bluuebunny/crossref_metadata_2025_split huggingface dataset:
Healthcare utilization during the COVID-19 pandemic: changes, potential causes. A Swiss cohort study
Authors: Harju E , Speierer A , Jungo K T , Levati S , Baggio S , Puhan M A , Probst-Hensch N , Michel G , Rodondi N , Chocano-Bedoya P 
Published: October 2023

Abstract

Background
The COVID-19 pandemic led to a decrease in the provision and use of healthcare. Few studies reported reasons for these changes. We aimed to (i) describe the frequency of changes in healthcare utilization in those requiring ongoing treatment, and possible reasons thereof, and (ii) assess characteristics associated with change, during the second wave of the pandemic.

Methods
Participants from the Corona Immunitas e-cohort study (age ≥20 years) completed monthly questionnaires between September 2020 and February 2021. We used descriptive and bivariate statistics, to compare participants reporting a change in healthcare utilization with those who reported no change. We used negative binomial regression to explore characteristics associated with the number of changes.

Results
In total, 3190 adults from nine research sites participated in this study. One-fifth (N = 658, 21%) reported the need for regular treatment. About 14% of them reported a change in healthcare utilization, defined as events in which participants reported that they changed their ongoing treatment, irrespective of the reason. Reported reasons for change were medication changes and side-effects, specifically for hypertension, or pulmonary embolism treatment. Females were more likely to report changes in healthcare utilization (Incidence Rate Ratio (IRR)=1.69, p = 0.030), and those with hypertension were least likely to report changes (IRR=0.45, p = 0.092).

Conclusions
Among those who needed regular treatment, few reported changes in healthcare utilization. The importance of continuity of care for females and chronic diseases other than hypertension must be emphasized. This calls for tailored measures considering gender disparities.

Key messages
• Changes in healthcare utilization were more pronounced in women than men during the Covid-19 pandemic.
• Tailored disease surveillance is necessary considering gender disparities and chronic diseases other than hypertension.
Innovative strategies for the management of common mental disorders
Authors: Ali S 
Published: October 2023

Abstract
Innovations such as computerized/internet-based interventions are taking centre stage in the management of common mental disorders. For example, computer-assisted cognitive behavior therapy (CCBT) has been proposed as a method for improving access to effective psychotherapy, reducing cost, and increasing the convenience and efficiency of treatment for depression. Results from our own research suggest that CCBT may have significantly greater effects on depressive symptoms than treatment as usual (TAU) in primary care patients with depression. Our study population included people with lower income and lack of internet access who typically have been underrepresented or not included in earlier investigations of CCBT; hence, results suggest that this form of treatment can be acceptable and useful in diverse primary care settings.
Comparison, by Country, of the Uptake of COVID-19 Vaccination by Health Care Workers in the EU/EEA
Authors: McGlacken T , Codd M 
Published: October 2023

Abstract

Health Care Workers (HCWs) are at high risk of exposure to COVID-19 when providing care to patients. We investigated the uptake of COVID-19 vaccination among HCWs in the EU/EEA and discuss the factors which influence this uptake.- The aim of this study was to compare, by country, COVID-19 vaccination uptake by HCWs from January to June 2021, to assist with policy making and prospective planning in these countries during the current pandemic and into the future. The study population included all the countries in the European Union (EU) and European Economic Area (EEA). The secondary data file was downloaded from the European Centre for Disease Prevention and Control (ECDC) website Descriptive and comparative data were analysed and presented using Excel and Chi-square test of hypothesis. The percentage of HCWs in EU/EEA countries ranged from 1.2% to 5.1% per population. From January to June 2021, the percentage of first and second dose vaccinations of HCWs ranged from 20% to 100% and from 21% to 100%, respectively. The Comirnaty-Pfizer/BioNTech vaccine (COM) was the most administered vaccine in all EU/EEA countries, followed by the Moderna mRNA-1273 vaccine (MOD) and the Astra-Zeneca-Vaxzevria vaccine (AZ). The Janssen-Ad26.COV 2.5 vaccine (Janss) use ranged from 0.1% to 4.8% for the one dose vaccine. Hungary was the only country that administered the Sputnik V vaccine (SPU) and the Beijing CNBG vaccine (BECNBG). In January 2021, a median of 29% of HCWs received their first dose of COVID-19 vaccination. Italy was the only country with a mandatory vaccination policy for HCWs. Vaccination uptake rates were statistically different among EU countries (p &lt; 0.05). Data such as these could be used in mathematical modelling potential future pandemics to predict vaccine up-take by selected, exposed, vulnerable sectors of the population, for whom it is relevant.

Key messages
• Vaccine hesitancy in healthcare workers.
• Planning for the next pandemic.
Viricide activity of antimicrobial blue light (405 nm) against the SARS-CoV-2 and influenza virus
Authors: Dragoni L , Amodeo D , Cevenini G , Marchi S , Trombetta C , Nante N , Messina G 
Published: October 2023

Abstract

Background
Over the years, antimicrobial blue light (aBL) at a 405 nm wavelength has emerged as a potential alternative treatment for reducing the environmental contamination. It is well accepted that aBL is much less detrimental to host cells than UV-C irradiation and can be used in the presence of people. This study aims to determine the viricide activity, against the SARS-CoV-2 and influenza virus types A and B, of the nUV-A radiation, using a customized nUV-A ceiling lamp System.

Methods
The experiment took place in March 2023. An nUV-A ceiling lamp prototype, composed of 9 LEDs at 405 nm, was fixed on a metal scaffold, on which the outline of a multiwell plate (24 wells) was traced to carry out the tests correctly. Each plate well was inoculated with 100 µL of SARS-CoV2 or influenza virus types A or B suspension. The multiwell plate was irradiated at 32 cm for 45 and 90 minutes, with an emitted energy dose of 12 J/cm2 and 24 J/cm2. Three samples were inoculated with viruses and subjected to the action of nUV-A as per protocol, and 3 samples were inoculated but not treated with nUV-A to determine viral titer after recovery and examined immediately after inoculation. The re-collected suspensions were used to inoculate a wells plate into which the VERO E6 cell cultures were fixed and then incubated for 3 days at 37° C.

Results
The results showed that after a 45 min exposition, the measurable log10 mean reduction was 1.50 for SARS-CoV2, 0.13 for influenza virus type A and 0.12 for type B; after 90 min the log10 mean reduction was 2.33 for SARS-CoV2, 0.16 for influenza virus type A and 0.17 for type B.

Conclusions
Tests have shown that aBL can be effective in reducing the viral load of the SARS-CoV2 virus and, to a lesser extent, the influenza A/B viruses. Disinfection with aBL appears effective and avoid the adverse effects of using UV-C. Further studies will evaluate how to improve the results on influenza viruses and the application on other viruses such as RSV.

Key messages
• NearUV-A lamp has proven to reduce the virucide activity of all viruses, more for sars-cov2.
• Using aBL avoids the adverse UV-C’s effects.
Management and control of an outbreak of NDM-producing Klebsiella pneumoniae in a teaching hospital
Authors: Tocco Tussardi I , Stevanin G , Montesarchio L , Palladini F , Aprili I , Zandonà E , Tardivo S 
Published: October 2023

Abstract

Background
Outbreaks caused by New Delhi metallo-β-lactamase (NDM)-producing Enterobacteriaceae are a major public health threat. We report an outbreak caused by NDM-producing Klebsiella pneumoniae (KP) in an Italian teaching hospital and describe the composite management approach that led to a successful containment.

Methods
On August 12 2022, a 39-year old Ukrainian patient with known colonization (rectal swab) by NDM-producing KP was admitted to the Hematology Unit of the University Hospital of Verona, Italy. Six days after, a second patient tested positive for carbapenem-resistant (CR) KP from rectal swab and 2 additional cases (rectal and pharyngeal swab respectively) were identified in the following 2 weeks. The 4 cases were identical strains.

Results
A multidisciplinary team coordinated the response actions. Isolation measures were ordered for positive patients, including use of dedicated instruments. Screening at admission and every 7 days was placed for all the ward patients. On-site inspections and microbiological screening of ward surfaces and devices were carried out. Infection prevention and control (IPC) measures were strengthened among personnel. Environmental cleaning was implemented by deep treatment of critical points (e.g. toilets) and reinforcement of routine cleaning. The Risk Manager developed an original checklist based on literature to review the implementation of IPC practices for CR Enterobacteriaceae. No new cases were identified from screening in the following weeks and the Unit returned to standard IPC measures. Given that environmental samples were negative and the cases had overlapping personnel, the hypothesis of contact transmission through caregivers was the most plausible. Reinforcement of training on hand hygiene and transmission-based precautions was planned.

Conclusions
It was possible to contain the hospital outbreak through rapid and diversified reaction capacity. Continuous IPC education is an essential control measure.

Key messages
• The spread of NDM-producing Enterobacteriaceae in the hospital setting must be countered with enhanced prevention and, in case of outbreak, rapid control.
• Effective containment involves a mix of established measures (screening, hygiene, environmental controls) and innovative approaches (e.g. literature-based checklists).
Forecasting of COVID-19 spread in Poland as part of health needs mapping
Authors: Witczak K , Raczyńska M , Kozioł-Rostkowska M , Śmiglewska A 
Published: October 2023

Abstract

The development of a robust model for COVID-19 forecasting was a crucial task undertaken by the Ministry of Health of the Republic of Poland in response to the pandemic. High-quality forecasting rendered the inclusion of COVID-19 modelling in health needs assessment indispensable at the regional as well as country level. The model served as a basis for data-driven policy-making, such as the introduction or lifting of non-pharmaceutical interventions and the management of hospital resource allocation. The proposed model draws upon the population-adjusted infection fatality rates, vaccine-induced immunity, reported test positivity rates, and COVID-19-related mortality to infer the dark figure of cases. The estimates of the true number of infections lay the foundations for the computation of variant-dependent effective reproduction numbers, which constitute the workhorse of the model. The algorithm utilises the Bayesian prediction of those metrics along with the estimation of hybrid immunity levels to arrive at a short-term forecast of the course of the pandemic. The implemented model yields reliable results throughout the outbreak, allowing for the assessment of the strain of consecutive epidemic waves on the healthcare system.

Key messages
• Forecasting of COVID-19 spread is vital for health needs assessment and health crisis management policy-making.
• Short-term forecasting of COVID-19 spread using effective reproduction numbers yields high-quality results.
Implementation of COVID-19 measures for Dutch nursing home staff and their insights
Authors: van Dijk Y , van Tol L S , Achterberg W P , Zuidema S U , Janus SIM 
Published: October 2023

Abstract

Background
Measures against COVID-19 in nursing homes impacted both clients and staff, yet the importance of measures from the staff's perspective remain underexplored. This study examined measures related to staff during the COVID-19 pandemic, staff perspectives of their importance and the involvement of staff in deciding these measures.

Methods
In this qualitative study, the minutes of 41 nursing home outbreak teams in the period March to November 2020 were analyzed and 4 group meetings were conducted between June-November 2020. Qualitative content analysis was used for the minutes data, whereas reflexive thematic analysis was used for the group meeting data.

Results
Measures implemented for staff focused on prevention of COVID-19 transmission, (suspension of) educational activities, testing, additional tasks and staffing capacity, promoting well-being, and other means of support. The results showed overlap between the implemented measures and the measures considered important by staff, except for measures on decision-making support and communication, which were considered important by staff but not listed among the implemented measures. Measures were prioritized by staff because they affected their well-being, workforce scheduling, decision making, or preventing infections. Furthermore, the group meetings revealed that decision making shifted from mainly implementing national guidelines to more context -adjusted decision making in the staff's or clients’ situation.

Conclusions
Although there was overlap regarding measures taken, our findings suggest that organizations should be encouraged to explore ways of timely involvement of staff in decision making when implementing measures in future pandemics. During the COVID-19 pandemic, information about the pandemic response strategies and policies were shared with policymakers and nursing home organizations to learn from each other and make more informed decisions about how to respond to the pandemic.

Key messages
• The information gained through the group meetings can lead to an improved fit between implemented measures and staffs’ working procedures during future pandemics.
• Decision making support and communication should receive more attention according to staff during future pandemics.
COVID-19 vaccine hesitancy among healthcare workers and its associated factors: A systematic review
Authors: Fakih L , Copas A 
Published: October 2023

Abstract

Background
The COVID-19 pandemic is considered one of the most significant public health crises in the 21st century. Healthcare workers (HCWs) as frontliners are at a greater risk of infection compared to the general population. HCWs can influence the general public's decisions when it comes to their health, particularly vaccination. Vaccine hesitancy can be a threat to controlling pandemics, at times when timely interventions are needed to save lives and reduce the burden on healthcare systems. Understanding vaccine hesitancy among HCWs can inform policy change and better pandemic preparedness.

Methods
This systematic review investigated vaccine hesitancy and its associated factors among HCWs following the approval of the first COVID-19 vaccine. Searches were run in three databases on eligible studies published between December 2, 2020, and June 15, 2022.

Results
We included 24 studies with a total of 74,739 [241- 12,610] HCWs from 12 countries including the United States, China, Germany, Belgium, Switzerland, and Greece. Most studies were conducted shortly after vaccine approval. The average prevalence of vaccine hesitancy across the studies was 24%. Factors associated with vaccine hesitancy among HCWs were classified using a five categories ‘5C model': confidence, complacency, convenience, communication, and context. Age, gender, healthcare profession, a history of flu vaccination, a positive history of COVID-19 infection, and confidence in COVID-19 vaccine safety were the most commonly identified factors associated with vaccine hesitancy.

Conclusions
This review suggests that the reasons underlying vaccine hesitancy among HCWs are multifactorial and might be unrelated to vaccine availability. Future studies could study vaccine hesitancy on a wider timeline following vaccines approval, to understand whether low uptake reflects hesitancy or a delay in vaccination. Understanding vaccine hesitancy among HCWs is crucial for pandemic preparedness and control.

Key messages
• Understanding vaccine hesitancy among healthcare workers and its underlying factors is crucial for pandemic preparedness and response.
• Vaccine hesitancy among healthcare workers is multifactorial and may be unrelated to the availability of vaccines. Future research should expand on this topic to understand factors underlying it.
Encouraging the planetary health diet via food taxes and subsidies: a model concept
Authors: Mészáros A , Vokó Z 
Published: October 2023

Abstract

Background
Several studies simulated the effect of food taxes and subsidies on health and environmental outcomes, but they are diverse and rarely model both health and the environment. Incomplete models’ estimates can be misleading: outcomes can be detrimental in a topic that was not included in the model. The aim of this study is to map the important areas affected by planetary food taxes and subsidies and to build a comprehensive model concept.

Methods
A systematic literature search database was used to map the areas. An initial model concept was then iteratively redesigned and finalized.

Results
The main included outcome areas are health, dietary, financial, and environmental outcomes, the latter assessed in diverse areas, like freshwater use, land use, and biodiversity loss. The elements which can greatly influence the model estimates should be carefully assessed, like consumption change, which lies in a central part of the model: included complementary and substitution foods, and consumed diet mass stability is assumed to be more accurate. Health outcomes include the health effects of climate outcomes, affecting not just the modeled region but the whole world population. The input data is scarce, especially reliable price elasticity estimates, and the health effects of climate change.

Conclusions
The stability of consumed diet mass is still not agreed upon but leads to a biologically more accurate outcome. The inclusion of the health effects of climate outcomes can broaden the picture and emphasize the global nature of our food choices. Input data for building a comprehensive model is currently not optimal, more data are needed on consumption change and the health effects of climate change. The next step for public health could be to model food taxes and subsidies for Europe and to compare the estimates with previous models, also to map the stakeholders’ impressions regarding such a tax and subsidy.

Key messages
• We need comprehensive models of food taxes and planetary health to make responsible decisions.
• A model concept was made which includes important areas and relations between them.
Association between metals and metalloids with cognitive status in Mild Cognitive Impairment subjects
Authors: Urbano T , Filippini T , Carbone C , Chiari A , Marti A , Zamboni G , Michalke B , Vinceti M 
Published: October 2023

Abstract

Mild Cognitive Impairment (MCI) is regarded as a transitional state between normal aging and dementia. Several risk factors have been related to MCI and dementia vulnerability. Among these, metals and metalloids have been hypothesized to affect dementia risk. Our objective was to study the associations between metals and metalloids (cadmium, copper, iron, manganese, selenium, zinc) concentrations in serum and cerebrospinal fluid (CSF) with cognitive impairment status of MCI subjects. 144 individuals newly diagnosed with MCI were recruited at Neurology Memory Clinics at Modena and Reggio Emilia Hospitals (Italy) in the period 2019-2022. The concentrations of elements in paired serum/CSF were determined using inductively coupled plasma mass spectrometry. Participants’ global cognitive status was assessed using the Mini-Mental State Examination (MMSE). Muti-adjusted spline regression analyses were performed to assess the relation between the serum/CSF concentrations and MMSE. Median serum and CSF concentrations were generally higher in men than women, except copper in serum and iron in CSF demonstrating higher concentrations in women. A positive linear association emerged between serum iron concentrations and MMSE, while a slight negative one emerged for serum selenium levels. Cadmium in serum was positively associated with MMSE until 0.2 µg/L and then the association became null, while in CSF a U-shaped relation emerged. A U-shaped relation was also observed for serum copper and CSF iron and manganese levels. CSF selenium concentrations were inversely related to MMSE, although above 5 µg/L the curve flattened. Zinc exhibited the same pattern of association in both serum and CSF, i.e., an inverted U-shaped one. These findings suggest that CSF and serum content of the investigated elements may be differently related with global cognitive status in MCI subjects. Higher levels of selenium and zinc, in particular, are associated with lower MMSE score.

Key messages
• Heavy metals and metalloids display different pattern of association with global cognitive status.
• High levels of selenium and zinc are inversely related with global cognitive status in MCI subjects.
Plant-based foods on the Portuguese market: a salutary alternative to animal-origin counterparts?
Authors: Brazão R , Fernandes P , Lopes A , Dias M G 
Published: October 2023

Abstract

Background
The consumption of animal-origin products (AOP) has been linked to an increased risk of heart disease, diabetes and cancer and significant environmental issues. The growing interest for plant-based foods (PBF) have been raising important questions about their overall healthiness. In this context, this study aims to assess the nutritional quality of PBF available in the Portuguese market, analyzing their nutrient profiles and comparing them with AOP and nutrient reference values established. Evaluating if PBF are a salutary viable alternative, we expect to contribute to the promotion of healthier and more sustainable food choices and help inform public health policies.

Methods
Collection and comparison of the nutritional information of PB burgers, sausages and breaded food products and their AOP equivalents and with the reference values of the Integrated Strategy for the Promotion of Healthy Eating (EIPAS) and of the Directorate-General of Health Label Decoder.

Results
A cross-sectional survey of nutrients was conducted on 207 PBF and 253 AOP equivalents. When compared, all PBF categories had higher energy, carbohydrate and sugars. The PB burgers had lower levels of fat, saturates and protein but higher salt content. The PB sausages had lower levels of saturates and salt but higher fat and protein contents. The PB breaded food products had higher levels of fat, saturates, protein and salt. When jointly evaluated sugars and salt, 99.5% of all PBF did not meet EIPAS reference values.

Conclusions
The nutritional composition of the PBF studied vary widely. Although some presented lower saturates levels others had higher fat, sugars and salt compared to AOP, with 99.5% not meeting EIPAS sugars and salt reference values. In this context, public health actions to address the nutritional quality of PBF, normally perceived as healthier, are needed, namely food literacy initiatives and legislative measures concerning the labeling and reformulation of PBF products.

Key messages
• The nutritional quality of PBF available in Portugal varies widely. Although some have a better nutrient profile compared to AOP equivalents, others are high in fat, sugars and salt.
• Public health actions are needed to promote healthier and more sustainable food choices, including food literacy initiatives and legislative measures concerning PBF labeling and reformulation.