bluuebunny/crossref_metadata_2025_split huggingface dataset:
Feasibility of an artificially intelligent vaccines chatbot in Pakistan: A mixed methods evaluation
Authors: Munir M , Miraj F , Raza H , Hussain OA , Khan AA , Siddiqi DA , Khan AJ , Habib A , Chandir S 
Published: October 2021

Abstract

Background
Despite free vaccination services, gaps in information access impede immunization uptake in low and middle-income countries (LMICs), including Pakistan. We developed Bablibot (Babybot), a local-language, text-based chatbot to connect caregivers with immunization-related information in real-time, and evaluated its feasibility and acceptability in resolving immunization-related queries among Karachi's low-income communities.

Methods
We developed Bablibot using Natural Language Processing (NLP), Machine Learning, and Human in the Loop features. We conducted a sequential mixed-methods pilot in Karachi where caregivers were recruited when visiting selected immunization centers for any childhood vaccine except Measles 2 (last vaccine visit) or were informed through targeted text messages. We assessed Bablibot's feasibility and acceptability through user-engagement metrics and thematic analysis of qualitative interviews conducted with 20 pilot participants.

Results
Between March 9, 2020 and April 15, 2021, Bablibot accrued 677 users and participated in 874 conversations. Of 2,202 pilot-enrolled caregivers, 210 (10%) interacted with the bot; other 467 users were not pilot participants. Most queries were about due dates (25%; 221/874), delaying vaccination (17%; 146/874), or side-effect management (16%;137/874). The conversations now constitute a valuable training database for future local-language bots. Over 90% (277/307) of responses to text-based exit surveys indicated user satisfaction. Qualitative analysis showed caregivers appreciate Bablibot's convenience, reliability, and responsiveness.

Conclusions
Our results demonstrate the feasibility and acceptability of local-language NLP chatbots in providing immunization information. Text-based chatbots can minimize workload on helpline operators, in addition to quickly resolving queries that otherwise lead to delay or default. Bablibot's conversation data provides learning infrastructure for future health-related bots.

Key messages
An AI-based NLP chatbot is a feasible and acceptable intervention for providing immunization-related information to large number of caregivers 24/7 in limited resource setting. By serving as a remote, low-cost and confidential bi-directional channel, chatbots can address gaps in information access, especially for women, and have long term impact on immunization uptake.
7.H. Workshop: Knowledge Translation and Burden of Disease, from theory to practice
Authors:   Organised by: RIVM (Netherlands),   Chair persons: Henk Hilderink (EUPHA-FS), Elena Pallari (UK)
Published: October 2021

Abstract

Knowledge translation (KT) is an important concept to bridge the gap in health information between research and policy making. Also in Burden of Disease (BoD), with the Disability-adjusted Life Years (DALYs) as its main indicator, this gap exists. KT provides the theory and tools to better link researchers and policy makers to support evidence-informed policy making. The European Burden of Disease Network (COST Action CA18218), serves as technical platform for integrating and strengthening capacity in BoD assessment across Europe and beyond. The network promotes an interdisciplinary approach that integrates KT in the classical BoD framework. One of the work packages working groups focusses on the application of existing KT theory to BoD assessments. Several European countries are undertaking their own National Burden of Disease (NBoD) study, some of them already for many years. They have built up a substantial amount of knowledge on the practical side of KT in relation to BoD assessment. The joint workshop aims to bring together the more theoretical concept of KT with the more practical experiences in three different countries: Scotland, Germany and the Netherlands. The workshop will begin with a presentation on the different concepts of KT in relation to BoD. This will be followed by three presentations of NBoD experiences. Exchange with the audience will be facilitated by using an interactive Mentimeter poll during the session, In this poll, delegates will be asked what they consider to be good elements of KT, and what they consider as main obstacles for KT, in relation to BoD.

Key messages
Knowledge translation is crucial to bridge the gap between burden of disease research and evidence-informed policy making. Combining the theoretical approach with the practical experience of different countries give valuable complementary insights in effective knowledge translation.
Burden 2020: The German Burden of Disease Study Informative, comprehensive, appealing and digital: Providing health data to users. Accessibility of scientific results in the burden context
Authors: Anton A , Fleckenstein T , Von der Lippe E , Rommel A 
Published: October 2021

Abstract
The aim of the BURDEN 2020 project is to calculate the Burden of Disease for Germany at the national and regional level. Based on the methods of the Global Burden of Disease study, the results will assess the impact of diseases on population health thus providing a freely accessible information basis for policy making and health care planning. How can the transfer from science to society take place on a low-threshold basis? We will talk about our strategy reaching out to decision-makers within health care planning in Germany and Europe. In addition, it will be examined how we wanted our results to be accessible, which possibilities of publication we choose beyond scientific articles and what options we had when talking about research marketing. We will also have a closer look on our demands for data visualization and transparency. In an ongoing process, two things were at stake: how do we define our target groups and how we address them. It has been proven to be a good strategy to continuously build up (international) networks, to share our knowledge and implement feedback. When publishing scientific results, it has turned out to be helpful for the project to approach a well-known bi-lingual journal with a wide range of coverage. We aimed to present the pilot project online with an appealing data visualization and graphic formats. This type of presentation made it easier to approach members of the press. Also, the inclusion of current topics such as COVID-19 helped to increase the media response. There are plans to include the use of the data in media formats such as webinars. Burden of Disease assessments can be challenging in implementation and communication. Before the start, the use of the metrics for Germany had to be thoroughly explained to national stakeholders. Within the project, we had to discuss how our data should be communicated to the public, to explain strength and weaknesses, and to produce publication formats that suit different target groups.
Country experiences with data linkage initiatives
Authors: Allin S , Ghafur S 
Published: October 2021

Abstract
This session highlights the experience from two countries in data linkage: Canada and the UK. Canada's ten provinces and three territories have primary responsibility for the organization and delivery of health care services and for the supervision of health care providers. As such, many data linkage initiatives are at the provincial level, and the recent Health Data Research Network aims to facilitate access to multi- province data for researchers. Also the Social Data Linkage Environment (SDLE) represents a national effort led by the federal government (Statistics Canada). The SDLE has a centrally maintained ‘key register' containing new identifiers based on a number of identifying characteristics which are used to link a wide range of data sets, including the Labour Force Survey, national health surveys, the hospital discharge database, census data, and a range of provincial data on crime, education, mental health, etc. Thus, the SDLE is not a consolidated database per se, but a tool to link other databases, and has potential for use in scientific research. Similar to Canada, the different nations of the UK operate separate data linkage initiatives. One internationally renowned national database, the Clinical Research Practice Datalink (CPRD), reflects the important role of GPs. The CPRD brings together de-identified microdata data from GP practices in the UK on the basis of the respective electronic practice information systems. The data collected includes demographic details, information on service providers, clinical presentation, referrals, vaccinations, laboratory findings and medication prescriptions, with the ability to link to other data sets to research the care pathway. As of 2019, the CPRD data covers 42 million patients and has been used for more than 2000 scientific publications that have researched issues such as drug safety, drug use, the effectiveness of health policy measures, the organization of service delivery and the development of risk factors.
Impact of COVID-19 on drug use disorders and provision of drug related interventions in prison
Authors: Montanari L , Vandam L 
Published: October 2021

Abstract

Introduction
With the emergence of the COVID-19 epidemic, most European countries implemented measures to prevent the spread of infections inside prison, including: use of personal protective equipment (PPE), hygiene practices, limits to mobility, reduction of overcrowding. Their implementation affected the drug related interventions. The EMCDDA has conducted a rapid assessment to evaluate the impact of those measures on the provision of drug treatment and harm reduction services in the European prisons of 15 countries between March and June 2020.

Methods
The study was based on a mixed method approach that triangulated the results of an on-line survey, the outcome of a focus group with prison and drugs experts and case studies from four European countries.

Results and discussion
Most countries reported a reduction in the provision of drug treatment and, to a lesser extent, of harm reduction interventions inside prison during the early phase of the pandemic. The drug services tried to adapt to the new context. Innovations were introduced, including the use of telemedicine in counselling and pharmacological treatment, a better partnership between security and health staff and a more individualised approach to drug treatment. Concerns were expressed around reduction of some interventions, such as group-based interventions, services provided by external agencies, interventions in preparation for release, continuity of care and possible reduction in testing and treatment of drug related infections such as HIV, HCV and HBV due to the priority given to the COVID-19 emergence.

Conclusions
With the emergence of COVID-19, drug services had to address various challenges, making efforts to maintain the provision of drug-related interventions inside prison, while introducing the COVID-19 containment measures. Ensuring the equivalence and continuity of health care provision for those in prison with drug problem remains of central importance.
Prisons, drugs and COVID-19: Early releases and continuity of care
Authors: Shirley-Beavan S 
Published: October 2021

Abstract

Introduction
Detention settings are high-risk environments for the spread of infectious diseases. Since 2020, COVID-19 has posed unprecedented challenges for governments and prison administrations. In some jurisdictions, this has catalysed early release programmes to decongest prisons to minimise the harm of COVID-19 in prison systems.

Methods
From March to June 2020, HRI monitored the adoption of prison decongestion measures in response to COVID-19 in Europe and worldwide. HRI tracked criteria for eligibility and implementation of the measures and distributed online expert surveys as part of the Global State of Harm Reduction 2020 that included questions on harm reduction in prisons and the response to COVID-19. Survey data was supplemented by a review of academic, governmental, and non-governmental literature. A review to update the data will be carried out by mid-2021.

Results and discussion
Results show prison decongestion schemes initiated in 17 countries in Europe and 109 countries worldwide. Overall, by July 2020 decongestion measures reduced the global prison population by 16% in Europe and just 6% worldwide. In a quarter of countries (including at least four in Europe), people incarcerated for drug offences were explicitly excluded, regardless of whether they suffered from health condition or belong to a vulnerable group. We found no evidence of expanded access to harm reduction programmes to address the risk of overdose after release. Issues that exacerbate overdose risk included interruptions to the provision of opioid agonist therapy (OAT) and the unavailability in most jurisdictions of naloxone on release.

Conclusions
People who use drugs and are in detention settings have been inadequately served during the COVID-19 pandemic. To address the unique health risks of detention settings, there is a need for greater commitment to the adoption of non-custodial measures, and diversion from criminal justice towards a health-led response to drug use.
Impact on invitation and participation in the CRC screening in the Basque Country due to Covid19
Authors: Idigoras Rubio I , Portillo Villares I , Bilbao Iturribarria I , Aguinaco Garcia C , Gomez Lopez M , Santos Zorrozua B , Gonzalez Nieto N , Herrero Hernandez JJ 
Published: October 2021

Abstract

Background
The colorectal cancer screening programme (BCSP) obtains excellent participation rate, reflected in early detection and treatment of pre & malignant lesions, objectifying a downward trend in incidence & mortality rates

Objectives
To compare invitation coverage and impact on participation with faecal immunochemical test (FIT) pre&post pandemic. To compare the participation rate in Primary Care Units (UAP) in which the invitation and FIT pickup was interrupted with those that were not, in order to design prioritization strategies in the face of another lockdown

Methods
Retrospective cohort study of invitations from 2018-2020. Indicators of coverage and participation rate to COVID 19, during the interruption due to lockdown, and subsequent invitations sent out without interruption afterwards. Data analysis R version 4.0.1 stats and MKinfer

Results
40% of the planned invitations were taken up (81,097/200,000) showing a decrease in participation rate (71.9/68.8%) P ≤ 0.05 95% CI(2.79-3.52), with significant differences in all groups by age and sex. In the comparative analysis between UAPs that interrupted test collection in March resumed in June or when the invitation was made without interruption (September to December), higher participation rates were observed in the group that did not interrupt the screening (68.1/69.8%) P ≤ 0.05 95%CI (1.18-2.23), with differences in all groups of age and sex. In order to reorganize the activity, agreements were made:1)prioritization of screening colonoscopies, 2)reduce the burden of follow-up colonoscopies based on the evidence. Advanced lesions, has passed from 1 to 3ys, and only the resection in piecemeal ≥20mm sessile is done in under 1y

Conclusions
The Covid-19 pandemic has affected the BCSP with a decrease in scheduled invitations, but only a slight decrease in the participation rate. The impact is lower if the collection of FIT samples is not interrupted. If a new lockdown is needed, we will not stop the collection of FITs

Key messages
The Covid-19 pandemic has affected the BCSP adn will impact in incidence and mortality of CRC. The impact is lower if the collection of FIT samples is not interrupted.
Sedentary behaviour and risk of breast cancer according to occupation and family size
Authors: Pinto-Carbó M , Vanaclocha-Espí M , Hernández-García M , Ibañez J , Salas D , Molina-Barceló A 
Published: October 2021

Abstract

Background
Nowadays there is a lack of consensus on the relationship between sedentary lifestyles and breast cancer (BC). In this study we aim to shed light by analysing the relationship between a sedentary lifestyle and breast cancer in women participating in the Breast Cancer Screening Programme of the Valencian Community (BCSP-VC) (Spain) according to occupation and Family Size (FS).

Methods
Cohort study with women aged between 45-70 years participating in the BCSP-VC. The sample consists of 506 cases and 120853 controls. Multivariate logistic regression models (M) were performed to study the relationship between sedentary lifestyle and BC. The explanatory variables were: M1: sedentary behaviour adjusted for age and family history; M2: M1 + reproductive variables (menopausal status, hormone replacement therapy, months breastfeeding); M3: M2 + lifestyles (Body Mass Index, smoking); M4: M3 + gender variables (child burden, FS) and M5: M4 + social variables (educational level, occupation). These M are implemented in the total sample and stratified by occupation (manual, non-manual, housewives and non-working) and FS (small, medium, large). Results are given in terms of Odds Ratio (OR) and 95% confidence interval (CI).

Results
M1 shows that sedentary women are more likely to have BC (OR = 1.25 CI=1.01-1.55). This association is maintained in M2 (OR = 1.25 CI=1.00-1.57) and M3 (OR = 1.25 CI=1.00-1.57) but not when adjusting for gender and social variables. When stratifying by occupation and FS, we observe that, regardless of the variables taken into account in the M, housewives and women with small FS who are sedentary are more likely to have BC (p &lt; 0.05). No statistically significant results were observed in the rest of the occupational and FS strata.

Conclusions
Sedentary behaviour increases the risk of developing BC, with this relationship being observed in housewives and those with small FS. Further work is needed on how gender and social variables modulate this effect.

Key messages
Sedentary behaviour increase the risk of breast cancer, and this relationship is affected by gender and social characteristics. The positive relationship between breast cancer and sedentary behaviour is observed in housewives and those with small family size.
1-year impact of COVID-19 on childhood immunizations in Pakistan: analysis of &gt; 3.7 million children
Authors: Chandir S , Siddiqi DA , Mehmood M , Iftikhar S , Siddique M , Jai S , Dharma VK , Khan AA , Akhter MA , Khan AJ 
Published: October 2021

Abstract

Covid-19 has universally disrupted primary health care, but routine childhood immunizations are one the most affected services. We analyzed big data in vaccines for measuring the 1-year impact of Covid-19 on outline childhood immunizations for the 48 million population in the Sindh province of Pakistan. We extracted and analyzed &gt;3.7m real-time immunization records of 0-23 months old children from the Sindh Government's Electronic Immunization Registry (EIR). Using a 6-month baseline preceding the COVID-19 lockdown, we quantified the lockdown's (March 23-May 9, 2020) impact on daily immunization rates by geographical area and the change in coverage rates at the one-year mark since the lockdown. The lockdown resulted in 53% drop in the number of immunizations. The impact in rural areas as more than in urban areas (54.9% decline vs 47.5% decline from baseline), and slums had a slightly larger decrease in immunization coverage than non-slum areas (53.8% vs. 51.3%). Of 1,246,321 children who missed immunizations during first year of the pandemic, 76% of these children were eventually vaccinated by the end of March 2021. Similarly, of the 417,553 children who had dropped out during the initial 7-week national lockdown (March 23-May 10, 2020), 79% were immunized by March 2021. Our analysis of EIR data shows that the catch-up and recovery of coverage rates have primarily been driven through intensive outreach vaccination efforts instead of an increase in demand. One year since the onset of the pandemic, the average daily immunization doses administered through outreach increased by 121 percent above baseline estimates. In contrast, vaccines administered at immunization clinics were still 22 percent below baseline. The example of Pakistan shows LMICs can successfully deploy mitigation strategies to catch up with missed children during Covid-19 and sustain routine childhood immunizations to close immunity gaps.

Key messages
Although the lockdown resulted in a 53% drop in immunizations, at the 1-year mark since the pandemic started, 76% of children who missed immunizations are vaccinated. Pakistan data shows LMICs can rectify routine immunization coverage and immunity gaps and rebound successfully to their pre-COVID-19 coverage rates.
7.P. Workshop: Mental health during the Covid19 pandemic & corresponding national health promotion measures
Authors:   Organised by: BZgA (Germany), Santé Publique (France), Epidemiologia Piemonte (Italy),   Chair persons: Yvette Shajanian Zarneh (Germany)
Published: October 2021

Abstract

Background
To an initially non-expected degree, the wellbeing of the population in European countries has been affected by the containment measures during the course of the COVID-19 pandemic. The longer the pandemic holds the more visible become also the economic effects, which in turn will affect the populations mental health and wellbeing on the longer term and have the potential to dramatically increase health inequalities. Whether the psychosocial burden of containment measures will be followed by a significant increase of mental illness is hotly debated and yet to be determined. National institutions have the task to promote health during such crises. Therefore, mental health and wellbeing was monitored in most European countries, and in many countries, approaches to support the population and its subgroups under the burden were developed, acknowledging the monitoring data and dynamics within the pandemic and containment activities. In this workshop the data on population wellbeing during the pandemic from Germany, Italy and France will be presented and the different approaches to promote mental health explained and discussed. The input from the three countries will be the basis for a discussion with the audience: What similarities can be identified from the measures and programs presented? What lessons can be learned for their further development? What synergies could arise in the future?

Objective
The goal is to present, compare and critically review the mental wellbeing of populations and subgroups in the three countries since the beginning of 2020, to assess its association with the pandemic waves and the according containment measures and discuss the resulting health promotion activities (with a focus on national-level interventions and approaches). Selected interventions to promote mental health and wellbeing will be presented that were developed based on the monitoring data available in the countries. The interventions will be discussed in terms of their relevance to reach subgroups and improve wellbeing in the dynamic situation of the COVID-19 pandemic.

Key messages
The longer-term effects of the pandemic and its containments measures on mental health and wellbeing of populations is yet to be defined. The psychosocial burden is higher in certain subgroups and demands specific interventions that improve access to preventive (partly preexisting) mental health services.