bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evidence and gap map of infodemic management interventions in emergencies: a case of COVID-19
Authors: Purnat T , Pundir P , Machiri S , Ishizumi A , Rajwar E , Murthy S , John O , Briand S , Nguyen T 
Published: October 2023

Abstract

Background
Because infodemic management (IM) is an evolving field that is bridging science into practice, it is often conducted in the field in an ad-hoc manner, focusing on implementation to address immediate challenges, and is less evaluated or reported in the scientific literature. This project used the Evidence and Gap Map (EGM) as a tool to provide an overview of investments in research and evidence for IM interventions.

Methods
A WHO working group advised development of protocol and of taxonomy of IM interventions and outcome measures based on literature review and expert discussion. Search was conducted on electronic databases and grey literature. Screening/coding of the studies was carried out independently by reviewers in two stages: the title and abstract and the full-text screening stage. Data extraction/critical appraisal was carried out for the included studies.

Results
983 studies were included from 29,117 search records. Among impact studies that measured and reported outcomes, the reported interventions were on ‘science & health communication’ (n = 30), ‘education & training’ (n = 30), and ‘engagement’ (n = 10). ‘Individual knowledge, attitude and behaviors’ was the most frequently measured outcome. In descriptive studies not measuring outcomes, majority reported an intervention of ‘monitoring/detection of narratives, questions, concerns, and misinformation in the information ecosystem’ (580 studies), by ‘science + health communication’ (n = 258), ‘education + training’ (n = 86), ‘engagement’ (n = 86) and ‘laws, regulation + ethics’ (n = 60).

Conclusions
The EGM reviewed the evidence base on IM interventions. The analysis shows scarcity of impact evaluation studies in this area. Moreover, the map reflects concentrations of research in social media analytics studies, model studies for misinformation detection, individual level interventions. Major gaps exist in systems level interventions that address the information environment, and in broader impact measures.

Key messages
• Research funders should prioritize impact evaluation studies for systemic interventions to address infodemic to support solutions in design and implementation of such complex studies.
• More research on infodemic management interventions is needed in LMICs and at health system level.
Cluster analysis of sub-national differences in life expectancy at birth in the European Union
Authors: Pinheiro V , Santos J V , Feldens T , Devleesschauwer B 
Published: October 2023

Abstract

Background
Life Expectancy (LE) at birth, the average number of years a person is expected to live from birth, supposing constant age-specific mortality, is an essential indicator of a country or region's well-being, reflecting policy options at the regional level and highlighting progress and gaps in societal health, including at the sub-national level. In this study, our goal was to explore patterns on groups of European Union (EU) member states according to sub-national gaps in LE at birth, between 2000 and 2020.

Methods
A longitudinal retrospective analysis on differences in LE at birth among NUTS2 regions in 20 EU countries (due to data availability issues) was performed, taking the largest absolute difference between NUTS2 regions, in 2000-2020, as the country value. A hierarchical agglomerative cluster analysis was then performed. All data was retrieved from Eurostat and analysis performed in R version 4.0.0.

Results
3 clusters were identified: (1) Belgium, France, Czechia, Hungary, Portugal and Spain (cluster mean: 3.78); (2) Austria, Slovenia, Croatia, Romania, Bulgaria, Poland, Finland, Germany, Italy and Greece (cluster mean: 2.44); (3) Denmark, Netherlands, Sweden and Lithuania (cluster mean: 1.17).

Conclusions
3 clusters of EU member states based on sub-national gaps in LE at birth were identified. Further studies are necessary to assess possible associated factors, such as health expenditure and health system efficiency, in order to better inform public policy and close the gap on existing inequalities.

Key messages
• Important sub-national differences in LE at birth exist in the EU, with considerable variability across groups of countries.
• These results may have an important impact on policy-making and inequalities.
Vaccination and risk compensation during the COVID-19 pandemic in France
Authors: McColl K , Raud J , Martin-Lapoirie D Dylan 
Published: October 2023

Abstract
Vaccination has played a key role in reducing the health burden of COVID-19 (World Health Organisation (WHO), 2022), however, concern has been raised worldwide that risk compensation, a process whereby feelings of security arising from being vaccinated may lead people to reduce their engagement in other protective behaviours (Hedlund, 2000), could detract from the overall health benefit of the COVID-19 vaccination campaign (WHO, 2020). We explored whether COVID-19 vaccination elicited risk compensation and whether this changed over time by conducting a repeated cross-sectional study at seven intervals over the initial months of the vaccine rollout in France (February–September, 2021). Participants (N = 14,003) completed an online survey measuring vaccination status, vaccination intention and engagement in four preventive behaviours: mask wearing, avoidance of physical contact, hand hygiene, and avoiding social gatherings. Risk compensation was measured indirectly by comparing levels of engagement in protective behaviours according to vaccination status, with those unvaccinated but intending to vaccinate serving as a baseline. Risk compensation did not occur systematically and was mostly observed towards the end of the vaccine rollout for two of the four protective behaviours: avoiding social gatherings and wearing a mask. Fully-vaccinated participants reported avoiding social gatherings less often than those intending to vaccinate in July (Adjusted Odds Ratio (AOR) = .72, p = .045), and in September (AOR = .54, p = .022). A similar trend was observed in September among participants vaccinated with one dose who reported wearing a mask less often than their unvaccinated-but-intending-to-vaccinate counterparts (AOR = .48, p = .029). Our findings suggest that whilst unlikely to impede the overall effectiveness of public health campaigns, risk compensation, particularly among certain groups, nonetheless merits attention when designing informed, targeted public health messages and policy.

Key messages
• Limited evidence of risk compensation was observed towards the end of the vaccination campaign in France.
• Risk compensation may not negate overall health benefit of a vaccination campaign, however from a public health perspective, nonetheless merits attention.
Precarious employment at a young age and alcohol-related health problems
Authors: Thern E , Elling D L , Badarin K , Hernando-Rodriguez J C , Bodin T 
Published: October 2023

Abstract

Background
Precarious employment, a known determinant of poor health, is increasing in prevalence, particularly among young adults, where the long-term health consequences are not fully understood. The aim is to examine the effects of precarious employment at a young age on later alcohol-related health problems.

Methods
We used register-based data from the Swedish Work, Illness, and Labor-market Participation (SWIP) cohort to follow a cohort of 367 655 young adults aged 27 years between 2000-2003. Register data on labour market establishment (precarious employment, sub-standard employment, unemployment, and standard employment) was collected three years after graduation from school. The Swedish index of alcohol-related diagnoses was used to define the outcome, which was collected during a 26-year follow-up. Alcohol-related morbidity and mortality was combined into the outcome of alcohol-related health problems and collected from the National Patient Registers and Cause of Death Register. Cox Regression models were used to obtain hazard ratios (HR) with 95% confidence intervals (CI).

Results
The preliminary results suggest, after adjusting for important covariates (e.g. sex, parents highest level of socioeconomic status and prior mental and alcohol-related health problems), that young adults who were precariously employed three years after graduation from school were at an increased risk of alcohol-related health problems compared to young adults with standard employment (HR 1.49, 95% CI: 1.37, 1.61). Young adults in long-term unemployment had an even higher risk (HR 2.05, 95%CI: 1.89, 2.22).

Conclusions
In Sweden, a nationwide register-based study with a long-term follow-up suggests that young adults with lower labour market attachment when entering the labour market are at an increased risk of later alcohol-related health problems.

Key messages
• Exposure to precarious employment at labour market establishment can have long-term determinantal consequences on later well-being.
• Policies targeting the transition from school to the workforce are needed to ensure decent employment conditions for the vulnerable group of young adults.
Poliomyelitis alert on Tunisian borders: response and challenges
Authors: Ben Mrad I , Bouguerra H , Yahyaoui M , Driss N , Ben Khalil M , Ammari L , Haddad-Boubaker S , Triki H , Gzara A 
Published: October 2023

Abstract

Introduction
Poliomyelitis, which disappeared in Tunisia 30 years ago, should be the second disease to be eradicated after smallpox. However, a few endemic foci persist and its recent detection in some regions is causing great concern. On January 11, 2023, Tunisia received an alert with the notification of 2 polio cases in Algeria, the second of which was detected in November 2022 at about 400 KM from Tunisia. The objective of this study is to describe the results of the investigations following this alert as well as the prevention and response measures triggered.

Methods
We conducted an active search for acute flaccid paralysis (AFP) cases in all governorates and a retrospective search for possible unreported AFP cases hospitalized from November 1, 2022. Vaccination coverage was verified for catch-up if incomplete vaccination. Surveillance of poliovirus shedding in patients with primary immunodeficiencies (PIDs) was also conducted as well as other public health measures.

Results
As of April 20, 2023, 38 AFP cases have been reported through active search. Retrospective hospital-based surveillance has revealed 31 cases. In addition, 3142 children with deficient vaccination were identified, distributed differently by region. All of them were caught up with Inactivated polio vaccine (IPV). A total of 90 PIDs were followed up. The replacement of the Oral polio vaccine (OPV) dose at 6 months by IPV in the national immunization schedule as well as a request for verification of the possibility of using the new OPV2 in Tunisia and of the required requirements were made.

Conclusions
The risk of poliomyelitis resurgence in our country is not negligible. Sustained vigilance is necessary, particularly through ensuring high vaccination coverage and effective surveillance to rapidly detect any imported case. This is essential in view of the global context and the existence of outbreaks especially in certain African countries with which several exchanges and migratory flows remain.

Key messages
• The Poliomyelitis alert on Tunisian borders in January 2023 is a real threat, that should also be taken into consideration by neighboring countries.
• Sustained vigilance is necessary, particularly through effective surveillance and appropriate vaccination strategy.
Predictive performance of polygenic scores for coronary artery disease in multiple genetic ancestries
Authors: Regazzi L , Bolli A , Cadeddu C , Boccia S , Busby G 
Published: October 2023

Abstract

Background
Polygenic scores (PGS) for coronary artery disease (CAD) measure a person's genetic liability for CAD. PGSs for CAD are generally considered sufficiently predictive in individuals of European ancestry, but their performance is attenuated in non-European ancestry groups (AGs). We collated publicly available CAD PGS and benchmarked their performance across several AGs to evaluate their utility for personalized prevention.

Methods
We queried the “PGS Catalog” to extract standardized odds/hazard ratios (OR/HR) for published CAD PGSs across multiple AGs (European-EUR, African-AFR, Hispanic-HIS, South-Asian-SAS, East-Asian-EAS). We restricted our analysis to PGSs specifically developed for prevalent and/or incident CAD and identified the five best-performing PGSs in each AG. We then computed these PGSs in a sample of 504,096 individuals of EUR (94.5%), AFR (2.6%), SAS (1.9%), EAS (0.7%) and HIS (0.3%) AG and evaluated their performance through logistic regression (covariates: age, sex, family history of CAD, principal components of AG).

Results
PGS000018 performed best in SAS (1.69[1.56-1.83]), EUR (1.62[1.60-1.64]) and EAS (1.45[1.11-1.89]). PGS001780 was the best performing PGS in AFR (1.18[1.04-1.33], on par with PGS000749) and ranked second in EUR (1.59[1.57-1.61]) and SAS (1.64[1.53-1.76]). Finally, PGS002262 was best in HIS (1.39[1.07-1.81], almost on par with PGS000337) and second in EASs (1.41[1.13-1.75]). Overall, the highest standardized ORs were found for the SAS and the EUR AGs, while the AFR AG had the worst performances. PGSs performed differently than previously reported both in an absolute and relative way, corroborating the need of a standardized comparison.

Conclusions
There is currently no gold-standard trans-ancestry CAD PGS, but the employment of different AG-specific CAD PGSs can achieve the best possible predictive performance in every individual, an essential prerequisite towards implementing PGSs in CAD personalized prevention protocols.

Key messages
• No gold standard PGS for CAD exists that can be applied with equal predictive performance across all AGs, which can be partially counterbalance by using the best performing PGS in each AG.
• In our analysis, the absolute performance of all PGSs was worse than expected and the best performing PGS for each AG was different from the one reported in the “PGS Catalog” across all AGs.
Regional health and social inequalities in Bulgaria
Authors: Tsanova D , Georgieva S , Kamburova M , Mineva-Dimitrova E , Ivanova B , Seizov A , Vitkova T 
Published: October 2023

Abstract

Background
The administrative division of Bulgaria divides it into 28 regions, which differ significantly in terms of both socioeconomic development and a number of demographic indicators. The death rate is an indicator according to which our country has been at the top of the world rankings for several years. Cardiovascular diseases stand out among the leading causes of death and they are one of the most important problems facing our society and health system. The study aims to analyse the relationship between the death rate due to CVD in different regions in Bulgaria with the average annual salary of employed persons as an indicator for the socioeconomic development of the regions.

Methods
The regional differences in the death rate due to CVD and the average annual salary of employed persons were analysed based on the National Statistical Institute data. Analysis and calculations were performed by MS Excel 2019.

Results
The death rate due to CVD in Bulgaria varies widely - from 1739.7 per 100000 in region Vidin, 1685,2 in region Montana to 878.0 in the city of Sofia, with a national average of 1163.2 /2021/. At the same time, Vidin and Montana regions are also among the regions with a very low average annual salary of employed persons - respectively 12 855 and 13 983 BGN, which is much lower than the average for the country - 21 128 and than the capital Sofia - 25 724 BGN /2021/.

Conclusions
The regional health inequalities in Bulgaria are very important in order to control and decrease the level of mortality in the country, especially the death rate due to CVD. Bulgaria is among the counties that have the most serious challenges related to high cardiovascular deaths and should be among the priorities of public policy. The profound regional differences that were found impose permanent monitoring and directing the regional social and public health policies to avoid their unfavourable effects. Society should be making major and cost-effective efforts to reduce mortality.

Key messages
• The elimination of regional inequalities in the country is one of the possible ways to deal with the difficult demographic situation which occurred in the years after the democratic changes.
• Regional health inequalities create the need for a long-term health policy that will improve the population's health status and the effective functioning of the healthcare system in our country.
Assessing Vulnerability to Health Impacts of Climate Change in French Municipalities
Authors: Pereira Barbosa H , Roué-Le Gall A , Thomas M-F 
Published: October 2023

Abstract

Background
Climate change significantly threatens human health, particularly in vulnerable municipalities. Multiple climatic, environmental, and socioeconomic factors influence municipal vulnerability. To effectively reduce this vulnerable, evidence-based tools for local decision-makers are needed. This study aims to present the development and application of a multicriteria decision analysis (MCDA) model to assess vulnerability to the health impacts of climate change in French municipalities.

Methods
We selected 59 municipalities to develop and apply the model. The development of the MCDA model involved a literature review on climate change and health, as well as active participation from an interdisciplinary committee composed of members from academic, associative, and professional sectors. This led to identifying 38 indicators to characterize vulnerability based on three components: climatic exposure, environmental and socioeconomic sensitivity, and adaptive capacity. These indicators were used as input to the MCDA model, which applied an outranking method to rank municipalities from most to least vulnerable.

Results
The MCDA model generated partial rankings by the components of vulnerability, as well as a complete ranking that integrated the three components. The results revealed the main indicators that explained the rankings and allowed for a typology of municipalities. The results helped prioritize interventions by identifying the indicators that have the greatest impact on the vulnerability of each municipality studied.

Conclusions
This study highlights the importance of considering multiple criteria and their interdependencies when assessing vulnerability. The results of the MCDA model provide an evidence-based tool to support decision-making processes at the local level. The MCDA model is a valuable tool for identifying and prioritizing effective interventions to reduce vulnerability in the studied municipalities.

Key messages
• The developed MCDA model is a valuable tool for local decision-makers to prioritize interventions and reduce vulnerability.
• The developed MCDA model provides a robust evidence-based tool to support decision-making processes.
Joint effects of US area-level social mobility & income inequality on mortality: an ecological study
Authors: Igelström E , Brydon R , Dunn J R 
Published: October 2023

Abstract

Background
Income inequality and its relationship with health has been extensively studied. Intergenerational income mobility (IGIM) has received less attention, but may be an important independent mechanism explaining health inequalities.

Methods
We conducted ecological analyses of the effects of IGIM and income inequality on mortality across commuting zones (CZ) in the US. IGIM was measured using rank-rank slope, i.e. the correlation between household income rank at age 15-19 and own income rank at age 29-30. We used CZ-level IGIM data from the Opportunity Insights project, Gini index of inequality from the American Community Survey, and mortality rates from CDC WONDER. Cross-sectional and longitudinal (CZ fixed effects) regression models were fitted adjusting for mean income and weighted by population.

Results
CZs with higher IGIM between 1995-2001 and 2011-12 had lower age-standardised mortality in 2009-2013, with 53.9 (95% CI: 48.9-58.9) fewer deaths per 100,000 for a standard deviation (SD) increase in IGIM (adjusting for mean income and Gini index in 2009-2013). This equates to 778 (773-783) deaths at the lower quartile vs. 710 (705-715) at the upper. Income inequality had a negligible association at 1.1 (-5.0, 7.3) deaths per SD increase. Longitudinal analysis across three 5-year periods confirmed that within-CZ changes in infant mortality were predicted by changes in IGIM (32.0 [12.7-51.2] fewer deaths per SD increase) but not income inequality (4.5 [-12.0, 20.9] deaths per SD increase).

Conclusions
Preliminary evidence suggests IGIM is a more important indicator for population health than income inequality. European researchers and public health bodies should further research and monitor IGIM, which may require improved availability of intergenerationally linked income data. Policy measures that improve social mobility, such as education and early-years interventions, may have greater health effects than policies only aiming at resource redistribution.

Key messages
• Differences in intergenerational income mobility accounted for substantial differences in mortality across US commuting zones, while income inequality appeared relatively unimportant.
• European policymakers should put greater emphasis on social mobility as an economic determinant of health, and facilitate research using intergenerationally linked income data.
Assessing the mental health among adolescents using a two continua model approach
Authors: Söderqvist F , Uvhagen L 
Published: October 2023

Abstract
The latest World mental health report states that mental health is an integral component of health and well-being and is more than the absence of pathology. Indeed, the view of mental health is slowly shifting to an emphasis on positive health indicators as national authorities around the world are increasingly adopting the two continua model of mental health (TCM). Adopting the TCM has several important implications for public health practice. One is that the epidemiological surveillance will have to include measures of both mental illness and mental well-being. The purpose of this presentation is to illuminate the conceptual and practical use of the TCM in the analysis of adolescent mental health. The presentation will be limited to a focus on the theoretical underpinnings and methodological considerations made to operationalize and categorize mental health according to the TCM. It will consider the added value of the TCM to epidemiological surveillance as well as its implications for public health practice when it comes to meeting population needs with appropriate interventions. To construct the model, data from population-based regional public health surveys among adolescents including validated measures of both mental ill health and mental well-being was used. The Kessler 6 scale was used to estimate the proportion of adolescents with or without probable serious mental illness (SMI, &gt;13) and the Mental Health Continuum - Short Form was used to estimate the proportion of adolescents with flourishing (FMH), moderate (MMH) or languishing (LMH) mental health according to the original categorization developed by Keyes. Combining these two dimensions of mental health and their respective categories will yield six mental health status groups: Complete mental health = FMH without SMI, Vulnerable = MMH without SMI, Most vulnerable = LMH without SMI, Symptomatic but content = SMI with FMH, Troubled = SMI with MMH, and Most troubled = SMI with LMH.