bluuebunny/crossref_metadata_2025_split huggingface dataset:
Life expectancy in multimorbid older adults: Why it matters for preventive care
Authors: Gastens V , Chiolero A , Anker D , Feller M , Bauer DC , Rodondi N , Del Giovane C 
Published: October 2022

Abstract
Multimorbidity is highly prevalent among older adults and associated with a shorter life expectancy. Many guidelines recommend tailoring preventive care of multimorbid people according to life expectancy. Indeed, there is a time lag between a preventive care intervention and the expected potential benefit, and patients with a relatively short life expectancy might not have the time to benefit from the preventive care intervention. Further, both patients and health care providers tend to overestimate benefits and underestimate risks of interventions. It is therefore necessary to have a valid index for mortality prediction in multimorbid patients, but there is no life expectancy estimator designed and recommended for this population. The paper describes the development and internal validation of a new life expectancy estimator. In this presentation, we focus on the importance of life expectancy estimation in multimorbid older adults: Why does it matter in this population? What is the time lag to benefit of a preventive intervention, e.g., cancer screening? What is the state in this field, in research and clinical practice? How could tailoring preventive care to life expectancy improve patient outcomes?
Leveraging Citizen Science to Improve Urban Public Health
Authors: Hotting J , Clemens T , Guinto R , Commers M , Brand H , Czabanowska K , Elands RJJ 
Published: October 2022

Abstract

Background
Mobile health approaches in community based participatory projects keep the promise to encourage sustainable behavior in citizens by engaging communities in data collection and connecting their individual level behavior to larger level community health. This review evaluates the effectiveness of the implementation of citizen science for health promotion of non-communicable diseases in urban community-based participatory research projects.

Methods
A scoping review was conducted using PRISMA-ScR. Pubmed and Web of Science were searched for citizen science studies. We included research 1.) conducted in an urban setting, 2.) related to environmental sustainability, 3.) focused on non-communicable diseases, and 4.) applied citizen science methodology.

Results
32 community-based participatory research projects were identified using the following data collection technologies: mobile applications (n = 7), photovoice (n = 6), Stanford Healthy Neighborhood Discovery Tool (n = 6), monitoring (n = 6), mixed-methods (n = 4) and sensors (n = 3). The Stanford Healthy Neighborhood Discovery Tool was most effective at delivering real time data collection, exploring new communication and dissemination opportunities for remote and marginalized communities, and at offering a flexible and cost-effective approach to identify health promotion interventions. Studies that implemented photovoice tools and mobile applications had challenges with regard to recruitment and retention of participants as well as privacy concerns.

Conclusions
Mobile health technologies in community-based participatory research projects may be a promising way to uncover unknown local risk factors, raise awareness and identifying targeted policy solutions to promote healthy and sustainable environments in urban spheres. The effectiveness of mobile health applications for health promotion of non-communicable diseases may vary between community-based participatory studies by data collection method.

Key messages
• Mobile health technologies in communities may be a promising way to promote healthy and sustainable environments by raising awareness and offering targeted policy solutions in urban spheres.
• The effectiveness of mobile health applications for health promotion of non-communicable diseases may vary between community-based participatory studies by data collection method.
Association between worries about climate change and mental health in Norwegian adolescents
Authors: Dahhlen Granrud M , Bonsaksen T , Lien L 
Published: October 2022

Abstract

Background
Climate change has a great impact on the future of children and young people. Since the global climate strike movement, many adolescents expressed worries about climate change. But do these worries lead to declined mental health and future optimism? Thus, we aim to explore associations between prevalence of worries about climate change, leisure activities and mental health problems in a representative sample of Norwegian adolescents.

Methods
In 2021, the youth survey Ungdata collected data from 139,841 Norwegian adolescents, which corresponds to a response rate of 75%. Descriptive analysis was used to calculate the prevalence of worries about climate change cannabis use and bi- and multivariate logistic regression analysis to examine the association between worries about climate change and mental health, leisure activities and alcohol and cannabis use, controlled for sociodemographics.

Results
Around 37% of Norwegian adolescents are worried about climate change. Worries increased with age and are more prevalent among girls. There is a relationship between mental health problems and worries about climate change (OR = 1.80 (CI:1.75-1.86)) still after adjusting for sociodemographic variables, leisure activities and alcohol and cannabis use (OR = 1.71 (1.10-1.42)).

Conclusions
The results indicate a real connection between mental health problems and worries about climate change, but the causal relationship needs further study. This knowledge makes it important for all profession, working with adolescents, paying special attention to possible negative effects of worries about climate change on the mental health of young people.

Key messages
• Worries about climate change has an impact on mental health of young people.
• Adolescent’s worries about climate change should be taken seriously.
Measuring health literacy and its associations with health behaviors of adolescents in Germany
Authors: Loer A , Domanska OM , Jordan S 
Published: October 2022

Abstract

Background
The questionnaire “Measurement of Health Literacy Among Adolescents Questionnaire” (MOHLAA-Q) was developed and validated in a multi-stage process to measure generic health literacy among 14- to 17-year-olds. The MOHLAA-Q combines subjective and objective measurements, consisting of four scales. The instrument was applied to explore associations between generic health literacy and different health behaviors among adolescents in Germany. The data should contribute to the age-appropriate development of health promotion interventions.

Methods
We carried out a nationwide cross-sectional online survey with 1,235 adolescents aged 14-17 years in Germany in 2019. Data on generic health literacy were collected using the four scales of the MOHLAA-Q and data on health behaviors were collected using single established single-item questions on sports, diet, alcohol consumption, and smoking. Bivariate and multiple analyses were performed for investigating associations between generic health literacy and health behaviors, adjusted for age, gender, education and self-efficacy.

Results
Not consuming fruit and vegetables daily was associated with lower health literacy levels in all examined scales. Doing no sports as well as smoking showed positive associations with low levels in “health-related communication and interaction skills” and “attitudes toward one's own health and health information”. No associations were found between risky alcohol consumption and health literacy.

Conclusions
The results indicate that strengthening health literacy should be part of health promotion activities for increasing physical activity and healthy diet among adolescents. The MOHLAA-Q allows us to identify which specific dimensions of health literacy might be addressed in order to promote different health behaviors.
Accounting for vaccines specificities in the Joint Clinical Assessment (JCA): a proposal for guiding principles
Authors: Beck E , D'Agostino P , Chapman R , Largeron N , Louette L , Sabale U , Schaible K , Quilici S 
Published: October 2022

Abstract

Issue/problem
Vaccines are an important public health intervention protecting the population against infectious diseases. The value of vaccines is broad ranging from individual to societal as achieving community immunity protects the unvaccinated, minimizes the risk of outbreaks, reduces the emergence of antimicrobial resistance, and leads to broader societal benefits.

Description of the problem
Vaccines’ market access processes are characterized by the development of recommendations by NITAGs followed by the assessment of health technology assessment (HTA) bodies in less than half of 27 EU member states. Despite that HTA for therapeutic drugs is well established, there is very limited experience in applying HTA methodologies to vaccines, especially for clinical assessments, as HTA methods and frameworks are traditionally geared toward therapeutics. However, following the adoption of the EU regulation on HTA, Joint Clinical Assessments (JCAs) of vaccines are expected.

Results
To support a discussion on how to account for vaccine specificities in the JCA, Vaccines Europe has performed a project which aimed at developing a proposal for high-level guiding principles on processes and methodologies for clinical HTA for vaccines. The proposal is informed by findings of literature reviews on currently applied processes, methods, and clinical assessment frameworks of vaccines as well as the outcomes of an advisory board with scientific experts.

Lessons
A proposal for high-level guiding principles for clinical HTA for vaccines is being developed based on both evidence and the advice from scientific experts which focuses on processes (e.g., horizon scanning, early advice, consideration of vaccine-specific expertise) and methods (e.g., unmet need, safety, efficacy/effectiveness, real-world evidence and technical characteristics of the technology). Lastly, the implementation of vaccines specificities in JCA represents a call for action.
Changes in healthcare utilization after mass trauma: A register-based study of young survivors’ utilization of primary care and mental health services before and after the Utøya attack in Norway
Authors: Stene L , Thoresen S , Wentzel-Larsen T , Dyb G 
Published: October 2022

Abstract

Introduction
Using register-based data, this study had a unique possibility to investigate how young survivors’ use of primary care and mental health services (MHS) changed after a terrorist attack.

Methods
We analyzed data on consultations with primary care physicians (PCP) and MHS among 255 survivors (48% female) of the 2011 Utøya youth camp attack in Norway three years before and after the attack, and their reason for encounter with the PCP according to the International Classification for Primary Care (ICPC-2).

Results
The majority of survivors consulted PCP both before and after the attack, with a marked increase in psychological reasons for encounter after the attack. Few consulted MHS before the attack, while most survivors did after the attack. In total, 93% of female survivors and 88% of male survivors consulted PCP in the three years before the attack, compared to respectively 98% and 96% in the three years after the attack. Moreover, 17% of female survivors and 11% of male survivors consulted MHS in the 3 years before the attack, compared to respectively 80% and 65% in the 3 years after the attack. From the year before to the year after the attack, the mean yearly consultation rates (CR) increased two-fold for PCP and nearly 8-fold for MHS in female survivors, and more than two-fold for PCP and nearly 12-fold for MHS in male survivors. Both before and after the attack, the consultations rates for PCP and MHS were higher for female than male survivors. The levels of posttraumatic stress, depression and anxiety symptoms and somatic symptoms were also higher in female survivors both early and at long-term after the attack.

Conclusions
Our study demonstrated that both PCP and MHS played important roles in providing healthcare for psychological problems in young survivors of terrorism in Norway. Potential implications for public health preparedness to mass trauma will be discussed in the presentation.
Comparative Effectiveness in terms of Understanding of Nutri-Score and NutrInform in Spain
Authors: Fialon M , Babio N , Salas J , Galan P , Kesse-Guyot E , Touvier M , Sarda B , Hercberg S , Nabec L , Julia C 
Published: October 2022

Abstract

Background
Interpretive Front-of-Pack Labels (FoPLs) are supported by WHO as a key policy tool to promote healthy diets. At present, various FoPLs formats co-exist in the European Union (EU). However, as part of the Farm to Fork strategy, the European Commission stated it would adopt a single mandatory FoPL in 2022. The aim of this study was to analyze Spanish consumers reactions to Nutri-Score and NutrInform, two FoPLs that are currently the subject of debate in EU, testing preference through subjective understanding and perception but also performance through objective understanding of the FoPLs.

Methods
The experimental study was conducted in 2021 on a representative sample of 1026 Spanish adults (50% women, mean age±SD = 46±14 years), through an online randomized questionnaire where participants were exposed to Nutri-Score or NutrInform. Performance of and preference for these two FoPLs were assessed in three food categories (Breakfast Products, Breakfast Cereals and Added Fats). Performance was tested using multivariate logistic regression while preference using principal component analysis and t-tests.

Results
In terms of objective understanding, Nutri-Score was significantly associated with an increase in consumers’ ability to identify healthier food products across all food categories compared to NutrInform (OR = 19.1 [14.2-25.7], p &lt; 0.0001). On the preference dimension, Nutri-Score was perceived as significantly easier to use and was more liked than NutrInform (standardized PCA dimension resp. 0.32±1.58 vs. -0.29±1.66, p &lt; 0.0001 and 0.080±1.18 vs. -0.072±1.17, p = 0.039) and participants found Nutri-Score more helpful to discriminate the nutritional quality of Breakfast Products and Breakfast Cereals (resp. 1.32±1.00 vs. 1.14±1.02, p &lt; 0.01 and 1.33±1.00 vs. 1.00±1.03, p &lt; 0.0001).

Conclusions
Results of this study provide new evidence to support Nutri-Score in comparison with the NutrInform battery, on both performance and preference aspects.

Key messages
• Nutri-Score better helps participants identify healthier food products than NutrInform.
• European Commission should consider results of this study in its decision on a harmonized Front-of-Pack Label.
Calculation of Purchasing Power Parities for Pharmaceutical Products via EURIPID database
Authors: Habl C , Zuba M 
Published: October 2022

Abstract

Background
Purchasing power parities (PPPs) are indicators of price level differences for all goods and services across countries. Their calculation follows the ÉKS method (https://ec.europa.eu/eurostat/cache/metadata/en/prc_ppp_esms.htm). Prices of pharmaceuticals are collected by national statistical offices using different methods, from asking prices in pharmacies to retrieving scanner data. The sample is limited to 150 top-selling medicines, which are not available in all countries. Consequently, the PLIs (price level indices) and PPPs derived are sometimes based on only 50 pharmaceuticals. In a cooperation between Eurostat and EURIPID the PPP calculation was alternatively done with the EURIPID database for 28 countries.

Methods
The study compared the PLIs/PPPs derived from the E20-2 “Furniture and health” survey (aka CGS) with those from EURIPID for 2018-2020. The main challenge was to identify comparable products from the 224,448 products in EURIPID. For this we grouped those that shared the same 1) ATC, 2) active substance(s) & strength(s), 3) pack size group and 4) dosage form group (e.g., oromucosal) resulting in 157,186 distinctive products compared to 1,928 included in CGS. We used the Gross Retail price (GRP) as defined in the Eurostat PPP manual.

Results
The ranking of PPPs was similar in both approaches, with Switzerland and Iceland in the lead and Poland and Hungary in the end. Only for some countries, e.g. the Netherlands deviations were identified. The Pearson correlation between the 2020 PLI for the Euripid subsample using the asterisk method with all products marked as representative and the CGS results was 0,946.

Conclusions
Results from EURIPID show the same trend as the CGS. It is possible to replace the national data collection by a central source. This would reduce the data collection burden on the statistical offices and allows a closer monitoring of the evolution of pharmaceutical prices (bi-annual PPP publication instead of current 3-year interval)

Key messages
• To monitor affordability of medicines for all citizens it is important to compare prices on a regular basis with a simple tool as e.g. some products prices differed by 1000-times across countries.
• The EURIPID database (www.euripid.eu) allows detailed analysis of pharmaceutical prices in Europe and is available for free to non-commerical researchers.
Network analysis of a COVID-19 outbreak in the west of Ireland in February 2021
Authors: Timoney C , Smyth B 
Published: October 2022

Abstract

Notification and contact tracing systems of COVID-19 hold a vast amount of information on transmission chains of the virus. It can be hard to gain an understanding of these due to the number of individuals involved. Network analysis can be used as a method of visualising these systems, gaining understanding of transmission chains and as a potential tool for monitoring outbreaks. It can link cases together and show how far reaching initial infections were. Here, a system developed in the programming language R links the Irish infectious disease notification system and contact tracing system together and creates a network representation of the result. The system finds any cases or close contacts linked in any manner to the known cases. The result is a network from the earliest found case to the latest found case or contact related to the outbreak. A large outbreak of COVID-19 occurred in the student population in the West of Ireland in February 2021 with 449 cases linked to it by the Department of Public Health at the time. Using the system, 192 further positive cases were found to be linked to the outbreak. A total of 1,431 individuals were linked in some manner to it with 68% in the 19-24 age group and less than 1% in the 65+ age group. This takes a matter of seconds to run and highlights clusters within the outbreak, the largest of which had 96 cases and 121 not detected close contacts. Visualising the transmission chains also showed that there were no other large clusters outside of the outbreak at the time. A system such as this can link cases to outbreaks not previously linked, dramatically reduce the time taken to link cases together and visualise transmission chains to gain a deeper understanding of what is happening. This automated system frees up resources to allow for deeper investigation into cases and situations of concern. It also has the potential to link outbreaks together and spot previously unnoticed situations of concern.

Key messages
• Network analysis is beneficial for the monitoring of the spread of an infectious disease like COVID-19.
• Here, 192 cases were found to be linked to an outbreak that was thought to have 449 cases in it.
Lessons and long-term implications of the covid-19 response in Denmark from a resilience perspective
Authors: Vrangbæk K 
Published: October 2022

Abstract
The paper focuses on crisis responses and resilience within hospitals. The study is based on structured expert interviews with medical directors in selected hospital departments in two of the five regions of Denmark and primary care physicians in the same regions. We investigate stage 3 (Shock impact and management) and stage 4 (Recovery and learning) within hospital organizations using Denmark as case country, and we pay particular attention to issues of “organisational learning”, “purchasing flexibility and reallocation of funding”, “distribution of human and physical resources” and “motivated and well-supported workforce”. Particular attention is paid to care for patients with chronic care needs and lessons for the long-term resilience building in the health system. The study highlights strategic choices and lessons for the long-term resilience within hospitals. It demonstrates, how the initial strategy of organizing specific COVID-19 response units was abandoned relatively early, as it appeared more efficient to integrate COVID-19 patients in the regular specialized department structure. Emergency wards experienced increasing pressure during the pandemic as primary care clinics were referring (too) many patients suspected of COVID-19. This raises questions about capacity and relations between primary and specialized care in crisis situations. Management of human resources is crucial. While the initial phases of the pandemic response were characterized by flexibility and “team-spirit”, there has been a negative long-term impact particularly among the nursing staff, where burnouts and attrition are major issues. Pandemic crises place significant strain on health systems and personnel. This raises issues about communication of strategies and principles for organizing efforts. The Danish health system managed the crisis adequately, but there are also lessons that should be learned regarding long-term implications and preparedness for future crises.
From COVID-19 to Health System Reform: Qualitative Insights on Resilience and Lessons Learned from Finland
Authors: Tynkkynen L-K , Kihlström L , Keskimäki I 
Published: October 2022

Abstract
The pressure of COVID-19 on health system functioning has made policies to strengthen health system resilience a major theme of research. Accordingly, crises like COVID-19 can be seen as windows of opportunity for health system reforms to enhance health system resilience. In Finland, COVID-19 arrived on the eve of a major health system reform. In 2023 running health and social services will be transferred from 309 municipalities to 22 counties. While the reform was framed before the pandemic, we explore how lessons from COVID-19 matter for the future reform. Our results come from interviews of 53 top managers and civil servants in the year one of COVID-19, representing municipalities, municipal healthcare authorities and state agencies. The results offer a lookout to how national and local healthcare leaders view pandemic responses in connection to the future reform. Finland fared well in the pandemic compared to many countries e.g. in terms of excess deaths. However, our results reveal a tension between major issues in managing COVID-19 and implementing the reform. While the data suggest that dealing with a prolonged crisis proved challenging due to lack of trust, communication, and transparency between national and subnational actors in the health system, the dominant lessons learned and needs for reform among the interviewees build upon obvious fixes, such as ensuring supply of PPEs and ICU beds for the next pandemic. While being important in preparedness, these can build a legacy not tackling the root causes of lacking resilience and can be inconsistent with reform goals. The pandemic provides an opportunity to analyse the reformed system from a new viewpoint and may reveal weaknesses not considered in reform planning. Reforms can impact health system resilience in positive and negative ways. While different shocks may open new avenues for system transformation, they can also create path dependencies weakening the systems’ ability to prepare for unknown threats.