bluuebunny/crossref_metadata_2025_split huggingface dataset:
Resilience and life quality of health professionals in capital of Turkey during COVID-19 pandemic
Authors: Tonbuloğlu Altıner Ö , Uğraş Dikmen A , Gingir C , Özkan S 
Published: October 2022

Abstract

Background
COVID-19 pandemic has had significant effects on physical and mental health of health professionals. It is thought that resilience protects individuals against mental illness and helps individuals cope with difficulties and stress more effectively. In this study, it was aimed to evaluate resilience, life quality and related factors of health professionals during COVID-19 pandemic.

Methods
A cross-sectional study was performed among health professionals working at a tertiary hospital in Turkey’s capital Ankara. An occupation based stratified sampling was done with taking alpha 0.05 and 1-beta 0.80. A questionnaire that consists of sociodemographic information, COVID-19 Impact on Quality of Life Scale and Connor Davidson Resilience Scale was used to collect data. The results of scales were divided into two parts by taking the median values as cut off points. Descriptive/inferential statistics and logistic regression were performed on IBM’s SPSS 27.0 program.

Results
A total of 987 participants were surveyed. 66% of them were female, and the average age was 36. Multivariate logistic regression analysis results that physicians (OR:1.48, 95% CI:1.05-2.07, p = 0.024) and nurses (OR:1.46, 95% CI:1.08-1.97, p = 0.013) have lower resilience. The impact of COVID-19 on quality of life was higher for the following groups; physicians (OR:2.07, 95% CI:1.43-3, p &lt; 0.001), nurses (OR:1.61, 95% CI:1.10-2.36, p = 0.013), who have bachelor/higher degrees (OR: 1.54,95% CI: 1.02-2.31,p=0.038), infected with COVID-19 (OR:1.33, 95% CI:1.02-1.74, p = 0.034), have COVID-19 related relative lost (OR:1.42, 95% CI:1.06-1.89, p = 0.016), and live with risk groups (OR:1.31, 95% CI:1.01-1.71, p = 0.042).

Conclusions
Physicians and nurses who take care of patients one-on-one have lower resilience and higher decrease in life quality due to COVID-19 impacts. This result indicates a significant quality drop in health services is inevitable during pandemics and should be considered by the policy makers.

Key messages
• Policies should be developed to increase the resilience of healthcare professionals so that they can effectively combat public health emergencies such as COVID-19 and not affect their quality of life.
• It is necessary to determine risk groups among health workers and plan training programs to increase resilience.
Does political stringency change students’ adherence to governmental recommendations?
Authors: Berg-Beckhoff G , Bask M , Jervelund SS , Quickfall A , Rabiee Khan F , Oddsson G , van der Wel KA , Sarasjärvi KK , Skalická V , Van de Velde S 
Published: October 2022

Abstract

Introduction
Knowing predictors for adherence to governmental recommendations is fundamental to guiding health communication in pandemic situations. This study investigated whether political stringency was associated with students’ adherence to the COVID-19 governmental measures in the Nordic countries (Denmark, Finland, Norway, Iceland, and Sweden) and the United Kingdom (UK).

Methods
We used data from a cross-sectional online survey, from university students in all Nordic countries and the UK (N = 10.345), in May 2020. Data on socio-demography, study information, living arrangements, health behaviors, stress, knowledge, and concern about COVID-19 infection supplemented with measures on political stringency from the Oxford Covid-19 Government Response Tracker were utilised. Multiple linear regression analysis methods were applied.

Results
Around 66% reported that they followed governmental measures. Our model explained only 10% of the variation of adherence. The main predictors for adherence were older age, female sex, and being worried about the COVID-19 infection. More days since lockdown and political stringency were also associated with adherence to governmental recommendations in all countries. Sweden had the lowest willingness to adhere to governmental recommendations even though the strength of the association between political stringency and adherence was similar to other countries.

Conclusions
Political stringency and congruent communication are important in ensuring adherence to governmental recommendations during the first wave of the COVID-19 pandemic.

Key messages
• Political stringency is important to ensure adherence to governmental recommendations.
• Congruent communication is important to ensure adherence to governmental recommendations.
Using Citizen Science to examine health and access to health care of uninsured patients in Germany
Authors: Warth J , Köllges R , Böckenholt L , Kriegsmann-Rabe M 
Published: October 2022

Abstract

Background
Estimates suggest that numerous people live without health insurance in Germany. Existing evidence on uninsured patients’ health and care use is scarce, specifically in Germany. The present study involves citizens’ engagement to identify community perceptions of factors associated with health and medical care and to generate community-driven policy recommendations.

Methods
Representatives of civil society, affected patients and citizens (‘co-researchers') participate in a participatory health research project (MoveCitizenS) located in Bonn, Germany, using Photovoice and Community-based Mapping. The study is composed of five work packages over a 24-month period: (1) Photovoice workshops for co-researchers to produce, select and analyse photographs; (2) a series of workshops to conduct community-based mapping to identify barriers and facilitators of health care utilization; (3) workshops to co-design a cross-sectional survey of uninsured patients (n = 300); (4) project evaluation by co-researchers; (5) a dissemination strategy (e.g. advocacy event, exhibition) will be developed.

Results
Procedures to facilitate the active engagement of citizens and patients are discussed. Preliminary results on community perceptions of uninsured patients’ health and medical care and factors influencing health outcomes and care utilization are presented at the conference.

Conclusions
This is the first citizen science study which facilitates the understanding of barriers and enabling factors of good health and access to medical care for patients who lack health insurance coverage in Germany. This case study of a participatory project can be adapted to a range of settings to integrate local perspectives to improve population health for all.

Key messages
• Numerous patients in Germany are uninsured but evidence on their health and medical care is lacking.
• Using participatory methods to address these key questions is an important approach to generate suitable policy recommendations to meet the needs of the community and improve population health.
Short and long-term inequity in outpatient medical use by the type of medical institutions in Korea
Authors: Yang JY , Lee JH 
Published: October 2022

Abstract

Background
Many countries agree with the horizontal equity that medical resources should be allocated according to medical needs, regardless of income. Although the short-term equity index calculated through cross-sectional data doesn't reflect the dynamics of individual income and medical use, it can be supplemented by the long-term equity index using panel data. Koreans tend to choose expensive but highly specialized services without considering their medical needs because they are free to choose service providers. This study aims to empirically examine how the patterns of outpatient medical use that are not based on medical needs differ in terms of short- and long-term equity for each type of medical institution.

Methods
Using Korea Health Panel Survey(2014-2018), the equity of outpatient medical use(number of visits, medical expenses) of 10,244 people was measured by type of medical institution (tertiary general hospital, general hospital, hospital, clinic, and dentist). Wagstaff&van Doorslaer(2000)’s tool and Jones & Lopez-Nicolas(2004)’s tool were used to calculate the short and long-term horizontal equity index(HI), and mobility index(MI) to compare short and long-term inequity.

Results
In tertiary general hospitals and dentists, there were short and long-term pro-rich inequalities(HI &gt; 0, p &lt; 0.05). As a result of comparison, long-term inequality was greater in the number of visits (MI &lt; 0), while inequality was easing in the long-term in medical expenses(MI &gt; 0) in tertiary general hospitals. In dentists, long-term inequality was less than short-term inequality in both the number of visits and medical expenses (MI &gt; 0).

Conclusions
The short-term equity index is likely to underestimate or overestimate inequity in our society, so a long-term perspective is needed. Inequality patterns for each type of medical institution should be considered in healthcare reforms for fair distribution of medical resources.

Key messages
• Short-term equity index differs from the long-term equity index in outpatient medical use.
• The pattern of short and long-term equity indices may differ by type of medical institutions.
The role of income in the lives of people with long-term disabilities: A multi-country analysis
Authors: Oña A , Pacheco Barzallo D 
Published: October 2022

Abstract

Background
Health is a fundamental human right. Yet, people become ill and die because they do not have enough money to access the necessary healthcare. Studies confirm that on average, more income translates to better health status. The magnitude of this relationship and its consequences beyond health like reintegration or spillovers are not widely understood but are expected to be significantly different among countries. This is especially the case in vulnerable populations like those with a spinal cord injury (SCI). This study aims to better understand the role that income plays in promoting health in people with SCI and their differences across countries.

Methods
The research focus on three aspects, one, the estimation of the health income gap using years after the injury and a comorbidity index, two, the decomposition of different factors of this inequality with a special interest in the unmet healthcare needs, and three, their consequences in their social participation measured by the reasons of unemployment.

Results
There are significant differences in health status by income and between countries. On average, the poorest income groups with SCI are up to 40 times more likely to be ill than people in the richest groups and live 4-6 years less after the injury. The working conditions and the unmet health care needs are important factors that explain that differences. In addition, the health status, the lack of sustainable employment opportunities, and workplace accessibility issues are the main issues to reintegrating into the labor market.

Conclusions
Health inequalities are a global problem that affects people with long-term health conditions disproportionately to others without. Even in more equal and high-income countries with a universal health system, there are different realities for the people according to their income, where the estimations and solutions for the ‘average’ individual do not target the needs of people in the extremes.

Key messages
• This study generates evidence about the role of income in health, lack of health services, and consequences in people with SCI across and within countries.
• To achieve the goal of health equity, it is important to target the different realities focusing on the needs of people who most need which goes beyond the health system and changes by income level.
Inequality in access to COVID-19 vaccines: an annual experience in Verona (Italy)
Authors: Sartorello A , Paiola E , Moretti F , Accordini L , Postiglione C , Tardivo S , Benoni R 
Published: October 2022

Abstract

COVID-19 vaccination campaigns involved massive resources worldwide. However, the disparity in vaccine accessibility is a global issue. The study evaluated whether birthplace is a barrier to healthcare access in a high-income country (HIC). The retrospective cohort study included fully vaccinated adults in the Verona district between 27/12/2020 and 31/12/2021. In Italy, the vaccination was opened at different times according to the risk category. Two multiple linear regression models explored the relationship between (1) days before getting the first shot (IV) and (2) the distance between the municipality of residence and the vaccination point, and age, sex, and Income Group (IG, as defined by the World Bank). Distance (km) was estimated with Q-GIS. Results are reported as Marginal Effect at the Mean (MEM) with a confidence interval of 0.95. 500,001 first doses were included, with a mean age of 47 years (SD = 21) and a mean IV of 47.5 days. 6% of the sample was UpperMiddle (UMIC), 6% Lower-Middle (LMIC), and 0.3% Low-Income Countries (LIC). The mean age was higher for HIC (p &lt; 0.05). Male outnumbered females in LMIC (61%) and LIC (69%), but not in HIC and UMIC (p &lt; 0.001). LMIC and LIC were vaccinated at local facilities (5.8%) and pharmacies (4.2%) more than other groups (3%) and at hub centers less (p &lt; 0.05). The IV was lower for subjects from HIC (p &lt; 0.05) with a MEM of 24 [22; 26] for LIC, 21 [21; 22] for LMIC and 27 [26; 27] for UMIC. Men from UMIC (9 [4; 14]), LMIC (7 [6; 8]) and LIC (4 [3; 5]) had a higher IV than women. All variables being equal, IV decreased with age (MEM -0.48 [-0.49; -0.47]). Distance was shorter for LMIC and LIC than for HIC (p &lt; 0.05). The MEM on the distance of the Income group was -2.8 [-3.5; -2.2] for LIC and -2.0 [-2.1; -1.8] for LMIC (p &lt; 0.05). The Income Group of one’s birth country is a barrier to vaccine accessibility in Italy, a HIC. Hence, we address public health workers to improve access to vaccination in community settings to narrow this gap.

Key messages
• Birthplace Income Group could be linked to vaccine accessibility in High Income Countries.
• Public Health stakeholders should consider community and social barriers to healthcare access when planning health interventions.
The paid sick leave and sickness benefits for universal health coverage: a scoping review
Authors: Lee H , Kwon Y , Ryu K , Sohn M , Chung H 
Published: October 2022

Abstract

Background
The countries with paid sick leave (PSL) and sickness benefits (SB) mostly provide the benefit coverage to specific categories of workers, which results in health inequalities among employees in COVID-19. The PSL and SB are key factors to achieve universal health coverage (UHC) in that they protect access to healthcare and improve population health. This study attempted to investigate whether the policies helped achieve the UHC when they were expanded.

Methods
This review followed the scoping review protocol of PRISMA-ScR. On April 6, 2021, we extracted the literature using the keywords ‘paid sick leave', ‘sickness benefits', ‘paid sick day', and ‘earned sick leave’ from PubMed and Web of Science and added two studies through hand-search. All articles were written in English. We did not limit the publication date.

Results
Forty-four selected studies were based in four single countries and the European Union. Most of the studies were published after 2010 (84.1%) and were conducted as cross-sectional (72.7%) studies. Not only workers who use PSL and SB but also children whose parents use PSL and SB increased their use of healthcare services and getting flu shots. Also, using PSL and SB decreased their unmet healthcare needs and emergency use. The various health status factors, such as infectious disease incidence, mortality, and presenteeism, also decreased.

Conclusions
The provisions of PSL and SB offer individual and public health benefits by allowing employees and their families to use healthcare services. Group of employees, we can expect similar public health impacts on newly covered groups, thus contributing to achieving the UHC. Since more than 90% of articles are published from the United States, future studies need to evaluate the outcomes of health effects in various European or Asian countries.

Key messages
• The provision of PSL and SB positively affects employees and their families by allowing them to use healthcare services.
• The expansion of PSL and SB contributes to the UHC by guaranteeing indirect medical costs that enable universal access to essential healthcare services.
Involving YOUNG people with Type 1 Diabetes in reSearch and the development of healTh cARe activities
Authors: Ganahl K , Paldán K , Bernhard A 
Published: October 2022

Abstract

Background
Typ1 Diabetes (T1D) us a complicated condition that requires constant monitoring and making many decisions. Living with T1D means to check blood sugar levels, inject oneself insulin, and be careful what you eat. In the life of a young adult there are a lot of things going on and youngsters don't want to control themselves all day and night. They want to rebel and feel free.

Methods
Teenagers living with T1D are actively involved in the research process from data collection to data interpretation. Following the photo voice method the teenagers documented their everyday life with T1D by photographs and recordings (Summer 2021), and discussed their need and resources in group discussions. The visual and audio-data was structured on a muti-touchscreen for which a software was developed during the project. From the inductively formed categories, measures were derived together with the young people and transferred into an action plan, which was presented and discussed with decision-makers.

Results
During the photo voice process, the teenagers identified 26 categories (i.e. nutrition, coping strategies, autonomy, etc.) that were important for describing their life with diabetes and there categories were categorized into 4 dimension: psycho-social, time, subject and space. The project-team used a systematic action planning process to develop 9 goals for an action plan to improve their life with T1D. They presented their action plan to local political leaders and stakeholders from different setting, such as health care and youth work. The responses during the stakeholder dialog were positively and there was agreement to achieve the defined goals.

Conclusions
The photo-voice method was helpful in immersing the participants in the lives of young people with type 1 diabetes. Structuring and organizing the visual- and audio-data together was beneficial for the participatory process. Together, an action plan could be developed and discussed with decision makers.

Key messages
• The photo voive method using digital tools (like smartphones and multitouchscreen) is a route to empower young people and give them a voice.
• The participating patients are experts for their bodies and the disease and should be perceived and taken seriously as such.
Breast cancer trends in women in Cyprus: a population-based study between 2004-2017
Authors: Quattrocchi A , Demetriou CA , Cory OA , Saad B , Constantinou C , Marcou Y , Demetriou A , Scoutellas V , Kolokotroni O 
Published: October 2022

Abstract

Background
In Cyprus, breast cancer (BC) is the first in incidence and second in mortality cancer in women. A national screening programme (NSP), targeting women 50-69 years, was introduced in 2007. The aim of this study is to provide a better understanding of cancer trends.

Methods
Data from the national population-based Cyprus Cancer Registry on adult women diagnosed with BC between 2004-2017 with follow-up until 2019 were analysed as follows: Joinpoint regression for age-adjusted (overall and by tumor stage at diagnosis - TSD) and age-specific rates (&lt;50, 50-59, 60-69, 70-79, ≥ 80) incidence and mortality rates; 5-year age-adjusted Net Survival (NS) rates, overall and by TSD. TSD was categorised as localised, regional, and distant.

Results
Age-adjusted incidence rate increased from 135.3 (2004) to 153.2 (2017) per 100,000, with an annual percentage change (APC) of 1.1% (95%CI: 0.4-1.9). The greatest increase was in the age groups ≥70 years. A positive time trend was found for localized cancers between 2006-2017, while for all other stages nonsignificant trends were detected. Age-adjusted mortality rate increased from 37.0 (2004) to 50.0 (2019) per 100,000 (APC: 2.7%; 95%CI: 1.9-9.4). Significant increases in mortality rates were detected in the age groups ≥70 years. By TSD, increased rates were found at localised and regional stages, however smaller increases were detected since 2007. NS rates for the most recent period (2014-2017) was 93% for localized, 81% for regional, and 32% for distant and did not significantly improve compared to the previous years.

Conclusions
Trends in BC incidence continues to increase, especially in the older age groups and for early-stage cancers. As expected, since the introduction of the NSP, the incidence of localised cancers increased whilst the incidence of advanced stage cancer decreased, albeit non-significantly. Survival trends did not change but mortality rates for localised and regional cancers increased at a slower pace.

Key messages
• The introduction of the national screening programme may have played an important role in the increasing BC incidence trends.
• Despite survival rates not improving since the introduction of the national screening programme, mortality rates for early-stage cancers show a less steep increase.
Impact of a Cancer Diagnosis on Quality of Life among Cancer Survivors and their Partners
Authors: Bessa F , Morais S , Lopes-Conceição L , Costa AR 
Published: October 2022

Abstract

Background
Cancer survivors (CS) often experience physical, psychological and socioeconomic problems, which may have a negative effect on their quality of life (QoL). Additionally, cancer may also have a significant impact on patientś families, particularly their partners (PCS), who are typically the main informal caregiver.

Objective
To estimate the association between a cancer diagnosis and a poor QoL among both members of the couples, according to sociodemographic, health-related and cancer characteristics.

Methods
This cross-sectional study was based on data from the Sixth Wave of the Survey of Health, Ageing and Retirement in Europe - SHARE, conducted in 2015, in 18 countries. All cancer survivors (n = 2,040) who lived with a partner in the same household, as well as PCS (n = 2,040) were selected, and were country-, sex-, age- and education-matched (1:1) to non-cancer individuals (NC) and their partners (PNC), respectively. QoL was assessed using the Control, Autonomy, Self-Realization and Pleasure scale (CASP-12). The association between a cancer diagnosis and a poor QoL among both members of the couple was estimated through odds ratios (ORs) and 95% confidence intervals (95%CIs).

Results
In nearly one-fifth of couples, both members reported a poor QoL (17.0%); this outcome was more frequently observed among CS than NC (OR = 1.31, 95%CI: 1.10-1.56). A tendency towards stronger odds of poor QoL among both couples’ members was observed among CS who lived in urban areas (OR = 1.91, 95%CI: 1.30-2.80), with no multimorbidity (OR = 2.07, 95%CI: 1.14-3.76), as well as among those diagnosed &lt;5 years (OR = 1.65, 95%CI: 1.21-2.24) and with cancers with a usually poor prognosis (OR = 1.82, 95%CI: 1.04-3.18), when compared with respective NC.

Conclusions
A poor QoL among both couples’ members was more frequent among couples dealing with cancer than those without cancer, which highlights the importance of closely monitoring CS and their partners, throughout the cancer survivorship course.

Key messages
• Couples dealing with cancer more frequently reported a worse quality of life among both members, when compared with couples without cancer.
• The findings of this study highlights the importance of family-focused care from an early phase after the cancer diagnosis and throughout the cancer survivorship trajectory.