional level were asked about the two most challenging phases of the current pandemic among: crisis early recognition, peak of the emergency phase, declining epidemic, long tail. The most important healthcare leaders' skills were investigated among competence, awareness, communication, decision-making, inspiring trust and data interpretation.

Results
A total of 48 healthcare leaders participated. Women were 56.3%. Mean age was 53.4±7.9. According to the leaders interviewed, the two most challenging phases of such crisis were crisis early recognition (45%) and the peak phase (31%). Lesser important phases were recognized in the declining epidemic (15%) and the long tail phases (8%). Concerning healthcare leaders' skills required to manage with pandemic, the most reported were communication (35%) and decision-making (26%); while lower importance was identified in inspiring confidence (5%).

Conclusions
The two most challenging phases identified by this study suggested the importance of public health surveillance and monitoring systems. Communication appeared a critical success factor for leaders in public health emergencies.

Key messages
Early recognition of the crisis and the emergency peak management are considered the most challenging phases of the COVID19 pandemic by healthcare leaders. Ability to communicate and decision-making emerged as the two most important crisis skills, and should be included among public health leaders core competencies.
Primary care health actions to homeless people during covid-19:an experience report
Authors: Schettino R , Simim D , Soares S , Almeida S , Castro V 
Published: October 2021

Abstract

Objective
Experience report by professionals from Basic Health Care Centers working with homeless people during COVID-19 pandemic.

Methods
Descriptive and reflexive study by professionals and Nursing professors and academics.

Results and discussion
Professionals experience challenges when facing the pandemic considering the life conditions and misinformation of homeless people about COVID-19.Brazil's Unified Public Health System needs to take some measures to promote social distancing, access to toilets, mask and food distribution. Meetings with health teams and clinic on the street teams were held to organize care according to local reality, infrastructure, and users' flow. In a similar vein, intra and intersectoral articulations for joint actions on the street were articulated to provide access to health care and social assistance, and to accommodate and care for those presenting respiratory symptoms till improvement of the condition. Reorganizing actions is a dynamic process because each epidemiological stage demands new strategies as the pandemic advances or recedes. Attendance at Basic Health Care Centers was defined as priority:suspected COVID-19 cases and people with mental suffering or chronic disease.These people were identified to have face-to-face consultations or teleconsultations. In this sense, therapeutic interruption and worsening of conditions were avoided. Some management challenges are listed:information dynamics, the need to publicize, to qualify professionals and to articulate the network;care with the health team, keep away professionals from the group of risk and COVID-19 confirmed cases;training demands, input assurance, and agendas;electronic means to share information and to keep collegiate management.

Conclusions
To face COVID-19 and to work with homeless people it becomes fundamental to share challenges and caring strategies to minimize impacts.Health professionals perform to sensitize users according to their life experiences and singularities.

Key messages
The caring process is built through dialog and reflection. It is of utmost importance to make the population aware of the COVID-19 prevention.
Pediatric outpatient care during the COVID-19 pandemic: Results of a qualitative interview study
Authors: von Sommoggy J , Grepmeier EM , Curbach J 
Published: October 2021

Abstract

Background
Pediatric outpatient care in Germany is significantly affected by the COVID-19 pandemic. The study aims at exploring the subjective views of pediatricians on changes in their routine healthcare work during the COVID-19 pandemic.

Methods
19 qualitative semi-standardized telephone interviews were conducted with pediatricians in Germany. The interviews were audio-recorded, transcribed verbatim and analyzed based on qualitative content analysis (Kuckartz 2012) using QDA software (Atlas.ti, V8).

Results
COVID-19 infection protection measures induce substantial changes in the pediatricians' work, e.g. separating infectious and non-infectious patients, re-structuring appointments and practice setting and wearing PPE. Some interviewees emphasize that re-structuring measures have set positive impulses for the future. Wearing face masks is difficult when communicating with infants and children with psychosocial issues. Pediatricians feel well-informed on COVID-19-related health information but find it challenging to constantly re-adjust their professional position based on the rapidly changing official recommendations. This also makes it difficult to communicate COVID-19-related information to their often insecure patients. The pediatricians are concerned about a changed (degree of capacity) utilization: Preventive appointments are utilized almost as before, however, parental fear of visiting the practice and infection protection measures in the children's living environments have led to a significant decline in utilization for mild infections. While some pediatricians appreciate this as a relief of workload, others experience severe financial distress.

Conclusions
The decline in healthcare utilization for mild infections and the resulting financial distress call for health policy measures in order to ensure comprehensive pediatric care in the future. Positive experiences regarding the pediatric practice should be spread as “best practices”.

Key messages
Pediatricians in outpatient care in Germany experience substantial changes in their routine work due to the COVID-19 pandemic, e.g. practice organization and infection protection measures. They are especially affected by rapidly changing official recommendations and a changed (degree of capacity) utilization.
The COVID-19 policy response in Spain and Portugal: a study of measures to slow down infection rate
Authors: Nogales Crespo K , Muniz Rocha J , Vázquez M , Ricoca Peixoto V , Dias S 
Published: October 2021

Abstract

Background
The COVID-19 global pandemic triggered massive policy responses worldwide. Measures taken during the pandemic differed across countries and time. Governance systems may influence the capacity of countries to respond promptly and mobilize the necessary resources in time. Identifying measures and when they appeared are critical questions to assess emergency response strategies. The objective of this study was to analyze the policy response to slow down the infection rate of COVID-19 cases in Portugal and Spain according to timing (related to death rates) and stringency.

Methods
A descriptive comparative study of non-pharmaceutical interventions was conducted through a content analysis of policies and records review of official government sources. Portugal and Spain were selected considering the similarities between national health systems, but different government organization and epidemic impact. The Autonomous Community of Madrid was also included as example of subnational systems. Death rates were retrieved from daily statistics of open secondary sources.

Results
Results show that countries responded with a complex mix of measures across policy sectors, following dynamic patterns established by the epidemic evolution and governance systems. Policies aimed to reduce the spread of the virus, enable individuals and businesses to comply with restrictions, and reinforce National Health System's capacity. The declaration of state of emergency was a critical tool to organize actions under clear leadership, especially in devolved contexts.

Conclusions
Our findings suggest that, in early epidemic phases, a centralized command can be more effective at timely enacting nationwide stringent measures. Evidence from this study contributes to the argument that a fast, robust, and early response might have been more effective at containing spread at the initial stages of the pandemic.

Key messages
The policy response included measured to reduce spread of infection, enhance adherence and strengthen health systems capacity to deal with the pandemic. The declaration of state of emergency was essential to ensure an organized, coherent, timely, and robust response, especially in devolved contexts.
The association between face mask use and SARS-CoV-2 RNA viral clearance: A cohort study in Tunisia
Authors: Ben Nasrallah C , Zemni I , Charrada I , Dhouib W , Ben Hassine D , Abroug H , Ben Fredj M , Kacem M , Bouanene I , Belguith Sriha A 
Published: October 2021

Abstract

Background
The outbreak of coronavirus disease (COVID-19) continues to constitute an international public health concern. Scientific evidence showed that community mask wearing is an effective nonpharmacologic intervention to reduce the spread of this infection. However, few data are available about the effect of face masking on the duration of the disease. We aimed to study the association between recovery time among a Tunisian cohort of COVID-19 confirmed patients and mask wearing.

Methods
A prospective cohort study was conducted from March to July 2020 including patients with COVID-19 admitted to the Tunisian national containment center. Data were collected via phone call interview. Kaplan-Meir Methods and Cox proportional hazards regression models were, respectively, used to study the association between recovery time and face masks use.

Results
Among the 264 patients included, the median duration of viral clearance was 20 days (interquartile range (IQR 17-32days)). The median time to RNA viral conversion was 18 days (IQR 16-21 days) when using masks versus 23 days (IQR17-36 days) without wearing masks. Face masks use was significantly associated with an accelerated RNA clearance of SARS-CoV-2 (HR 2.006, 95% CI 1.247-3.228) (p = 0.004).

Conclusions
With the emergence of new variants, it is important to adopt widespread mask wearing to avoid SARS-CoV-2 infection and accelerate RNA negative conversion, until effective levels of vaccination are achieved nationally.

Key messages
Face masking was associated with accelerated RNA clearance of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Promoting community mask wearing during COVID-19 pandemic is crucial.
Viral shedding in asymptomatic versus symptomatic patients with COVID-19
Authors: Zemni I , Ben Nasrallah C , Dhouib W , Maatouk A , Ben Hassine D , Ben Fredj M , Abroug H , Kacem M , Bouanene I , Belguith Sriha A 
Published: October 2021

Abstract

Background
An outbreak of coronavirus disease 2019 (COVID-19) is becoming a public health emergency. Data are limited on the association between a prolonged viral shedding in patients with COVID-19 and having symptoms. We aimed to study the association between the presence of symptoms and recovery time of COVID-19 confirmed patients.

Methods
We conducted a prospective cohort study of COVID-19 patients admitted to the designated national COVID-19 center in Monastir, Tunisia from March to July 2020. Kaplan-Meier survival curve and Cox proportional hazards regression models were used to assess viral shedding in asymptomatic versus symptomatic patients with COVID-19.

Results
Among the 264 patients included in the study, symptoms such as anosmia, dry cough, and fatigue were reported by 34.4% (n = 75) of cases. The median time to RNA viral conversion was 24 days (IQR 18-36 days) for symptomatic patients versus 20 days (IQR 16-30 days) for asymptomatic patients. Having symptoms was significantly associated with a prolonged viral shedding (HR 0.600, 95% CI 0.401-0.897) (p = 0.013).

Conclusions
Our findings revealed that having symptoms delayed viral clearance among COVID-19 patients. Therefore, symptomatology should be taken into consideration in isolation strategy for infected patients.

Key messages
Having symptoms was associated with a delay in SARS-CoV-2 RNA clearance. The presence of symptoms should be taken into consideration for patient’s isolation strategy.
Life expectancy loss due to the COVID-19 pandemic exemplified by Moscow
Authors: Zubko AV , Sabgaida TP , Evdokushkina GN , Kulikova VA , Ivanova AE 
Published: October 2021

Abstract

There is high excess mortality against the background of the pandemic in Moscow (an increase of 36.2% against 18.1% on the national average). According to preliminary data, the loss of life expectancy is 3.1 years for Muscovites (from 78.9 years in 2019 to 76.2 years in 2020) and 1.9 years for the Russian population (from 73.4 to 71.5 years). As in other countries, elderly people suffering from chronic diseases were the most affected. The age-specific mortality rates in 2020 are significantly higher than those of 2019 in the age interval of 45 years and older as well as among children 10-14 years old and young people 25-29 years old. The maximum increase in mortality was recorded in age groups over 80 years old in males and 25-29 years in females. At the same time, infant mortality in Moscow has significantly decreased which is associated with a sharp decrease in the share of births among nonresidents (it exceeded a quarter of all births in the capital in 2019). The reduction in labor migration due to the closure of borders has led to a decrease in births among nonresidents. Using the decomposition method, it was shown that the greatest negative contribution to the loss of life expectancy in both sexes was made by mortality in the age group of 70-74 years which reduced life expectancy by 0.36 years for men and 0.27 years for women. Life expectancy decreased by 0.25 and 0.19 years due to death of men and women aged 75-79 years and by 0.09 and 0.02 years due to death of people aged 25-29 years. Reducing infant mortality yielded a life expectancy gain of 0.15 years for men and 0.11 years for women. These results changed the assessment of the significance of shifts in mortality in age groups. Analysis of changes in age-specific mortality and evaluation of its impact on changes in life expectancy shows different perspectives of the problem, which is important for making adequate decisions in health.

Key messages
The reduction in labor migration due to the closure of borders has led to a decrease in births among nonresidents. Analysis of changes in age-specific mortality and evaluation of its impact on changes in life expectancy shows different perspectives of the problem.
Individual level changes in body weight among Finnish adult population during the COVID-19 pandemic
Authors: Sääksjärvi K , Jääskeläinen T , Ristiluoma N , Pietilä A , Lundqvist A , Koponen P 
Published: October 2021

Abstract

Background
The indirect effects of COVID-19 pandemic are yet undefined, but behavioral and lifestyle consequences of the containment measures may cause weight changes, with different concerns across demographic groups. Our aim was to determine weight changes based on the data collected from same individuals before (2017) and during (2020) the COVID-19 pandemic.

Methods
Participants aged 25+ years, from the nationally representative FinHealth 2017 Study and its follow-up survey in autumn 2020, with information on self-reported weight in both years were included (n = 4770). Weight maintenance was defined as &lt; ± 5% change in body weight for each individual (i.e. weight loss = ≥5% loss; weight gain = ≥5% gain). Prevalence was estimated using inverse probability weights, acknowledging sampling design and non-response.

Results
Overall, two thirds of the population maintained weight during follow-up, but prevalence rates for weight change differed by age and sex. Prevalence of weight loss was highest among 70+ year olds (22% in men, 95% confidence interval (CI) 17-27; 26% in women, 95% CI 22-30), while they rarely experienced weight gain. Among 50-69 year olds weight gain was as common as loss, being around 15% for both indicators and sexes. Prevalence of weight gain was highest among 25-49 year olds (20% in men, 95% CI 18-23; 36% in women, 95% CI 33-40). Men with lowest education had gained weight more often (24%, 95% CI 19-30) than those with middle (16%, 95% CI 14-19) or high (14%, 95% CI 12-16) education, while for women no differences emerged, the prevalence ranging between 20-24% by education.

Conclusions
The weight loss among 70+ year olds seems worrying, but might be age related. Moreover, younger women and men with low education gained weight, groups known to be vulnerable for weight gain. Further analyses are required to evaluate whether containment measures related to COVID-19 pandemic have caused additional change compared to ageing and time related change.

Key messages
Few weight changes were observed in the Finnish adult population. As weight gain/loss may take longer time to develop, further studies are needed to address the long term effects of COVID-19 pandemic. To avoid increasing health inequity after pandemic, public health promotion should stress obesity prevention among young women plus men with low education. Weight loss is a concern among the elderly.