bluuebunny/crossref_metadata_2025_split huggingface dataset:
Using advanced computing to improve outcome monitoring in substance use disorder treatment in Alaska
Authors: Ray R , Madison Pohl A , Licht P , Crews W 
Published: October 2024

Abstract

Issue
In Alaska, crime associated with substance misuse is a massive public health and safety concern costing over $2.3 billion annually. Government officials make substantial investments to address this challenge but have little ability to monitor the long-term effectiveness of these interventions. Treatment providers are also stifled by minimal feedback regarding their lasting impact. While government databases exist that contain relevant information related to long-term treatment outcomes, low knowledge transfer continues to occur between these big data systems and treatment providers.

Description
To determine if emerging database technology can effectively monitor long-term recidivism outcomes, a prototype was implemented by Alaska’s leading treatment provider, Set Free Alaska. The Recidivism Tracking Interface is an innovative database system that strategically connects treatment records with the criminal justice system database. While maintaining high confidentiality and security standards, the first-of-its-kind interface assessed long-term recidivism outcomes of Set Free Alaska’s former clients from 2010 to 2023.

Results
Of those who successfully completed treatment (n = 970), only 12.06% were convicted of a new crime with an average of 1,167 days between discharge and new criminal charges. The current recidivism rate in Alaska is 66.3%. In addition to recidivism outcomes, the interface also revealed data incredibly useful for informing treatment services and relapse prevention practices. The Recidivism Tracking Interface effectively demonstrated that advanced computing systems can be utilized to monitor long-term outcomes in a manner that was previously unavailable to treatment providers.

Lessons
In the age of advanced cloud computing and generative AI, treatment providers around the world and their government partners can overcome current knowledge transfer barriers to monitor long-term outcomes in a manner that is automated, inexpensive, and easy to use.

Key messages
• Advanced computing offers new opportunities to improve long-term outcome monitoring.
• Expanding secure access to relevant government databases can ultimately improve treatment outcomes and advance outcome-based funding models.
Fall risk factors and prevention among older adults in primary care in Belgium, 2019-2021
Authors: Moreels S , Bensemmane S , De Schreye R 
Published: October 2024

Abstract

Background
Falls are a major public health problem and ageing populations further increase the burden of fall-induced injuries. Falling among older persons is a multifactorial health condition needing multifactorial care. General practitioners (GPs) are well placed to implement a multifactorial management. A surveillance study of accidental falls studied characteristics of falls, risk groups and fall risk factors as well as fall prevention by GPs.

Methods
A 3-year retrospective population-based study by the Belgian network of Sentinel General Practitioners (SGP) on all patients aged ≥ 65 years consulting their GP for new fall-related injuries.
Descriptive statistics were used to characterize falls, fallers, fall risks and preventive measures. Logistic regression analyses were performed to identify factors associated with a multifactorial fall risk profile.

Results
During 2019-21, 1138 accidental falls were registered. Medical and/or nursing intervention was required for 24% and 22% had a severe injury. During consult, 30% was referred to hospital. 61% of patients showed at least one of the four most prevalent fall risks, i.e. deficits of mobility or balance, polypharmacy, cognitive impairment or psychotropic medication. A multifactorial fall risk profile was observed in 45% of fallers and was associated with recurrent falling (p &lt; 0.001), fall location (p &lt; 0.05), activity when falling (p &lt; 0.01) and pandemic year 2020 (p &lt; 0.05). Addressing surrounding and walking problems were the most frequently delivered preventive measures. For 28% of patients, other primary care providers (mainly nurse and physiotherapist) were involved in preventive care.

Conclusions
This study highlights the importance of identifying fall risk factors among fallers in primary care. Preventive fall measures, taken in about one in four general practice patients in collaboration with other healthcare providers, are crucial for preventing accidental falls in older persons in Belgium.

Key messages
• A multifactorial management of fall risk factors by GPs is crucial for preventing accidental falls in older primary care patients.
• Strengthening collaboration between primary healthcare professionals is needed for improving fall prevention in Belgium.
Assessing the severity of COVID-19 waves: beware of surveillance bias
Authors: Tancredi S , Cullati S , Chiolero A 
Published: October 2024

Abstract

Background
Indicators to assess the severity of epidemic waves during the COVID-19 pandemic were influenced by differences in detection modalities over time, leading to surveillance bias. We compared four indicators across three pandemic periods to assess surveillance bias.

Methods
We used data from one region of Switzerland. We compared seroprevalence, cases, hospitalizations, and deaths during three periods (period 1: Feb-Oct 2020, including the 1st wave; period 2: Oct 2020-Feb 2021, including the 2nd wave; period 3: Feb-Aug 2021, including the 3rd wave and after the start of the vaccination campaign). Data were retrieved from the Swiss Federal Office of Public Health or population-based studies. We compared each indicator to a reference indicator (seroprevalence during periods 1 and 2 and hospitalizations during period 3). We also assessed the timeliness of the indicators, i.e., the duration from data generation to the availability of the information to decision-makers.

Results
According to seroprevalence estimates, the severity of the 2nd wave was slightly larger (by a ratio of 1.4) than the severity of the 1st wave. Compared to seroprevalence, cases largely overestimated the 2nd wave severity (2nd vs 1st wave ratio: 6.5) while hospitalizations (ratio: 2.2) and deaths (ratio: 2.9) were more suitable to compare the severity of these waves. According to hospitalizations, the 3rd wave severity was slightly smaller (by ratio of 0.7) than the 2nd wave. Compared to hospitalizations, cases or deaths slightly underestimated the 3rd wave severity (3rd vs 2nd wave ratio for cases: 0.5; for deaths: 0.4) and seroprevalence was very biased due to high vaccination rates. Across all waves, timeliness for cases and hospitalizations was better than for deaths or seroprevalence.

Conclusions
To assess the severity of pandemic waves accounting for surveillance bias, different types of indicators must be used across time.

Key messages
• Differences in detection modalities over time can skew the assessment of the severity of COVID-19 pandemic waves, leading to surveillance bias.
• The effectiveness of indicators in describing the severity of COVID-19 pandemic waves depends on the type of indicator used and the stage of the pandemic.
Quality indicators of long-term care for older people in OECD countries; a rapid scoping review
Authors: Ordonez Cruickshank A , Zanuzdana A , Marujo V , Heldt K , Fuchs J , Gaertner B , Hasseler M , Eckmanns T , Scheidt-Nave C 
Published: October 2024

Abstract

Background
The COVID-19 pandemic has exposed the vulnerability of older people living in long-term care facilities (LTCF), highlighting the urgent need for research on the quality of care for this group of the population. There is no universal definition for quality of care in LTCF, and yet, multiple tools and indicators have been developed to measure it. In this rapid scoping review, we aim to provide a comprehensive overview of the current knowledge on quality of care concepts and indicators for older people in LTCF in OECD countries.

Methods
This review follows the World Health Organization (WHO) guide for rapid reviews and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA-ScR) extension for scoping reviews, including protocol registration (https://doi.org/10.17605/OSF.IO/34B2S). The electronic bibliographic databases MEDLINE (PubMed), EMBASE, and CINAHL were searched in September 2023 for studies published between 2013 and 2023 for quality indicators in LTCF. Experts in quality of care in LTCF were contacted and consulted to retrieve sources of grey literature. Information on the definition or framework of quality of care, quality of care dimensions, measurement instruments, context and purpose of the measurement will be extracted.

Results
Of the 8,516 identified records, 6,449 were screened by title and abstract after removing duplicates. A total of 469 publications will be screened in full-text. Experts recommended 40 websites to be screened for quality indicators. The PRISMA flowchart diagram will be provided to describe the selection process.

Conclusions
This review aims to improve the quality of care for older people living in LTCF. Our results will identify which concepts and dimensions of care are currently being measured in OECD countries, whether they are backed by any definition and scientific framework of quality of care for older residents of LTCF, and whether there is consideration of closing gaps in quality measurement.

Key messages
• Quality of care is an understudied field in the context of long-term care facilities for older people.
• In order to further improve quality in long-term care for older people, it is necessary to systematically review the current state of knowledge on quality concepts and indicators.
Diabetes mellitus EU comorbidity index: using data from EHIS 2019 and GBD disability weights
Authors: Mahrouseh N , Kovács N , Varga O 
Published: October 2024

Abstract

Background
Individuals with diabetes mellitus (DM) exhibit several of comorbidity burdens, with lower perceived quality of life also being a factor. Literature on the impact of DM is available, including studies on the index devised by (A. Andreella et al., 2023) for the assessment of comorbidities of health conditions. This study aims to adapt and validate this index for use as a standardized DM comorbidity index within the EU.

Methods
A cross-sectional study was carried out using microdata from the European Health Interview Survey (EHIS) 2019. The study included adults aged 25 years or older who reported having DM (n = 20,042) from 27 EU member states. Comorbidity index was calculated to assess the comorbidity of having 9 non-communicable diseases using disability weights obtained from the Global Burden of Disease 2019 and self-perceived general health using multiplicative approach. Beta regression analysis was used to evaluate the association between comorbidity index and several demographic, socioeconomic and lifestyle variables. Comorbidity index was calculated for each nomenclature of territorial units for statistics (NUTS 2).

Results
The comorbidity index ranged from 0.049 to 0.993. The results indicated that having a higher education and residing in urban areas were less likely to have a high comorbidity index. Being unemployed or in other employment statuses demonstrated a significant, positive association with the index. Income exhibited a gradual, positive association with each quintile, while consuming fruits and vegetables less than once a week was found to be associated with an increased index. The highest comorbidity index was observed in Calabria (Italy), followed by Lubuskie (Poland), and the lowest was observed in Antwerp (Belgium), followed by Övre Norrland (Sweden).

Conclusions
By identifying comorbidity burden, targeted interventions and regional-specific strategies can be implemented to improve the quality of life for individuals with DM.

Key messages
• Quantifying the burden of comorbidities allows understanding of health status of DM patients.
• Comorbidity index shows geographic variation in the EU which contributes to tailored policy interventions.
Inclusion of Long Covid patients in the care trajectory post-Covid-19: evidence from Belgium
Authors: Moreels S , De Schreye R , Bensemmane S 
Published: October 2024

Abstract

Background
Evidence suggests that 10-30% of COVID-19 infected people develop persistent symptoms that can be diagnosed as Long Covid. Most Long Covid cases are in patients with a mild acute COVID-19 infection and are mainly treated in primary health care. In July 2022, a care trajectory (CT) post-Covid-19 was launched in Belgium, in which Long Covid patients can benefit from reimbursement of treatment costs when consulting health professionals in primary health care for their rehabilitation. Patients are included in this CT mainly through their general practitioner (GP) and depending on patients’ care needs, treatment is organized in a monodisciplinary or multidisciplinary way.

Methods
A population-based study on data collected by the Belgian network of Sentinel General Practitioners (SGP) on all Long Covid patients consulting their GP during March-December 2023. Information on inclusion in the CT post-Covid-19 was also registered. Descriptive statistics were performed.

Results
End of 2023 in Belgium, GPs initiated the CT post-Covid-19 for more than 1000 patients, this mainly for monodisciplinary treatment, less than 10% of included patients received multidisciplinary follow-up. By the SGP, among the registered Long Covid sufferers (N = 14), a total of six cases were included in the CT post-Covid-19. Of these cases, the majority were female, of older age, higher educated and had one or two chronic conditions. Most had a mild or moderate prior COVID-19 infection and all were vaccinated multiple times against COVID-19. Symptoms lasted one year or more for 83.3% of included patients. Treatment focused mainly on self-management, energy management and physical exercise programs, mainly in collaboration with physiotherapists.

Conclusions
This study yields recent data on patients included in the CT post-COVID-19 in primary care in Belgium. It is important to focus on guidance, follow-up and rehabilitation of Long Covid sufferers by healthcare professionals in Belgium.

Key messages
• Long Covid patients included in the care trajectory post-Covid-19 in Belgium experience years of debilitating symptoms after their prior COVID-19 infection.
• The establishment of the care trajectory post-Covid-19 for Long Covid patients in primary care since July 2022 stimulated collaboration between care givers in Belgian primary health care.
The impact of fuel poverty on cold-related mortality in England and Wales: disentangling the effects of fuel price, income, and energy efficiency
Authors: Wan K , Taylor J , Hajat S 
Published: October 2024

Abstract
Cold temperatures have been widely acknowledged as an important burden of poor health in many parts of the world including the UK. Although the temperature is expected to increase in the future due to climate change, the latest UK Health Effects of Climate Change (HECC) report projected that the number of cold-related deaths in the UK is expected to be more than 2 times of heat in the 2070s even under a high emission climate change scenario (RCP8.5). Therefore, it is still imperative to take intervention to reduce the health impacts of cold. People spent more than 90% of their time indoor and hence being able to stay in warm homes is crucial for reducing the impact of cold. However, some people may not be able to warm their home enough, a problem known as fuel poverty. Multiple factors can contribute to fuel poverty, including low income, poor housing performance, high fuel price as well as competing interest in fuel consumption and other essential living expenses. These challenges have been witnessed markedly during the cost of living crisis since 2021. This research investigates the effect of fuel poverty on cold-related mortality risk in England and Wales using small areal data. The underlying contributing factors of fuel poverty are explored to study the main mechanisms. The findings can support the identification of those who may be mostly affected by fuel poverty, and hence improve policies and interventions on reducing fuel poverty and protecting the public health from low temperatures.
The impact of the COVID-19 pandemic on physical activity among primary school children in Ireland
Authors: Kilduff O , Slattery J , Lee C , Hunt E , Douglas A , O’Brien S , Murrin C , Kelleher C 
Published: October 2024

Abstract

Background
The containment measures implemented during COVID-19 to curb the virus’s spread disrupted family life globally and profoundly impacted children’s daily behaviours. A decrease in children’s physical activity during COVID-19 is one such health behaviour change that was observed in many European countries. This study aimed to understand the pandemic’s impact on primary school children’s physical activity in Ireland which is important given the epidemic of childhood obesity and chronic diseases in the long term.

Methods
All Childhood Obesity Surveillance Initiative (COSI) participating countries (n = 45) could voluntarily implement the COVID study as part of their COSI Round 6 (R6) data collection or separately. The parents of First and Second-class primary school children (n = 2,784) who consented to participate in COSI-Ireland R6 were invited to complete the family survey which included the standardised COVID study. The COVID module assessed children’s lifestyles and health behaviours before and during the pandemic through 12 questions. Consenting parents supplied their email or postal address and completed the survey in hardcopy or electronically using LimeSurvey. Descriptive statistics were then calculated on the cleaned pseudonymised dataset (n = 1,060) using IBM SPSS Statistics 27.

Results
The time spent playing actively outside school hours remained the same for some children on both weekdays and weekends (24.2% and 37.1%, respectively). An increase rather than a decrease in the time spent in active play was also observed among almost twice as many children across Ireland on both weekdays (47.3% and 24.2% respectively), and weekends (40.10% and 21.80% respectively).

Conclusions
The positive findings show that the public health messaging from the Irish Government which emphasized the importance of staying active during COVID-19 may have been effective. Further research to assess children’s physical activity during COVID-19 is warranted to inform future pandemics.

Key messages
• In Ireland, unlike in many European countries, a substantial number of primary school children increased their time spent playing actively during the COVID-19 pandemic.
• A unique trend in Irish children’s physical activity levels compared to their European counterparts.
Vaccination Coverage among Institutionalized Elderly Population: A Case Study in Cascais, Portugal
Authors: Quelhas C , Lopes M , Moniz C , Fernandes M 
Published: October 2024

Abstract

Vaccination stands as a cornerstone of public health, significantly reducing the morbidity and mortality associated with infectious diseases. However, the aging demographic, with declining homeostasis and immunosenescence, presents new challenges. Those residing in nursing homes face heightened risks of infectious diseases due to proximity and interactions with multiple staff members. In Portugal, elderly vaccination against tetanus/diphtheria (Td) is integrated into the National Vaccination Program, with additional official recommendations for pneumococcal (Pn), seasonal influenza, and COVID-19 vaccinations. Specific vaccination campaigns in nursing homes for influenza and COVID-19 are coordinated by Public Health Units. This study aimed to assess the vaccination coverage for these vaccines among the institutionalized elderly in Cascais municipality and evaluate the implementation of official recommendations. A survey of nursing homes in Cascais was conducted, and the vaccination status of residents was assessed through electronic records in February 2024. Statistical analysis was performed. Vaccination status for each vaccine was considered valid if individuals had received at least one dose of Pn13 or Pn23, a Td vaccine dose within the last 10 years, and vaccinations against influenza and COVID-19 within the last 6 months. Among 2189 institutionalized elderly in Cascais, 87% were vaccinated against both influenza and COVID-19, 39% against Td, and 17% against pneumococcal disease. While influenza and COVID-19 vaccination coverage is high, the tetanus/diphtheria vaccination rate is low, and pneumococcal vaccination is very low, despite official recommendations. This population remains at increased risk for preventable diseases. Monitoring vaccination status and implementing targeted vaccination campaigns are crucial for increasing coverage, realizing health and economic benefits and preventing severe diseases.

Key messages
• Vaccination is essential for safeguarding the health of institutionalized elderly populations. There is a need for targeted interventions to address preventable diseases and protect these individuals.
• Monitoring vaccination status and implementing targeted campaigns are critical for increasing coverage and realizing health and economic benefits among elderly populations in nursing homes.
How Avoidable Mortality is influenced by health expenditure: an Italian 14-year panel data analysis
Authors: Sanna A , Guarducci G , Golinelli D , Nante N 
Published: October 2024

Abstract

Background
Avoidable Mortality is a widely used public health indicator to assess the quality of healthcare systems. The aim of this study was to investigate how the allocation of private and public health expenditure (PHE) could influence avoidable mortality (AM), treatable mortality (TM) and preventable mortality (PM) of Italian citizens.

Methods
A pooled cross-sectional time series study was conducted. Italian healthcare data from 2009 to 2019 was extracted from ‘Health for All’, a WHO-related database released periodically by the Italian National Institute of Statistics. PHE was divided by providers area (directly provided services (DPS), general and specialist medicine, pharmaceutical, rehabilitation). Data about private health expenditure, gross domestic product per capita (GDPPC), level of education, medical drug consumption per capita (MDCPC), general practitioners per capita (GPPC), physical exercise, tobacco use, and obesity were collected. AM was divided into TM and PM using OECD/Eurostat lists of causes of death (2022). A fixed-effects regression was used to assess the effects of economic and social variables on AM, TM and PM.

Results
Higher spending on DPS (-0.027), higher MDCPC (-0.859) and higher GDPPC (-0.001) were associated with lower rates of AM. Higher sport activity (c -0.673) was associated with lower rates of TM. Higher levels of private health expenditure (0.022) and higher number of GPPC (0.023) were associated with higher rates of PM; these counterintuitive results could be caused by the inappropriateness of medical treatment directly requested by patients. Other variables were not significantly associated with AM, TM or PM.

Conclusions
The results highlight the importance of medical DPS by NHS (emergency departments, hospital care, specialized care, primary care, etc.). Analyzing health data divided by areas of NHS we could help policy makers to allocate human and economic resources more efficiently.

Key messages
• The allocation of public health resources could influence the health status of the polulazion.
• Italian National Health System could reduce avoidable mortality through the use of directly provided services.