bluuebunny/crossref_metadata_2025_split huggingface dataset:
A time series of tobacco use in Belgium based on a critical appraisal of data sources, 1997-2020
Authors: Nayani S , De Pauw R , Devleesschauwer B , Guariguata L 
Published: October 2023

Abstract

By being the leading risk factor for most of the leading causes of death worldwide, tobacco use represents an important public health issue that causes a significant health and economic burden. Despite policy regulations, the prevalence of the use remains substantial in many countries, such as Belgium. A comprehensive framework for the quantification of the health impact of tobacco use, based on representative data, is however still lacking. As a preliminary step, we aimed to map and critically assess the past and current trends of tobacco use from 1997 to 2020 in Belgium for establishing a time series of the true extent of tobacco use. Data sources assessing tobacco use in Belgium, meeting our inclusion criteria: frequency, type of survey, international comparability, consistency over time, and representativeness of the sample were included in the critical appraisal. The selected data source forms the basis for a time series of tobacco use from 1997 to 2020. We applied a Bayesian inference model using the integrated nested Laplace approximation, to estimate the distribution of tobacco use by age, sex, and region. We identified four data sources containing information on tobacco use in Belgium. The best available data source for creating a time series of tobacco use was the Belgium Health Interview Survey. The modelled time series based on this data shows a decrease in the prevalence of daily smoking from 1997 (25%) to 2020 (15%). In 2020, daily smoking was estimated to be the highest in the Walloon region (19%) followed by the Brussels region (16%) and the Flemish region (14%). In 2020, the prevalence of daily smoking was estimated to be higher among men (19%) and in the age category 45-59 (20%). This study provides a critical review of data sources monitoring tobacco use in Belgium. Time trends derived from modelling show the overall smoking trends are decreasing but the use remains a public health concern in Belgium.

Key messages
• Understanding the role of tobacco on population health as an attributable burden can improve health monitoring.
• Tobacco use is still a public health concern in 2020 with an estimated prevalence of daily smoking of 15% in the population. Different patterns of tobacco use can be seen at the regional level.
A pilot of the InterRAI Family Carers Needs Assessment form in Ireland
Authors: Carney P , Harrison M 
Published: October 2023

Abstract

Background
The health impact of providing informal care in Ireland is significant. Over ten years (2009-2019) among carers in Ireland poor health increased by 24%, depression increased by 70%, those experiencing anxiety rose by 26%. Access to respite services decreased from 57% to 29% with less support being provided in 2019 from GPs, PHNs and care workers than in 2010 (Family Carers Ireland, College of Psychiatrists of Ireland & UCD, 2019). InterRAI have developed a module to assess the needs of family carers (FCNA) and is being tested across a number of countries, including the West of Ireland. This assessment is conducted with the needs assessment on the person applying for services.

Methods
The FCNA was collected at 2 time points, baseline and 6 month follow-up. At baseline, carer preferences for services was obtained and, within current service capacity, carers were referred to their specified service. The FCNA captures demographics, mood, cognition, social needs, function, general health, carer characteristics, caregiver experience, supports for the carer and those in place for the care recipient. Regression analysis is carried out to estimate the effect of service provision on health outcomes over the period.

Results
62 completed FCNAs were obtained for the two periods from family carers across five care groups: carers of: older persons, person with dementia, person with mental health difficulties, person with physical and sensory difficulties and a person with an intellectual disability. At baseline, 51% of carers felt too exhausted to carry out normal day-to-day activities on a regular basis, 52% feel little interest or pleasure on an ongoing basis, 67% feel anxious, restless or uneasy and 67% indicated that they experienced major life stresses in the last 90 days.

Conclusions
The HSE can objectively identify and assess family carer need across all care groups to inform resource allocation, policy decision-making, service planning and service provision.

Key messages
• Standardised informal carer needs assessment leads to better understanding of issues faced by carers.
• Increased understanding of the service requirements of informal carers to support them in their roles to inform resource allocation, policy decision-making, service planning and service provision.
Reweighting in panel surveys: machine learning techniques for the Health Care and Social Survey
Authors: Cabrera-Léon A , Castro-Martín L , Rueda M , Sánchez-Cantalejo C , Ferri-García R 
Published: October 2023

Abstract

Background
Healthcare statistical services have used probability surveys to respond to such information needs. The Health Care and Social Survey (ESSOC) research project arises from the need to provide data on the evolution of the COVID-19 impact. This survey has an overlapping panel survey design with 4 measurements throughout 1 year with random samples.

Objective
To develop a new reweighting method for overlapping panel surveys affected by non-response.

Methods
Each ESSOC measurement is composed of two samples: a longitudinal sample from previous measurements and a new sample at each measurement. In each measurement, missing units are substituted by new surveyed units, allowing the obtention of cross-sectional and longitudinal estimates. The advantage of this design is that, in addition to being able to obtain longitudinal estimates, cross-sectional estimates are more accurate because of the larger sample size. However, the problem of non-response is particularly aggravated in the case of panel surveys, due to the fatigue of the population to be repeatedly surveyed.

Results
Considering the design, timing and objectives of this survey, our reweighting method produces suitable estimators for both cross-sectional and longitudinal samples. The weights are the result of a two-step process: the original sampling design weights are corrected during a 1st phase by modelling the non-response with respect to the longitudinal sample obtained in a previous measurement using machine learning techniques. Then, during a 2nd phase, they are calibrated using the auxiliary information available at the population level. The proposed method is applied to the estimation of totals, proportions, ratios, and differences between measurements as well as gender gaps.

Conclusions
For addressing future health crises like COVID-19, it is therefore necessary to reduce potential coverage and non-response biases in surveys by means of utilising reweighting techniques as proposed in this study.

Key messages
• It is therefore necessary to reduce potential coverage and non-response biases in surveys.
• This study proposes the utilisation of reweighting techniques based on calibration and XGBoost.
Feasibility of Health and Fitness Data Collection in Online Behavioral Intervention of Elderly
Authors: Kosutzka Z , Borosova S , Beblava E , Beblavy M 
Published: October 2023

Abstract

The global increase in life expectancy has led to a growing elderly population, which necessitates novel strategies to promote healthy ageing and maintain optimal quality of life. Lifestyle coaching has emerged as a promising intervention to address these challenges by offering tailored guidance and support for seniors to make sustainable lifestyle changes. This study investigates the feasibility of collecting health and fitness data reported by the elderly population participating in an online behavioural intervention. We recruited 60 community-dwelling elderly individuals between the ages of 55-80 (including both men and women) for a 14-week online intervention promoting healthy lifestyles using coaching principles. The main criteria for inclusion were a diagnosis of arterial hypertension with or without medication and/or overweight or obesity as defined by BMI. We collected health-related data (arterial blood pressure, weight, waist circumference, quality of life using EQ-5D-5L questionnaire) and fitness-related data (30-second chair test, 2-minute step test). All data were self-recorded by the participants and reported via an online system with the help of a health coach. Forty-seven participants were able to complete the entire 14-week intervention. The initial data set resulted in only 51% (24 out of 47) of the participants having reported the full dataset. We then used written and spoken reminders to notify participants to submit the collected data, which brought the percentage up to 70% (33 out of 47). The main obstacle in health and fitness-related data collection was the forgetfulness of participants to do the self-reported measurements and tests. Among other factors affecting the amount of collected data, we experienced a lack of understanding of the process of the fitness tests, as well as a low questionnaire completion ratio. Almost 80% of participants managed to report all of the health-related data which was also considered the least complicated to collect.

Key messages
• Elderly people with higher cardiovascular risk are able to self-report health and fitness data in online behavioral intervention but thorough guidance and reminders need to be applied.
• Elderly people are willing to participate on the online lifestyle behavioural interventions.
Austrian Health Expenditure Projections and Excess Health Expenditure due to COVID
Authors: Lackner S , Bachner F , Zuba M 
Published: October 2023

Abstract

According to System of Health Accounts (SHA) data total health expenditures in Austria have grown on average by 3.9% per year from 2000 to 2019. This was followed by high growth rates of 5.1% and 11.9% in 2020 and 2021, respectively. The steep increase was caused by the global COVID-19 pandemic. However, quantifying the effect of the pandemic on health expenditures is not straightforward and significant uncertainties remain about how future health expenditures will be affected and how they can most accurately be projected, particularly given recent high economic uncertainties. In this project we developed several models to predict Austrian health expenditures. Most importantly, we compare models based on demand and cost driving factors with a simple GDP-linked model. We assess the performance of the different models by predicting past health expenditure data up to 2019. Comparing the model predictions for the pandemic years with the actual SHA data provides an approach to estimate the net impact of the pandemic. Several different dynamics play a role in how COVID-19 has been affecting health expenditures. We find that the pandemic has caused sizeable one-time costs in the years 2020-2022, but “regular” health expenditures partially decreased during that time due to forgone elective and preventive care. As COVID-19 becomes an endemic disease it also becomes an additional long-term burden on the health system, but the main driver of health expenditure is currently inflation. The shock of the pandemic has created a structural break for the health sector with many not yet well-known consequences such as systematic changes in work conditions or salaries for health sector employees. With the currently available data and information, many of these effects cannot be directly built into the prediction models. However, we compare our models in their projections of future health expenses until 2030 with past projections from 2019 for the year 2030 under different scenarios.

Key messages
• The pandemic has caused sizeable one-time costs in the years 2020-2022, but “regular” health expenditures partially decreased during that time due to forgone elective and preventive care.
• As COVID-19 becomes an endemic disease it also becomes an additional long-term burden on the health system, but the main driver of health expenditure is currently inflation.
Co-production in public health research: The UK MAMAH Study involving underserved migrant mothers
Authors: Stevenson K , Ogunlana K , Alomari M , Agoropopoola R , Stevenson F , Knight M , Aldridge R 
Published: October 2023

Abstract

Problem
Research suggests some migrant women are at higher risk of mortality and morbidity in the perinatal period, however there is a gap in co-produced research to improve care.

Description of the Problem
The UK National Institute for Health and Care Research defines co-production as ‘an approach in which researchers, practitioners, and members of the public work together, sharing power and responsibility'. Here we summarise learning from the Migration and Maternal Health (MAMAH) Study which aims to co-produce solutions to improve maternity care for migrant women in the UK.

Results
We struggled to access comprehensive training on co-production, particularly in how to counter power dynamics and recruit a broad range of public participants. Early in the study we appointed a ‘Lead Patient Advisor’ (a migrant women with experience of pregnancy in the UK) who manages the relationship between the academics and the patient advisors. Additionally, we reimburse women's time, childcare, and travel. We have found that online meetings are preferable as women do not need to travel or arrange childcare. We meet our patient advisory panel four times per year. Some women have been directly involved in research such as systematic review screening and qualitative interviewing and have been given formal research training.

Lessons
Our initial research priorities didn't align with those of the women, and this has helped us to reshape our work. Women say that having a Lead Patient Advisor has made it easier to participate, particularly given some of the issues discussed are traumatic. To mitigate this, we have created additional support resources and offered formal debriefing. Using online interpreters has been challenging, and we have recently split into different language groups to maximise engagement. Overall, we have learned that taking a truly co-produced approach is expensive and time-consuming but has ensured our research prioritises the views of migrant women giving birth in the UK.

Key messages
• Co-production approaches are increasingly important to funders and represent a key opportunity for researchers to ensure their work has real-world impact.
• There is an urgent need for improved training and resources to better equip public health researchers to take a co-production approach.
Understanding the concerns of people living with Heart Failure in Portugal - a qualitative approach
Authors: Raposo B , Avelar F G , Cunha A S , Martinho H , Almeida M , Pardal M , Bernardo F , Pedro A R 
Published: October 2023

Abstract

Background
Heart failure (HF) is a complex chronic clinical syndrome that results of cardiac functional impairment secondary to many aetiologies, leading to significant struggles to an optimal care management. Person-centred care is an effective approach to integrate care and shared decision-making. Understanding the health concerns of the people with the disease, is fundamental to adapt and establish an integrated disease management. This study aims to comprehensively identify the main concerns of people living with HF.

Methods
Three focus group and two group interviews were conducted, involving 23 individuals where: 12 were people with HF and 11 healthcare professionals (HCP) following people with HF in Portugal. A convenience sampling (nonprobabilistic) was used to maximize the differences within participants’ characteristics. The inclusion criteria for people with HF were documentation of reduced or preserved ejection fraction, with or without decompensation for more than one year with different NYHA classifications. Regarding HCP were included physicians and nurses following people with HF. Data were analysed using thematic analysis and performed in MAXQDA®.

Results
Following data analysis, nine themes of concern were identified. Each theme was composed of several items of concern (codes) and were related to: 1) personal and family; 2) monetary costs; 3) changes in lifestyle; 4) autonomy and functionality; 5) health status; 6) symptoms and signs; 7) medication; 8) surgical procedures; 9) healthcare.

Conclusions
Several aspects of the daily life of the person with HF were identified. Those were not limited to concerns related to clinical conditions. Data reinforce the complexity of HF with several and broad implications in daily life. Based on these results we recommend a quantitative approach to measure the relevance and impact of each concern, enhancing the creation of more effective healthcare strategies that prioritize people’ needs and management.

Key messages
• The concerns of people with HF are not limited to clinical aspects, they cover several areas of the person's daily life.
• Heart Failure is a complex, high-prevalence disease, with several implications in daily-life, requiring specific coping mechanisms to face different challenges.
Reaching Consensus on a core outcome set for patient safety in perioperative care: SAFEST Project
Authors: Nunes A B , Teixeira J P , Seyfulayeva A , Casaca P , Leite A , Schäfer W , Valli C , Rodríguez A , Orrego C , Sousa P 
Published: October 2023

Abstract

Background
In the European Union, 8 to 12% of patients admitted to hospitals experience adverse events, imposing a considerable burden on the health systems. The lack of standardised indicators to comprehensively analyse perioperative patient safety limits the evaluation of interventions to tackle this public health problem. This study aims to prioritise the most relevant and feasible core indicators to assess patient safety in perioperative care to develop a Core Outcome Set.

Methods
A two-round eDelphi was conducted. Sixty-seven experts were invited to participate and asked to independently rate indicators in importance and feasibility on a 9-point Likert scale. The indicators were grouped by the perioperative period and subgrouped by Donabedian's quality of care conceptual model Structure - Process - Outcome. Consensus to include was defined as ≥75% of experts scoring an indicator as 7 to 9, and 15% or less scoring 1 to 3.

Results
Forty-eight experts completed the Round 1 eDelphi survey, and 8 started the survey but did not complete it. Round 1 survey was answered by a diverse range of targeted categories of experts, including healthcare professionals (76.8%) and patients (10.7%). From the 247 indicators included in Round 1, 15.8% reached a consensus to include regarding both importance and feasibility. Across the perioperative period and Donabedian's quality of care conceptual model subgroups, a higher consensus to include was achieved regarding importance than feasibility. The results of Round 2 have yet to be available, as the study is ongoing.

Conclusions
A consensus of a broad and heterogeneous panel of experts on core indicators for reporting perioperative patient safety was developed. While the experts highly punctuated the indicators' importance, the indicators' feasibility aspect needs to be further explored to implement effective and efficient monitoring and evaluation of surgical-related patient safety systems in clinical practice.

Key messages
• Prioritising indicators important for patients and the clinical practice is crucial to monitor and evaluate patient safety.
• This consensus facilitates benchmarking across EU countries.
Green List Prevention - An Evidence Registry for Prevention and Health Promotion in Germany
Authors: Walter U , Brender R , Bremer K , Groeger-Roth F 
Published: October 2023

Abstract

Introduction
Evidence-based prevention and health promotion will be supported by practice-relevant evidence registries. The Green List Prevention provides an overview of evidence-based prevention programs for children and youth in Germany. It was modeled after the U.S. Blueprints for Healthy Youth Development in the context of the Communities That Care community prevention system. Programs are reviewed for conceptual, implementation, and evaluation quality and are categorized into three levels of evidence: (1) effectiveness theoretically well established, (2) ∼ likely, (3) ∼ proven. The Green List Prevention is used in communities, at state and national levels, and research. This paper provides insight into its content, keywording and enhancements.

Methods
To characterize the evidence-based programs, an inductive-deductive procedure was used to form 14 super- and 33 subcategories with 226 characteristic attributes. Based on these, all registry entries were categorized and summarized descriptively.

Results
The 100 programs listed (4/2023) address not only the primary target group of children and adolescents, but also secondary target groups (mainly teachers n = 53, guardians n = 46, educators n = 19) and are located in different environments (mainly school n = 61, family n = 28, kindergarten n = 23). Behavioral prevention on violence including bullying n = 64, addiction n = 47 and mental health n = 34 are in the foreground; topics such as nutrition (n = 3) and physical activity (n = 2) are little represented. Social and life skills programs (n = 61) and training for guardians (n = 25) are listed particularly often.

Conclusions
The Green List Prevention provides an overview of effective prevention and health promotion interventions for different contexts. Its current expansion to rate environmental and behavioral prevention measures on nutrition and physical

Key messages
• The Green List Prevention enables stakeholders to make a targeted selection of evidence-based programs and offers practice-relevant information e.g. main focus, program formats, implementation.
• The evidence register Green List Prevention supports evidence-based prevention and health promotion in Germany.