bluuebunny/crossref_metadata_2025_split huggingface dataset:
The role of task shifting in mitigating health workforce shortages - the ambitions and results of the TaSHI project
Authors: Koder F 
Published: October 2023

Abstract
The shortage in the health workforce is a long-standing phenomenon while the importance of the human factor in health is constantly increasing. The COVID-19 pandemic has further increased the burden of the health sector, the workload, the stress and the risk of burnout. At the same time, the pandemic acted as a catalyst as professionals had to take on new roles, join new teams and increase collaboration with other health professionals. Task shifting can reduce the workload and skill-mix imbalances by sharing and redistributing tasks between health professionals, involving patients and the digital ecosystem. Task shifting can be an effective way to improve cultural sensitivity and openness thereby increasing a positive working environment. Moreover, task shifting can enlarge resilience while addressing HWF shortages and geographical imbalances, particularly in remote rural areas. TaSHI “Empowering EU health policies on Task SHIfting” aims to provide a novel understanding and up-to-date knowledge on task shifting, transferability and uptake of good practices in implementation. The project performs (regional) pilots in five European countries (Estonia, Italy, Lithuania, the Netherlands and Norway). It gathers evidence and data on the different types of task shifting in primary care, mental health care, wound care and eye care including the role of telemedicine and digital health. Through the involvement of health professionals TaSHI delivers a collection of good practices, useful tools and methods through case studies of the pilot experiences, producing a guidebook on task shifting supporting implementation, with practical training materials and curricula, and a set of recommendations. The deliverables on tangible solutions aim to support EU Member States at national, regional and organisational level to implement their own actions and promote sustainability of practices adapted to local settings. TaSHI project is co-funded by the Health Programme of the EU.
Trajectories of psychopathology among young people related to outcomes in young adulthood
Authors: Dooley N , Healy C , Cotter D 
Published: October 2023

Abstract
What does young adulthood look like for individuals who had mental health problems across childhood? Using the Growing Up in Ireland cohort (born in 1998 and studied from ages 9 to 20) we explored the association between mental health problems between ages 9 and 13, and subsequent poor outcomes in the same individuals at ages 17-20. We consider educational/economic outcomes, health service use, poor mental and physical health, social isolation, substance abuse, and subjective wellbeing in young adults. In a previous study that used latent class modelling, we identified four groups which captured mental health in a general population sample of children. Between ages 9 and 13, children could be grouped into: a low symptoms group (∼65%), an ‘externalising’ group with ADHD or conduct symptoms (∼20%), an ‘internalising’ group with depressive, anxiety or peer issues (∼10%), or a group showing many combined mental health symptoms (∼2%). All mental health problem groups had elevated odds across all 7 adverse outcomes in young adulthood. The 5 areas of young adult functioning most related to childhood mental health were: education/economics, subjective wellbeing, mental health, social isolation and substance abuse. Poor educational/economic outcomes were as likely as poor mental health (OR ∼ 2) in individuals with childhood psychopathology. The 3 childhood problem groups showed different risk profiles in young adulthood. For instance, the childhood internalising group had lower odds of substance abuse than all other groups, but had the highest odds of poor physical health by adulthood. Findings point to the need for a wider range of preventative supports for children and adolescents with a history of mental health problems, beyond just mental health support. These include interventions to improve physical health, treat substance abuse, reduce social isolation, and improve adverse educational and economic outcomes.
Risk and protective factors for cannabis use among young people - a population based survey
Authors: O'Dowd T , Power E , Cannon M 
Published: October 2023

Abstract

Background
Cannabis is the most commonly used illicit substance in Ireland and globally, with its use most likely to occur in adolescence when the developing brain is more vulnerable to cannabis-related harm. This study aims to ascertain the prevalence of and determine the risk and protective factors for cannabis use among adolescents in the North East of Ireland.

Methods
This study is a cross-sectional, secondary analysis of the 2021 Planet Youth survey. The population comprised a sample of 4404 adolescents aged 15-16 in Cavan, Monaghan and North Dublin. The outcome of interest was cannabis use in the last 30 days. Independent variables were selected a priori following a literature review. Associations between cannabis use and the independent variables were explored using logistic regression.

Results
The prevalence of current cannabis use among study participants was 7.3%. The odds of cannabis use were higher among current alcohol users (aOR 2.68, CI 1.79-4.02), smokers (aOR 3.17, CI 2.18-4.60), e-cigarette users (aOR 2.72, CI 1.87-3.96), adolescents who did not perceive its use as harmful (aOR 2.24, CI 1.51-3.32), felt their parents were not against cannabis (aOR 3.71, CI 2.43-5.66), had cannabis-using peers (aOR 9.81, CI 5.76-16.71) or felt peer pressure to use cannabis (aOR 1.91, CI 1.09-3.33). Low parental supervision was associated with higher odds of cannabis use. There was no association between gender and cannabis use.

Conclusions
This study identified five risk factors and three protective factors associated with cannabis use which can be targeted by policymakers when designing drug prevention strategies.
An ethics framework for social listening and infodemic management
Authors: Machiri S , Purnat T , Nguyen T , Ho C , Ballalai I , Biller-Andorno N , Germani F , Spitale G , Briand S , Reis A 
Published: October 2023

Abstract

Issue
Successful response to an infodemic requires social listening and integrated analysis to produce infodemic insights by identifying questions, concerns, information voids and circulating narratives including health misinformation. There is currently a wide variation in social listening and infodemic insights generation practices, and a lack of frameworks to be applied on ethical values and standards.

Description of the problem
In the context of infodemic management, infodemic insights are generated based on social listening, health system and data from online and offline sources. Where there is a difference between health guidance and behaviors during an emergency, rapid infodemic insights can help understand the underlying drivers of this divergence. Integrated analysis of this data informs infodemic management strategies generate insights that advise a wide range of public health interventions. Present ethical challenges influence data processing and use.

Results
The World Health Organization (WHO) convened a group of experts to develop an ethical framework for social listening and infodemic management. It will guide health authorities and practitioners in planning and setting up infodemic insights teams and implementing infodemic management activities. To support the deliberation of the WHO expert group, a systematic review has been conducted to understand present ethical concerns and challenges.

Lessons
Infodemic management strategies raise ethical concerns that relate to data control, commercialization, transparency, accountability and implications. Power and power imbalances, human rights, privacy and dignity, trust and respect for cultural practices may arise during data collection, analysis, interpretation, and intervention design. Without proper ethical oversight and guidance, the implementation of infodemic management strategies could harm individuals and communities, erode trust, and undermine the effectiveness of responses to a public health emergency.

Key messages
• Social listening and infodemic management by health authorities require consideration of ethical principles and guidance.
• WHO ethics guidance will help public health authorities establish infodemic management practices, policies and strategies.
Estimating the burden of Long COVID symptom clusters in Ireland
Authors: Igboanugo T , Kabir Z 
Published: October 2023

Abstract

Background
Long COVID is a multi-system illness with the potential for a substantial impact on society, from increased healthcare costs to economic and productivity losses. Long COVID is an umbrella term with no consensus on the definition. Long COVID burden estimations in Ireland are patchy and unavailable. We set out to estimate the burden of Long COVID symptom clusters (LCSCs) in Ireland from March 2020 to February 2022.

Methods
Data were obtained from the Health Protection and Surveillance Centre, Ireland. We modelled estimates of the proportion of individuals with Long COVID symptoms based on the Global Burden of Disease Long COVID Study framework. Years Lived with Disability (YLD) due to Long COVID symptom clusters were estimated by age and gender.

Results
An estimated 1.2 million symptomatic SAR-CoV-2 infection was reported in Ireland between March 2020 and February 2022. Overall, 6.3% of individuals who had symptomatic SARS-CoV-2 experienced LCSCs. About 13,657 individuals [females: 6,724 (95% UI: 2,444, 14,439); males: 6,933 (95% UI: 2,594, 14,515)] experienced LCSCs in the first year, and 58,983 in the second year of the pandemic [females: 30,511 (95% UI: 10,377, 69,087); males: 28,472 (95% UI: 9,779, 63,988). YLD attributable to Long COVID was 1,373 (95% UI: 363, 3878) and 4,687 (95% UI: 1,111, 14,575) in the first and second year of the pandemic, respectively. Females experienced a higher Long COVID burden (3,034 YLD) than males (3,026 YLD). Females aged 25-44 years had the highest burden of Long COVID (994 YLD). Long COVID contributed 81.2% (95% UI: 61.4%, 90.2%) of the total YLD [7,464 (95% UI: 2,399, 20,467)] due to COVID-19 within the period.

Conclusions
Long COVID estimates are crucially important for evidence-informed policymaking and developing a model of Long COVID care in Ireland. However, the full impact of Long COVID on population health and the healthcare system will be clearer once a core set of health outcomes is developed internationally.

Key messages
• Post-acute consequences of COVID-19 are the major contributor to the morbidity burden.
• Long COVID estimates are crucially important for evidence-informed policymaking and developing a model of Long COVID care in Ireland.
Adherence to Mask Wearing Policies in OECD and Non-OECD Nations
Authors: McCoy C , Adeyemi O 
Published: October 2023

Abstract

Background
When medical facemasks became a key non-pharmaceutical intervention (NPI) against COVID-19, public health researchers quickly tried to understand why persons did or did not comply with masking policies. Research connected mask adherence to various social characteristics and psychological attitudes. While important, much of this research was performed in the Global North and one might wonder: Are the characteristics of persons who adhere to mask policies the same in industrialising non-OECD nations as in more economically developed OECD nations?

Methods
To examine this question, we used the global COVIDiSTRESS survey and responses from over 15,000 persons in 49 countries to examine the demographics, socioeconomic status (SES), sources of COVID-19 information, and levels of trust of those persons who consistently adhered to mask policies. Using logistic regression analysis, we find important differences between respondents in non-OECD and OECD nations.

Results
We find that identifying as a woman has a significantly stronger impact on mask adherence in OECD nations than in non-OECD nations. In contrast, higher levels of SES (especially higher levels of education) have a stronger impact on mask adherence in non-OECD nations. Furthermore, only in OECD nations is social media use related to a decreased likelihood of adherence and trust in the government's ability to handle COVID related to an increased likelihood of mask adherence.

Conclusions
Our research shows that the characteristics related to adhering to mask policies varies depending on whether one is referring to OECD or non-OECD nations and that research from the Global North cannot not be simply applied to the Global South. Instead, when another global pandemic occurs, mask policies should be developed based on research findings specifically related to that nation and its level of economic development.

Key messages
• We find important differences in mask adherence between persons in non-OECD and OECD nations.
• Research on mask adherence produced in the Global North cannot simply be applied to the Global South.
Exploring flexible methods for national health examination surveys in Germany
Authors: Neuhauser H , Weihrauch T , Maier B , Wolff C , Hey I , Schienkiewitz A , Sarganas G , Gößwald A , Schmich P , Stahlberg S 
Published: October 2023

Abstract

Background
National health examination surveys (HES) are rarely carried out due to high costs and high complexity. We piloted more flexible methods such as self-sampling, self-measurements and household visits conducted by a study-nurse replacing physician examinations in study centers.

Methods
Feasibility of several new methods for the German HES was tested, e.g.: large-scale implementation of unattended self-sampled dried blood spots (DBS) and oral-nasal swabs (ONS) in a countrywide general population panel including a large subsample with migration background (Study 1, n = 15,122); household visits with brief biosampling & examinations (Study 2, n = 470); and unattended blood pressure (BP) self-measurements with mailed devices and video instructions (Study 3, n = 202).

Results
Among participants consenting to participate, Study 1 showed successful postal self-sampling of DBS for SARS-CoV-2 antibody tests in 98% of participants and 97% valid ONS for SARS-CoV-2 PCR tests. Study 2 showed successful standardized measurements of BP (97%), weight/height (99%) and DBS and venous blood sampling with onsite whole blood centrifugation (97%). Temperature requirements for centrifugation, cooled transport and ATC-coded medication assessment (Anatomical Chemical Classification) proved challenging and needed revised methods to avoid data loss. Nested validation studies confirmed use of a multiplex assay for various antibodies with DBS and of HbA1c analysis with uncooled specimen. The strict and time-consuming BP self-measurement-protocol with 12 measurements in Study 3 was followed only by 54% of participants.

Conclusions
Self-sampling and biosampling & examinations in households are feasible options for HES but protocols with high complexity may result in low data completeness.
Step-by-step towards regular health examination surveys in Portugal
Authors: Barreto M , Nunes B , Matias-Dias C 
Published: October 2023

Abstract
The 1st National Health Examination Survey was performed in Portugal in 2015 following the EHES procedures. It consisted of a cross-sectional population-based study representative at regional and national level. Individuals aged 25-74 years, residing in Portugal were selected from the national health users’ registry through multi-stage stratified probabilistic sampling. Data was collected in primary care units and included blood pressure, height, weight, hip and waist measurements, blood collection for lipid profile, HbA1c and blood count and a general health questionnaire. A biobank was created which includes serum, plasma, DNA and whole blood of consenting INSEF participants. Nationally representative quality epidemiological data is now available for public health monitoring, planning and research. The data has provided several indicators for the National Health Programs such as tobacco consumption, prevalence of diabetes, obesity, hypertension and dyslipidaemia for the National Program for Tobacco Prevention and control, National Program of Diabetes and National Program for the Promotion of Healthy Eating. In addition, indicators such as excessive salt consumption were used as a starting point for healthy eating campaigns towards reducing its use. The second National Examination Survey is currently being planned and is expected to be held in 2025 in a consortium with the National Food and Nutrition Survey and with the National Serological Survey. The planning and implementation of a single health survey that associates self-reported information on health status and disease, behavioural health determinants, including a detailed dietary and physical activity component, physical examination, and collection of biological products (blood and urine) would constitute an essential source of knowledge for the monitoring, evaluation of public health interventions, and for population-based epidemiological research.
Quantifying the environmental burden of disease for children and adolescents in Germany
Authors: Plass D , Kienzler S , Tobollik M , Wintermeyer D 
Published: October 2023

Abstract

Introduction
Children and adolescents are more vulnerable to the impacts of environmental risk factors. They are in a sensitive stage of life, where the organ systems are still developing. Already minor interferences can have an effect on their future health. The UKAGEP-project aimed to estimate the Environmental Burden of Disease (EBD) for children and adolescents in Germany.

Methods
We tested the feasibility of applying the EBD-concept, developed by the World Health Organization, for 18 environmental risk factors. Where possible, data from the German Environmental Survey (GerES V) was used as the basis for the analyses. In addition, we performed systematic literature searches to identify adequate exposure-response-relationships.

Results
EBD quantifications were performed for 5 out of 18 environmental risk factors (PM2.5, bisphenol A, environmental noise, second-hand smoke and benzene). For the remaining risk factors, only particular steps of the EBD approach were realized. Taking two exemplary risk factors, about 28 % (170,000) of all obesity cases in the 7-17-year-olds were due to the exposure to bisphenol A and nearly 5 % (1,300) of the disability-adjusted life years for lower respiratory tract infections in 3-17-year-olds were attributable to PM2.5 in 2016.

Conclusions
Even though quantifications were performed for several risk factors, we had to conclude that for the remainder, availability and quality, especially of the exposure-response relationships and health data, were not sufficient to estimate burden of disease. Further, the exposure to some of these risk factors assessed in the GerES-V-study was too low to allow estimating the EBD. This does not mean that the identified concentrations were generally uncritical or that lifelong exposure could not lead to health impairments in the further life course. It only means that potential health outcomes have not occurred yet or the concentrations may lead to subclinical alterations in human body systems.

Key messages
• Environmental risk factors cause considerable burden in children and adolescents.
• Estimating the environmental burden of disease for children and adolescents remains challenging.
Identifying health inequities using a health system performance assessment: findings from Germany
Authors: Achstetter K , Blümel M , Haltaufderheide M , Hengel P , Busse R 
Published: October 2023

Abstract

Background
Reducing health inequities is an important goal of high-performing health systems. Therefore, health inequities need to be assessed systematically, continuously and for all relevant aspects of a health system. The tool “health system performance assessments” (HSPA) aims at monitoring and evaluation the achievement of predefined goals and therefore the overall performance of a national health system. The aim of this study was to identify health inequities using a national HSPA.

Methods
A pilot study for a national HSPA in Germany was conducted between 2020 and 2023. The underlying framework defined the health system goals (e.g., access, quality, population health) and the respective indicators. Equity analyses (e.g., age, gender, socioeconomic factors, geographical region, type of health insurance) were conducted for each indicator to highlight inequities.

Results
Inequities were found for all health system goals. For example, unmet needs (“access”) were higher among people in the lowest income quintiles and in suburban areas. Potentially inadequate medication among the elderly (“quality”) was found more often for women and people 85+ years. The prevalence of infectious diseases (“population health”) was higher among men.

Conclusions
Using a national HSPA to discover health inequities can help identify these in all areas and for all goals of a health system and monitor their development over time. The systematic and continuous assessment within an HSPA is an important prerequisite for identifying and evaluating measures aiming at reducing health inequities.

Key messages
• A national health system performance assessment is useful for identifying and monitoring health inequities on a system level.
• Health inequities (e.g., regarding age, gender, geographic region) were found for every goal of the German health care system.
Improving the quality of translation for patients with language barriers
Authors: Patel M , Fernyhough C , Loo Y , Hillier M , James H 
Published: October 2023

Abstract

Background
Patients with language barriers have worse health outcomes. To promote equitable care, efforts must be made to ensure effective communication with patients, specifically by using professional impartial translation services.

Aims
To build upon previous cycles to promote the use of professional impartial translation.

Methods
A multi-centre quality improvement project in the Acute Medicine Departments of Bart's Health Trust Hospitals in East London. Patients with language barriers were identified; methods of translation were analysed; and interventions to improve access to professional translation were introduced. Professional impartial translation was defined as use of either a member of staff or interpreter.

Results
The first three cycles were completed at the Royal London Hospital. Interventions included the dissemination of information to staff members and also the provision of Bengali interpreters on the ward. This improved the number of patients receiving professional impartial translation from 5% to 20%. Further cycles at Newham Hospitals were then undertaken. The initial intervention included the provision of a portable language line device providing 24hour access to professional translation via telephone or video. Despite this, &lt;20% of patient received professional impartial translation, with &gt;50% still receiving translation via a family member instead. Following departmental teaching sessions on the project, this improved significantly with 35.7% having in person and 33.3% having telephone professional translation.

Lessons
Translation is commonly provided by family members who are often seen as natural advocates for patients; however they may lack impartiality and may be selective in their translation. Impartial professional translation is essential in delivering equitable care. Improved access to translation services alone was not enough, with significant increases in impartial professional translation only being seen after education on its benefits.

Key messages
• Education of staff and easy access to translation services improve their use.
• However, further research is needed to identify why family members are still chosen over professional services.