bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Impact of Covid-19 on the population-based cancer screening programmes. Basque Country (Spain)
Authors: Portillo Villares MI , Altzibar Arotzena JM , Arenaza Lamo E , Otegi Ariztondo A , Santos Zorrozua B , idigoras Rubio I , Davila Exposito T , Muñoz Santos C , Bilbao Iturribarria I 
Published: October 2021

Abstract

Background
The Breast Cancer (BCS) and Colorectal Cancer (CRCS) screening programmes are consolidated in the Basque Country with coverage and participation rates according to EU recommendations. The Cervical Cancer Screening (CCS) carried out in 2018 achieved an appropriate migration from an opportunistic programme an coverage in 2019. The pandemic disrupted the invitations and participation because of the lockdown and procedures offered because of Covid-19 safety measures since then. Objective: Analysis of the expected impact of the pandemic on early detection of advanced lesions and cancer.

Methods
Retrospective cohort study including all invitations 2016-2020 and results estimated (E) and observed (O) in 2020 without and with pandemic. Analysis R v 4.0. Description of measures taken into account to minimize the decrease of activity.

Results
Eligible population in BCS O/E were 54.4% (CI 95%: 41.0-41.6; p &lt; 0.05) (85,574 vs 150,534), estimating 202 BC (35 in situ and 167 advanced) not detected. In CRCS eligible population O/E were 39.2% (CI 95%: 44.9-45.3; p &lt; 0.05) (119,851 vs 257,889), estimating 1,695 advanced neoplasias (1,540 advanced adenomas and 154 invasive cancer) not detected. The CCS invitation had an important delay, with a 30% of target population invited (42,654 vs 142,180 women). Participation rate showed a slight decrease in the three programmes. The main measures implemented to minimize the disruption effects were: prioritization of confirmed diagnosis, increased activity to recover from the delays in 2020-2021 and the establishment of protocols to decrease intensive surveillance in case of post-colonoscopy.

Conclusions
The Pandemic has significantly affected the three population-based programmes, showing a reduction of its benefits in incidence and mortality at medium-long term as the COVID-19 and Cancer Global Modelling Consortium (CCGMC) appointed and published. Stakeholders should take into consideration the quick recovery of them.

Key messages
The benefits of the cancer screning programmes are seriously affected. It is needed to measure the COVID-19 consecuencies in cancer screening programmes.
Progress in lung and colorectal cancer survival, in Cyprus (2004-2017): a population-based study
Authors: Quattrocchi A , Demetriou CA , Cory OA , Saad B , Constantinou C , Papamichael D , Charalambous H , Demetriou A , Scoutellas V , Kolokotroni O 
Published: October 2021

Abstract

Background
Lung and colorectal cancer are the leading causes of cancer deaths in Cyprus. We describe preliminary analysis of (overall and by stage of diagnosis) age-standardised 5-year net survival (hereafter reported as NS) trends, for these two cancers.

Methods
We analysed data from the national population-based Cyprus Cancer Registry on adults (age 15+) diagnosed between 2004-17 with lung or colorectal cancer with follow-up until December 2019. We used cohort approach for 2004-08 (time 1-T1), 2009-13 (T2) and period approach for 2014-17 (T3) to estimate NS and 95% confidence interval (CI). Stage at diagnosis was categorised as localised, regional and distant, based on the Surveillance Epidemiology and End Results. The International Cancer Survival Standard age-specific weights were used for standardisation.

Results
Between 2004-17, all-stages NS increased from 16% (CI:15-17; T1) to 22% (CI:21-23; T3) and from 57% (CI:56-59; T1) to 61% (CI:60-62; T3) for lung and colorectal cancer, respectively. For lung cancer, NS increased from 37% (CI:29-47; T1) to 55% (CI:47-65; T2) and 65% (CI:57-74; T3) for diagnosis at localised stage, from 28% (CI:23-35; T1 and CI:22-35; T2) to 39% (CI:33-46; T3) for regional stage and from 4% (CI:3-6; T1) to 6% (CI:4-8; T2) and 7% (CI:6-10; T3) for distant stage. For colorectal cancer, NS increased from 75% (CI:71-80; T1) to 76% (CI:72-79; T2) and 84% (CI:80-87; T3) for diagnosis at localised stage, from 65% (CI:62-68; T1) to 69% (CI:66-72; T2) and 72% (CI:69-74; T3) for regional stage and from 11% (CI:9-16; T1) to 12% (CI:9-16; T2) and 15% (CI:12-19; T3) for distant stage.

Conclusions
Over the study period, survival improvements were observed. Late stage at diagnosis seems to be a contributing factor to decreased survival of lung or colorectal cancer patients in Cyprus. Increasing public awareness of cancer risk factors and symptoms and investment in early detection is vital to reduce delay in diagnosis and treatment and to improve survival.

Key messages
Lung and Colorectal cancer survival continues to improve although at different pace by stage at diagnosis. Any shift to earlier stages at diagnosis brings substantial survival improvements. Survival trends can help both in the formulation of strategies for cancer prevention, screening, and treatment and in the assessment of their effectiveness.
The Association between GDP and non-communicable disease mortality in the WHO European Region
Authors: Khanzada A , Mousa A , Thompson R , Rawaf D , Ikpeme M , Watt H , Mechili EA 
Published: October 2021

Abstract

Background
The WHO Europe Region consists of 53 countries, each of which has differences in mortality from cardiovascular (CVD), neurological, and chronic respiratory diseases. Such diverse metrics result from political, social, and economic events that have influenced the health performance of each European sub-region. From a public health perspective, an updated analysis of such metrics is required for policymakers and health system organisations to improve the overall population health outcomes.

Methods
This study utilised data between 1990-2017 from the Global Burden of Disease study 2017 to explore the association between GDP and NCD mortality in Western, Central, and Eastern Europe and Central Asia. The mortality data was already stratified by age and sex, and a fixed effected regression analysis was run to observe associations between both variables using STATA. Data completeness was 80-100% for GDP and 100% for mortality across the European region. The final results were reported as a rate per 100,000, with confidence intervals. The rate changes were calculated using an equation from the GBD.

Results
The most significant decrease per 100,000 of the population across all three NCDs as GDP increased was in Central Asia and Eastern Europe among both sexes. For every 1000 unit increase in GDP, we expect -12.13 [-13.60, -10.66] and -14.49 [-16.89, -12.29] less deaths in CVD in females and males per 100,000 of population, respectively. Western Europe had the lowest decrease per 100,000 of the population, as with every 1000 unit increase in GDP, we expect -2.42 [-2.59, -2.25] and -4.09 [-4.33, -3.84] fewer deaths in CVD in females and males, respectively.

Conclusions
The overall differential rate of mortality from the three NCDs is decreasing across all regions. However, there is a large disparity between the sexes. Males have a higher mortality rate across CVD and chronic respiratory diseases, whilst neurological disorders were highest among females.

Key messages
This study’s analysis has added to existing knowledge on chronic health patterns in the WHO European region. Governments in Eastern Europe and Central Asia should introduce health policies targeting unhealthy consumption of alcohol, smoking and diets, as seen in Western Europe.
Digital health technologies: a systematic review of their cost-effectiveness
Authors: Puleo V , Gentili A , Failla G , Melnyk A , Di Tanna G , Ricciardi W , Cascini F 
Published: October 2021

Abstract

Background
Digital health interventions have a potential to improve safety, efficacy and quality of care, reducing waste in healthcare costs. Despite premises, the evidence regarding cost and effectiveness of digital tools in health is scarce and limited.
Objectives: The aim of this systematic review is to summarize the evidence on cost-effectiveness of digital health interventions and to assess whether the studies meet the established quality criteria.

Methods
We queried PubMed, Scopus and Web of Science databases for articles in English published from 1 January 2016 to 31 December 2020 that performed economic evaluations of digital health technologies. The methodological rigorousness of studies was assessed with a well-established checklist (CHEERS). The incremental cost-effectiveness ratio (ICER)was calculated when the reviewed study reported related data but did not express the ICER.

Results
Searches identified 1476 results, 552 of which were selected for abstract and 35 were included in this review. The studies were heterogeneous by country, type of eHealth intervention, method of implementation, and reporting perspectives. The qualitative analysis identified the economic and effectiveness evaluation of seven different types of interventions: fourteen studies on a new telemedicine service; five on telecounseling; five on teletherapy; two on telemonitoring; five on new mobile applications; two on m-health programs; one on digital platforms and one on electronic health records.

Conclusions
Findings on cost-effectiveness of digital interventions showed a growing body of evidence and suggested a generally favorable effect in terms of costs and health outcomes. However, due to the heterogeneity across study methods, the comparison between interventions still remains difficult. Further research based on a standardized approach is needed in order to methodically analyze incremental cost-effectiveness ratios, costs, and health benefits.

Key messages
Digital interventions suggested a favorable effect in terms of costs and health outcomes. Digital health interventions have a potential to improve safety, efficacy and quality of care.
Intergenerational inequalities in COVID-19
Authors: Gabrijelčič Blenkus M , Costongs C 
Published: October 2021

Abstract
COVID-19 as a disease mainly affects older people. However, the measures that governments have introduced to prevent the spread of the pandemic will mainly impact on the younger ones. The key challenges for countries are to respond to both: (1) reducing the spread of the pandemic and (2) managing its syndemic, psycho-social dimension. Governments should design cross-cutting measures to address both these dimensions, be sensitive to and targeting different groups to enable, on one hand, a new normal life with the virus for individuals, and on the other hand, to enable society to function normally. For that aim, countries have to establish effective monitoring and measuring of the situation in order to ensure appropriate, effective and targeted responses. PANDA is an example of a good practice in Slovenia. The PANDA findings indicate that there are differences between generations in perceptions of the pandemic, in vaccine acceptance and in pandemic experiences. Mental health for example is one of the most affected components of health status in individuals, with worse results for younger generations. For the age group 65 - 74 years, 9 % are reporting depression symptoms and 13.5% reporting problems in mental health, while for the 18 - 29 years group, 17.8% are reporting depression symptoms and 28.5% mental health problems. Even more serious are the differences we could observe in assessing the financial situation, with 34.4% of the surveyed participants aged 18-29 years assessing their financial situation as worse in the last three months, compared to only 9.9% of those in the age group 65-74. Observed intergenerational inequalities are bringing along the responsibility of the older members of the population to get vaccinated, not only to protect themselves and prevent the collapse of the health system, but also to enable younger generations to get their lives back to normal and allow them to live and eat, attend education and socialise normally.
Colleagues affect healthy eating and exercise behavior
Authors: van der Put A , Ellwardt L 
Published: October 2021

Abstract

Exercising and eating healthy are not just an individual choice, but influenced by the social environment. Family members, friends or neighbors influence (un)healthy choices individuals make, yet little is known about other important contacts: colleagues. Many people spend at least 8 hours a day at work, mostly surrounded by the same colleagues. As a third of daily calories are consumed in the workplace and a lot of time is spent sitting there, colleagues could be important in shaping the (un)healthy choices employees make. We study to what extent colleagues influence each other's eating and exercise behavior. We focus on two pathways: colleagues can encourage a healthy lifestyle or act as role models whose behavior can be observed and copied. We use the European Sustainable Workforce Survey, with data on 4345 employees in 402 teams in 113 organizations. We measured healthy eating as how often employees eat fruit and vegetables. We measured exercise by the number of days in the past week employees did sports/physical activity for more than 30 minutes. Colleague encouragement was assessed by the extent to which employees said their colleagues encourage them to eat healthy food or exercise frequently. We computed colleague behavior by taking the average fruit and vegetable consumption, and exercise, of all colleagues in a team. We fitted multilevel models with employees nested in teams and controlled for gender, age, education, working hours, job physical demands, self-rated health, sector and country. Preliminary results show colleague encouragement for healthy eating positively affected fruit consumption (p&lt;.01), colleague fruit consumption did not(p=.62). Both colleague encouragement (p&lt;.01) and colleague vegetable consumption (p=.04) positively relate to vegetable consumption. Colleague encouragement positively (p=.03), and colleague exercise behavior (p&lt;.01) negatively, affected exercise. Worksite health interventions should emphasize the role colleagues may play.

Key messages
Next to family, friends and neighbors, also colleagues influence each other’s eating and exercise behavior. Worksite health interventions should the role colleagues may play into account when attempting to improve employee health.
School stress and health complaints: Testing the Adolescent Stress Questionnaire in Spain and Sweden
Authors: García-Moya I , Corell M , Paniagua C , Vaez M , Löfstedt P 
Published: October 2021

Abstract

Background
According to the Health Behaviour in School-aged Children (HBSC) study, over a third of adolescents feel pressured by schoolwork in European countries, with increases associated to age and in girls. School pressure has been linked with increased health complaints, which illustrates the importance of schools from a public health perspective. To get a better understanding of school stress in adolescence, there is a need to test measures that reflect a broader array of potential school-related stressors. The aims of this cross-national study were: (1) to analyze the functioning of a specific measure to assess school stress in adolescence and (2) to examine the links between school stress and health complaints.

Methods
The sample consisted of students aged 13 and 15 years: 1,249 students (54.6% girls) who had participated in project EASE in Spain, and 576 students (50.6% girls) in Sweden. The measure tested was the Adolescent Stress Questionnaire (ASQ-S), specifically the 9 items on school stress from the subscales school performance, future uncertainty, and school-leisure conflict. For the assessment of health complaints, the HBSC health complaints checklist was used.

Results
CFA supported a three-correlated factor structure and a high reliability of the three subscales of the ASQ-S in both countries. In regression analyses, the association between school stress and health complaints was significant when controlling age and sex, with the increase in the level of explained variability due to several stress dimensions being 18.8% in Spain and 25.2% in Sweden.

Conclusions
Different facets of school life can contribute to stress during adolescence, with more public health attention needed when it comes to school stress and its links with increased health complaints.

Key messages
The instrument used for school stress may be useful in cross-national studies in adolescent samples. More public health attention should be paid to school stress and its links with increased health complaints in adolescence.
Stakeholders’ involvement in identification of research and policy needs for children’s mental health
Authors: Ristovska G , van den Hazel P , Weber M , Jansen S , Benz S , White M , Arat A , Spiroski I , Schreckenberg D , van Kamp I 
Published: October 2021

Abstract

Background
The overarching aim of the Horizon 2020 Equal-Life project is to develop evidence-based guidance for policy-and decision-makers concerning child environment and long-term effects on mental health and cognitive development. Stakeholders at national and local level are crucial in improving the physical and social environments children grow up in. In this paper, we present preliminary results of a repeated survey on stakeholders' needs concerning environmental determinants of mental health and cognitive development of children and adolescents.

Methods
We invited potential stakeholders from relevant fields of expertise. Two of three rounds of the Delphi survey were performed by means of an on-line survey between November 2020 and February 2021.The questionnaire was aimed at identifying research questions, knowledge gaps and raised issues about data collection and analysis regarding improving mental health and cognitive development, policy needs related to environment and its role in children's mental health and the potential effectiveness of policy interventions.

Results and Conclusions
In the 1st survey round 34 stakeholders participated and in the 2nd survey round 51 stakeholders participated from 26 different countries and continents. Across both rounds of the survey most participants were from research institutes (21), public health organisations (8), civil society (6), national stakeholders (5) with only little involvement of local or regional authorities or child care organisations. Stakeholders identified several research priorities such as: instruments to improve children's mental health, preventive programs addressing mental health, integrated mental health care services, programs aimed at parenting skills and child care. Early life exposure to adverse social events and psychosocial stressors in the family and socioeconomic disadvantage were recognized as main factors for child development.

Key messages
The guidance from Equal-Life aims to include stakeholders in creation of intervention strategies and preventive measures for mental health and the cognitive development of children. Evidence-based policies and programmes can buffer the negative effects of adverse environments and create restorative ones, and by doing so improve mental health and cognitive development.
A European Partnership on Transforming health and care systems – state of play and future plans
Authors: Montante Sabrina 
Published: October 2021

Abstract
Horizon Europe will foresee the establishment of a number of European Partnerships. One proposed Partnerships is targeted towards Transforming health and care systems, which is presented in the opening presentation. Research and Innovation activities (R&I) in such a EU Partnership should accelerate the transformation towards sustainable health and care systems. It builds on the experience and outcomes of some closely related European initiatives, including the Active & Assisted Living Programme (AAL Programme), the Joint Programme Initiative “More Years, Better Lives', the European Innovation Partnership on Active & Healthy Ageing and the To-Reach Coordination and Support Action (CSA). The four initiatives share a common vision to improve the European citizens' health by reaching high quality, fairly accessible, sustainable, efficient, health promoting and resilient health and care systems for all EU citizens. The Partnership aims to achieve this objective by 2030 by means of providing multidisciplinary research with a particular focus on improving the ability of relevant health and care actors to take up innovative solutions, including organisational, service and policy innovations. The process is to develop a Strategic Research and Innovation Agenda (SRIA), building on work on already conducted by previous projects and initiatives, including the ones listed above. The workshop at the EPH Conference can be seen as part of a series of workshops to advance the Strategic Research and Innovation Agenda based on countries priorities and wide stakeholders' consultations, To provide cumulitative learning, the presentation will share the outcomes of a consultation process among European stakeholders so far, among others involving decision makers and research funding bodies to identify common goals and priorities, providing opportunity to workshop participants to reflect and add missing elements crucial for such a Strategic Research and Innovation Agenda.
The organisation of resilient health and social care following the COVID-19 pandemic – A critical review
Authors: Rogers Heather L. 
Published: October 2021

Abstract
As second presentation, a recent Opinion by the Expert Panel on effective ways of investing in Health (EXPH) will be shared and used as point of reference to assess what the key components are of a future Partnership. This Opinion on the organisation of health and social care following the COVID-19 pandemic (1) identifies the building blocks of resilient health and social care systems, (2) explores the elements and conditions for capacity building to strengthen health system resilience, (3) addresses healthcare provision for vulnerable patient groups and how to sustain such provision in a system under stress, and (4) sets out an approach to develop and implement “resilience tests” of Member State's health systems. The recommendations target a number of key areas, including: enhancing workforce training and resilience, identifying and reducing disinformation, fostering interprofessional and inter-sectoral collaboration with community health workers and informal care givers for example, strengthening primary and mental health care, and a number of other priorities. An overarching recommendation is to enhance investment from the European Commission in the development and implementation of (a) comprehensive resilience testing of health systems that use qualitative and quantitative data collection methodologies to generate meaningful, actionable results for health system transformation, and (b) corresponding learning communities within and across Member States to share lessons learned through this process. Based on this work, what are the priorities for a Partnership, and how can it add value to existing initatives?