bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rethink cities to promote an active lifestyle and tackle climate change: best practices from the OECD
Authors: Cecchini M , Piatrova A , Aldea A , Lerouge A , Cheatley J 
Published: October 2022

Abstract

Background
City design can have major health and environmental implications. The overall layout of cities influences air quality, as urban sprawl can encourage the use of motorised vehicles and decrease active travelling. Furthermore, lack of trees has a negative impact on particulate matter levels and contributes to the urban heat island effect. There is a growing interest for creating an urban environment conducive of healthier lifestyles.

Methods
The analysis uses the five OECD criteria to assess best practices in public health - Effectiveness, Efficiency, Equity, Evidence-base, and Extent of coverage - to carry out a systematic assessment of selected candidate best practices to improve the public health potential of cities. The impact of scaling up these interventions within and across countries is evaluated by using the OECD SPHeP-NCD microsimulation model.

Results
Interventions such as Superblocks in Barcelona, which reshapes the city layout to make them more people centric and less vehicles reliant, or Cycle Superhighways from Denmark, which develops cycling networks, have a the potential to avoid a significant number of chronic diseases by promoting an active lifestyle and decreasing transport-related pollution. Such interventions can also decrease healthcare expenditure and, if well designed, health disparities.

Discussion
While many urban design interventions are a good investment for countries and, in general, there is good support, a number of implementation hurdles exist. First, extent of coverage is still relatively limited across European countries. Second, changes take time to be implemented and some of the health impact materializes in the longer-term. Third, the implementation of such interventions is generally competence of other authorities, other than the health authorities. Building strong multi-stakeholder approaches and making a strong case for such investments can promote change.
Strengthening resilience to address climate change and chronic diseases: evidence from small states
Authors: Moncada S , Spiteri M 
Published: October 2022

Abstract

Background
Climate & environmental change are disproportionally impacting small states, given higher costs per capita associated with coping with the immediate risks of environmental & climatic events. Climate change has been identified as a serious public health threat. This is especially true for heatwaves in the Mediterranean Basin, with poor air quality worsening the health impacts during periods of extreme heat, often affecting already high levels of chronic diseases. Promoting climate change adaptation measures is crucial to address the negative socio-economic impacts brought by heatwaves, & its interactions with poor air quality. While awareness about the link between poor air quality & heat-waves is gaining momentum, there is still a gap in policy responses, especially in small states. This research assesses the level of preparedness of the European Union, with a focus on adaptation to heat-waves since the extreme European heat-wave of 2003. A case study on Malta is also presented, aiming at discovering what measures the island is adopting to tackle the problems arising from the interaction between poor air quality & heatwaves.

Methods
A systematic literature review is conducted, investigating the links between heat-waves & air pollution post 2003, followed by a qualitative content analysis to assess the preparedness of climate change adaptation measures in this regard.

Results and conclusions
The findings of this research show that the link between heat waves & poor air quality has not been sufficiently acknowledged by academia, with evident gaps in applied small states research. Also, a closer look at key adaptation policies & measures in Malta finds that heat waves & poor air quality are hardly been linked, leaving much scope to introduce policy & economic instruments to tackle both public health risks to address growing chronic diseases, & not to compromise current & future socioeconomic wellbeing.
How RIVM is responding to the challenge of protecting human health from the effects of climate change – now and in the future
Authors: Hall L , Zwartkruis J , Velders G 
Published: October 2022

Abstract
In 2020 the Dutch National Institute for Public Health and the Environment (RIVM) published its vision on climate change and health. This vision reflects the position of RIVM in society and highlights the transdisciplinary and collaborative nature of our work on this topic. We define this societal challenge as: protecting and promoting the health of people throughout society with regard to climate change and climate measures. The purpose of our work on this challenge is to support all levels of Dutch government with policy development and implementation and to forge links with both national and international organisations to further knowledge and expertise.
The focus of our work, in collaboration with the aforementioned actors, is as follows:
1. Knowledge translation of the health impacts of climate change for the public and government.
2. Developing instruments to promote health in relation to climate change and mitigation and adaptation measures.
3. Implementation research on solutions to mitigate and adapt to climate change.
4. Strengthening national and international cooperation to enhance synergies in our work.
In the workshop we will present examples of our work:
• Quantifying the health impacts of climate change, now and in the future under different global warming scenarios.
• Developing a set of indicators to monitor the health impacts of climate change and mitigation and adaptation plans and actions.
• Collating and disseminating easily digestible information for public health services on evidence-based, effective adaptation measures.
• Developing tools and instruments to ensure health benefits and limit unintended consequences of adaptation measures, such as green and blue spaces.
• Prioritising research on climate change and health through a research agenda.
Workshop participants will be encouraged to provide feedback to inform RIVM's future work and that of other national public health institutes, and to ensure we are fully supporting our stakeholders.
4.G. Workshop: Economic evaluations of public health interventions: from case studies to next methodological steps
Authors:   Organised by: EUPHA-ECO, EUPHA-HTA,   Chair persons: João Vasco Santos (EUPHA-ECO), Vanessa Gorasso (EUPHA-ECO)
Published: October 2022

Abstract

For establishing evidence-based or evidence-informed decision making in health systems, it is essential to determine which public health interventions and health policies are worth investing in, considering that public budgets are always limited. For that purpose, we can use well-established economic evaluation methods based on marginal analysis as cost-benefit and cost-effectiveness analyses. While the use of economic evaluations is a common practice in health technology assessment of drug and medical device in many high-income countries, the systematic assessment of public health interventions is marginal and non-compulsory. In fact, if conducted at all, many economic evaluations of public health interventions are performed internally without dissemination outside organisations. In general, there is already some guidance on how to perform and report economic evaluations that can also be used for public health interventions, as the recent update version of Consolidated Health Economic Evaluation Reporting Standards (CHEERS) check list. However, some methodological and implementation difficulties still persist, including insufficient or low-quality data on costs and outcomes (e.g. absence of experimental studies), complexities related to the need of measuring outcomes in the very long term an on aspects beyond the healthcare sector, or high relevance of contextual factors that are difficult to measure. This workshop will take on some examples of economic evaluations of public health interventions and explore how analyses, methods and implementation can be improved in order to allow a more evidence-based or evidence-informed decision making process.

Key messages
• Economic evaluations of public health interventions could be performed more frequently when it comes to the decision making. Planning and implementation difficulties are highlighted in this workshop.
• Methods used in current economic evaluations of public health interventions can still be improved with a correct estimation of costs and outcomes, based on good quality data.
A perspective on the assessment of the broad value of vaccinations
Authors: de Waure C , Calabrò GE , Ricciardi W 
Published: October 2022

Abstract
Vaccinations are considered a cost-effective public health intervention to control vaccine-preventable diseases and are commonly evaluated in respect to several domains, including efficacy, safety and cost-effectiveness, before being implemented nationwide. There are plenty of evidence of economic evaluations performed on single vaccines or vaccinations. They commonly relies on static or dynamic models and considers both direct and indirect costs, i.e., those linked to productivity loss, of vaccine-preventable diseases. Nevertheless, vaccinations are expected to provide also societal benefits that call to the development and implementation of methods to value them, also from an economic point of view. The scientific debate on the assessment of the broad value of vaccinations has pinpointed several relevant aspects that need to be paid attention in future evaluations. They include the antibiotic sparing effect of vaccination, their impact on antimicrobial resistance - which is a challenge of our days -, their effect on social cohesion, their role in avoiding the loss of school days and in ameliorating educational attainment. The economic evaluation of vaccinations need to be further developed in order to allow a quantitative exploitation of their broad value according to the aspects described above. As the experience is still scant, we need to work on several fronts, including capacity building, data production and sharing and new methods development.
Challenges in economic evaluation of public health interventions: the example of surveillance of high risk pancreatic tumour patients
Authors: Cortesi P 
Published: October 2022

Abstract
Evaluation of public health interventions raises a number of potential challenges in applying and performing economic analyses. The impact of interventions may extend beyond the health sector, and even within the health sector, the value may be difficult to estimate and extended beyond the health improvement of individuals. Screening and surveillance cancer programmes give the possibility to detect patients in a curable and treatable stage. Increasing number of expert recommendations and guidelines of cancer screening and surveillance have been recorded in the last decades. This scenario has increased the uncertainty on the most valuable and affordable approach to adopt. A case study can be provided by the premalignant pancreatic primarily cystic tumours surveillance. American, European and International guidelines for surveillance of asymptomatic cysts are available with significant differences in patients stratification, surveillance intensity (frequency of visits-exams), and duration. Further, real-world data suggest a significant variability in the surveillance approach even within Europe. However, no comparative data on different programmes efficacy are available, neither reliable medium-long term data on cancer risk. The lack of evidence must be considered with methodological issue associated to the inclusion of method to estimate inequalities created by the different programs and the indirect effect of healthcare resources consumption (e.g. CT and MRI) to access and allocation of these resources to other subjects (cancer and no cancer patients). Economic evaluations of surveillance or screening cancer program raise significant challenges, as data availability and methodological approach to apply. This scenario highlight the need of specific recommendation on data quality and type required to assess the programmes value and on methodological approach required (e.g. type of decision analytical models) to provide useful information for public health decision makers.
Methodological advancements in costing methods for (public) health economic evaluations: results from the European PECUNIA project
Authors: Simon J 
Published: October 2022

Abstract
(Public) health economic evaluations face significant problems regarding the standardization and comparability of their methods. In addition, at least a quarter of the total direct cost impact of healthcare interventions affects other economic sectors. International methods and tools are lacking for the rigorous and comparable assessment of the costs and outcomes of (public) health care from a societal perspective. The H2020 PECUNIA project (grant No 779292) brought together ten partners from six countries (AT/DE/ES/HU/NL/UK) between 2018 and 2021 aiming to improve the comparability and feasibility of multi-sectoral, multi-national health economic evaluations in Europe. A multi-step, mixed methods approach was used following a new harmonized costing concept to develop new methods and tools for the standardised identification, definition, measurement and valuation of costs in multiple sectors (health care, social care, (criminal) justice, education, employment and productivity, and patient, family and informal care), and for the broader, harmonised, supra-national assessment of outcomes using selected mental disorders as illustrative examples. This presentation will summarise the relevant advances in costing methods, give an overview of the developed tools that are now publicly available (www.pecunia-project.eu/tools), and discuss the lessons learned regarding how far it is possible to harmonize costing evidence with standardised tools in Europe, and what the necessary future research directions may be.
4.J. Workshop: Health system performance assessment in Europe – recent developments, evidence, and challenges
Authors:   Organised by: Berlin University of Technology,   Chair persons: Reinhard Busse (Germany), Carine Van de Voorde (Belgium)
Published: October 2022

Abstract

Assessing the performance of health systems is essential to initiate policy processes that further strengthen health systems to improve population health. Starting with WHO's World Health Report of 2000, Health System Performance Assessments (HSPA) gained increasing attention in research and policy. By now, several comparative HSPA initiatives of international organisations (e.g., OECD's Health at a Glance) and country specific HSPA (e.g., Sweden, Netherlands, Austria, Belgium) were implemented in Europe. Further countries are currently in the process of developing or piloting an HSPA (e.g., Germany). The objective of the workshop is to foster and strengthen the interchange of different HSPA initiatives in Europe and beyond. While each health system has its specifics, initiatives likely face similar challenges in the implementation and ongoing development, which holds a lot of potential for learning from each other. The workshop is supposed to be a platform for the exchange of and about HSPA initiatives and related topics by bringing together stakeholders of different countries and professions. Participants are supposed to gain new insights into recent activities in Europe and will be able to discuss challenges and lessons learned. The presentations give insights into recent activities of selected HSPA initiatives in Europe. One presentation originates from the Belgian HSPA which is well established. This presentation will focus on the transversal dimension of equity, on which a separate report was recently published. The second presentation is about the German HSPA which is still in development and currently tested in a pilot study. Both presentations represent HSPA initiatives at different stages, which provides a good basis for the following panel and discussion with all workshop participants. The two presentations of about 20 minutes each will be combined with a panel discussion. Afterwards, there will be room for exchange and discussions between all participants and presenters.

Key messages
• Recent developments of HSPA initiatives in Europe will be presented along two examples from Belgium and Germany and lessons learned and challenges will be discussed.
• The workshop provides a platform for the exchange of and about HSPA initiatives and related topics by bringing together stakeholders of different countries and professions.
Piloting the first health system performance assessment for Germany: key results and learnings
Authors: Blümel M , Achstetter M , Hengel P , Schwarzbach M , Busse R 
Published: October 2022

Abstract

Background
Health System Performance Assessment (HSPA) is a tool to monitor and evaluate the performance of health systems and to inform evidence-based policymaking. For the first time, a country specific HSPA is currently being piloted for Germany.

Methods
The HSPA is based on a newly developed conceptual framework including nine dimensions (e.g., access, quality, efficiency, population health). Indicators were selected based on a systematic search of (inter)national studies and HSPA initiatives. Where possible, indicators were analysed in their development over time (2000-2020), in comparison to eight European countries (e.g., Austria, Denmark, France), and along up to seven equity dimensions (e.g., sex, age, income, education, region).

Results
Overall, 90 indicators were included in the HSPA. Trend and equity analyses were possible for almost all and country comparisons for most indicators. A few indicators could not be analysed at all due to missing data. The overall HSPA provides an in-detail picture of Germany's health system. Access, for example, can be rated as good in Germany compared to the other countries, as insurance coverage and physician density are high, and unmet needs and waiting times for elective surgery are low. Results for quality are not as good, e.g., cancer survival rates, but most indicators show a positive trend. While population health outcomes are average in country comparison (e.g., fetal and infant mortality), resource input is comparatively high. Consequently, overall efficiency can still be improved (e.g., amenable mortality per total health expenditure).

Conclusions
This first HSPA for Germany allows new insights to the performance of the German health system which are important for policy and research. While the pilot benefitted a lot from previous HSPA initiatives, data availability remains one of the biggest challenges.
Long COVID among Children: Persistence of Symptoms 12 Weeks and More in a Cohort Study from Turkey
Authors: Turunç Ö , Emecen AN , Süner AF , Keskin S , Başoğlu E , Şiyve N , Belet N , Karaoğlu Asrak H , Duman M , Ünal B 
Published: October 2022

Abstract

Background
COVID-19 usually cause a mild infection among children with a low fatality rate. On the other hand, increasing evidence suggests that children may have prolonged symptoms related to COVID-19. This study aims to describe the persistence of COVID-19 symptoms up to 12 or more weeks among children and to investigate associated factors including perceived socioeconomic status and parents’ education level.

Methods
The study group consisted of 759 cases aged &lt;18 years detected as SARS-CoV-2 RT-PCR positive in DEU Hospital between March 2020, and May 2021. Interviews were conducted at 1st 3rd and 6th month of diagnosis. The ongoing self-reported symptoms 12 or more weeks after infection was the dependent variable. Multivariate logistic regression models were used to evaluate associated factors with long COVID, and robust clustering using links algorithm was used to assess long COVID symptoms clusters.

Results
Among 759 COVID-19 cases, 22 children were hospitalized, and 4 died. 9.6% of the children had at least one symptom related to COVID-19 after 12 weeks of the diagnosis, Symptom duration was minimum 84 days, maximum 344 days (mean±SD: 160±68 days). The most frequent symptoms were fatigue, muscle-joint pain, headache, and loss of smell and/or taste. In multivariate analysis, female gender (OR:2,3 95%CI:1.1-3.6) and symptomatic onset (OR:2,7 95%CI:1.7-20.9) were related to increased risk of long COVID. Age, long-term health conditions, socioeconomic status and mother's education level did not predict the risk of long COVID. No cluster of symptoms was found.

Conclusions
About 10% of children suffer from symptoms related to COVID-19 for up to six months. Female gender and symptomatic onset of disease increased the risk of prolonged symptoms. Socioeconomic status and mother's education level was not associated with the risk of long COVID, but the evidence of the effect of social determinants of health on the outcomes of COVID-19 among children is still needed.

Key messages
• One out of ten children may suffer from long COVID represents symptoms such as fatigue, headache, and muscle and joint pain. Girls and children with symptomatic onset have a higher risk of long COVID.
• The effects of social determinants on the susceptibility and outcomes of COVID-19, including death, were well studied among the adult population. There is a need for sound evidence for children.
Innovative Ante-Natal Care: Healthy Teeth Healthy Baby, An Interprofessional Collaboration Initiative In Indonesia
Authors: Adyatmaka I , Lee H 
Published: October 2022

Abstract

Background and problem
SDG 3.1 sets out that by 2030, the global maternal mortality ratio (MMR) should be reduced to 70 per 100,000 lives and no country should have MMR above 140 per 100,000 lives. Indonesia still has an MMR of 177 by 2017 data by the World bank. Urgent action is needed to improve the health and survival of women and babies. The main causes of MMR in Indonesia are Hemorrhage, followed by pre-eclampsia, and others, related with diabetes, stroke, etc.

Importance
Previous studies have shown the association between oral dysbiosis and pre-eclampsia, preterm birth and low birth weight. Oral microbiome of the mother being a key player in pregnancy outcomes. Periodontal disease is considered a possible risk factor for the health of the mother and the newborn.

Solution
Program goal of this program, “Innovative AnteNatal Care, Healthy Teeth, Healthy Baby”, is to create the ecology right from the start, by incorporating oral health diagnosis and prevention into routine antenatal care. This approach achieves a healthy oral condition that can improve systemic health during pregnancy. The program also achieves a healthy and resilient family through oral health empowerment and delivering healthy babies (superior generation 2045- President Joko Widodo). Processes included avocation to provincial health districts, initial survey of the perception and oral health status of pregnant mothers, module preparation, and socialization to health districts and related officers. The program has trained midwives and dental providers and secured governmental budgets for sustainable activities, including socialization and assistance to pregnant mothers and their husbands, field penetration by health professionals, and evaluation of the programs.