bluuebunny/crossref_metadata_2025_split huggingface dataset:
Health-related quality of life among five-year-old extremely preterm children with motor disorders
Authors: Aubert AM , Costa R , Johnson S , Ådén U , Pierrat V , Cuttini M , van Heijst AF , Maier RF , Sentenac M , Zeitlin J 
Published: October 2022

Abstract

Background
Motor disorders resulting from extremely preterm birth (EPT; &lt;28 weeks’ gestation) can limit daily activities, schooling and social relationships. Cerebral palsy (CP) affects about 10% of children and non-CP movement difficulties (MD) are highly prevalent, although they tend to be under-diagnosed, especially in children without other developmental difficulties. We investigated the association between motor disorders and health-related quality of life (HRQoL) among five-year-old children born EPT.

Methods
We included children at age five from a population-based EPT birth cohort born in 2011-2012 in 11 European countries (N = 1,021). Children without CP were classified using the Movement Assessment Battery for Children - 2nd edition as having significant MD (≤5th percentile of standardised norms) or being at risk of MD (6th-15th percentile). Parents reported on CP diagnoses and HRQoL using the Pediatric Quality of Life InventoryTM. We used linear regression to compare HRQoL scores by motor status adjusting for social characteristics.

Results
Children born EPT with CP, significant MD and at risk of MD had lower adjusted HRQoL total scores [95% confidence intervals] than those without MD: -26.1 [-31.0; -21.2], -9.1 [-12.0; -6.1] and -5.0 [-7.7; -2.3]. Decreases were greater for physical scores: -35.3 [-42.7; -27.9], -11.9 [-16.1; -7.8] and -5.4 [-9.1; -1.6] than psychosocial scores: -20.6 [-25.2; -16.0], -7.4 [-10.3; -4.5] and -4.9 [-7.6; -2.1]. These differences persisted after exclusion of children with other developmental difficulties.

Conclusions
Motor disorders among 5-year-old children born EPT were associated with lower HRQoL, even among children with less severe motor difficulties and without other developmental difficulties.

Key messages
Knowledge and use of antibiotics among health care users in Institute of public health of Belgrade
Authors: Belamaric G , Matijevic D , Vukovic D , Bukumiric Z , Mladenovic Jankovic S , Markovic G , Tamburkovski G , Vojvodic K , Jakovljevic M 
Published: October 2022

Abstract

Background
Antimicrobial resistance (AMR) is one of the major global public health threats that may lead to severe illness, hospital admissions, treatment failure and increasing of the health care costs. In order to address those challenges, the aims of this study were to examine the antibiotics consumption among the population of health care consumers in the Institute of Public Health of Belgrade, and their knowledge and attitudes regarding antibiotics compared to the inhabitants of EU and Japan.

Methods
A cross-sectional study was conducted on a sample of 321 respondents who visited the Institute of Public Health of Belgrade in July 2021. The basic survey instrument was a Eurobarometer questionnaire (with the permission of the Directorate General for Communication European Commission). The obtained data were analyzed by methods of descriptive statistics, which included frequency distribution with percentages. In addition, the Chi-square test was used to examine the difference in frequencies.

Results
More than half of all respondents used antibiotics in the previous 12 months (56.6%), majority of them with a doctor's prescription and 57.1% did some pre-testing (blood or urine test, swab) before or at the same time as using antibiotics. They used antibiotics most often for urinary infections (9,3%) and common cold (8,1%). We discovered that the knowledge of our respondents is somewhere in between comparing to the knowledge of the people from EU and Japan. 37.4% of our respondents knew that antibiotics are ineffective against cold and flu; 68.9% knew that unnecessary use of antibiotics makes them ineffective; 55.9% knew that taking antibiotics often leads to side effects such as diarrhea and 50.7% knew that antibiotics don't kill viruses.

Conclusions
Knowledge about the antibiotics is insufficient and interventions of education, better informing and awareness of general public are necessary to encourage rational use of antibiotics.

Key messages
• It is important to take evidence based interventions to reduce unnecessary use of antibiotics.
• This is the first study about antibiotics in Serbia which used the Eurobarometer model of research.
Personal budget: integration of social and health resources of frail elderly in supported discharge
Authors: Giusti M , Simoni S , Persiani N 
Published: October 2022

Abstract

During COVID-19 pandemic, health and social condition of frail elderly got worse at worldwide level. This aggravation was due both to isolation and higher mortality rate for COVID-19, influenced by the widespread condition of comorbidity in this segment of population. The progressive change of needs in this target weren't matched with a prompt and adequate response, which could guarantee the taking charge of frail elderly. Personal budget is a tool for integrating public health, social assistance and family efforts on the international scene. In the Italian context, it is emerging as means to program and coordinate economic and professional, institutional, and personal resources, finalising them to provide a personalised pathway. Research aims to value the contribution of personal budget association to effectiveness and efficacy of personalised pathway for frail elderlies in early supported discharges. A research-intervention approach was done. Personal budget was applied to a significant sample of cases of personalised pathways for frail elderly in supported discharge in the Local Health District of Teramo. The study compared used resources and obtained health outcomes between the sample and a control group. The application of the personal budget permits the immediate maximisation of resources use and the quantification of the deviation between the available and the needed resources for provision of personalised pathway. Moreover, this tool supported the planning of services, the integration of health and social actions, the monitoring of adherence to planned programmes and the application of corrective mechanisms, if these are necessary, improving the health outcomes. Personal budget contributes to increase the integrated and continued taking charge of frail elderly in supported discharges in the short-medium term. Globally, this tool could be an organisational and economic answer for responding in a sustainable way to international increasing of life expectancy.

Key messages
• Personal budget manages and controls both health and social activities and resources.
• Personal budget supports the establishment of an integrated and continuous taking charge system of the frail elderly.
Does community HIV combination prevention (HPTN 071 (PopART)) impact healthcare inequity?
Authors: Hansen C , Miraldo M , Hauck K 
Published: October 2022

Abstract

Background
This research explores the impact of the HIV Prevention Trials Network (HPTN) 071 combination prevention (PopART) trial on horizontal inequity in Zambia and South Africa. Evidence suggests there is often inequality in healthcare utilisation in relation to socioeconomic characteristics, such as wealth. This paper is the first to address such distributional outcomes and inequities in a randomised trial setting.

Methods
We utilise horizontal inequity as a key performance metric to make value judgements with regards to the distribution of healthcare utilisation in a health system. Additionally, we supplement this index by estimating the impact of PopART on inequality in healthcare utilisation and HIV prevalence, estimating concentration curves and indices.

Results
We find a pro-rich inequity in healthcare utilisation, as ranked by wealth, before and after the trial is implemented. Pro-rich implies, for example, the 20% poorest make up less than 20% of healthcare utilisation. This suggests the trial enabled the wealthier subset of the population to take better advantage of accessing healthcare.

Conclusions
Given the high prevalence of HIV in lower-income households in Zambia and South Africa, these results strengthen the case for interventions tailored to informing poorer households about the benefits of prevention and after-care.

Key messages
• The PopART trial demonstrates as with any intervention, there is a risk of exacerbating an underlying inequity. Policies directed at these problems specifically may help alleviate such burdens.
• This paper shows one example of a distributional imbalance in the HIV population. Given the absence of work on RCT interventions, the findings may also be used to inform future trial design.
“A basic frame existed but was not followed” – Finnish public health system's response to COVID-19
Authors: Huhtakangas M , Kihlström L , Karreinen S , Keskimäki I , Tynkkynen L-K 
Published: October 2022

Abstract

Background
Crisis management Managing crises often requires diverging from predetermined plans. In this paper, we investigate how public health authorities in Finland acted, what kind of roles they adopted and how the expected roles and actions appeared in relation to the legislative framework and preparedness plans during the COVID-19 pandemic. Based on inter-country comparisons, Finland has managed COVID-19 pandemic relatively well. The study provides qualitative insights on pandemic governance in a decentralized multi-stakeholder public health system.

Methods
Semi-structured interviews (n = 53) with key public health actors at central, regional and local levels were conducted during March 2021-February 2022. The data was analysed with thematic analysis.

Results
The predetermined roles and duties for pandemic management were not unequivocal in practice and appeared unrealistic considering the resources of the public health system. Responsibility was divided between several actors, but lack of interaction enhanced emerging tensions between them. Local and regional actors experienced national steering intervening in operational decisions. At central level distrust towards the capabilities of local and regional actors was expressed. The pandemic was framed and managed as a health crisis despite of its wider societal effects. This challenged local and regional decision-making, where wider societal impacts had to be considered.

Conclusions
Public health authorities in Finland interpreted their roles and responsibilities in pandemic governance in various ways: some actors adopted more active agency than others and the roles were not always in line with the existing regulative framework.

Key messages
• Interpretation of the roles outlined in preparedness plans are context dependent and may lead to conflicts between different actors.
• In a system with multiple actors at multiple levels, building trust and improving interaction are important for coordinated action.
Breast cancer incidence and mortality in Georgia by regions and municipalities in 2015-2019
Authors: Tkeshelashvili V , Gvazava T , Beruchashvili T , Shvelidze E 
Published: October 2022

Abstract

Background
According to the NCDC, in 2015-2019, breast cancer ranked first in the structure of cancer in Georgia. Additional studies are needed to identify breast cancer incidence and mortality by regions and municipalities of Georgia.

Methods
Electronic dBase of cancer population registry for 2015-2019 (52,178 cancer cases), Tbilisi registry database for 2002-2004 (33,478 deaths from all causes), methodology recommended by IARC and UICC, SEER program and 2014 Georgian census data were used in the study. Standardized cancer incidence and mortality rates (ASR, TASR, AAR, SRR, CR64, CR74, SIR, SMR, PIR, 95% CI) were calculated.

Results
29,303 cases of cancer (56% of all cancers) were registered in the Georgian female population in 2015-2019, including 18,432 (62.9%) cases of breast cancer. In the mentioned 5 years, breast cancer ranks first in the general structure of cancer incidence in female population of Georgia and Tbilisi. According to ASR (world standard) and AAR (Georgia and Tbilisi standards, 2014), annual incidence was 62,9%000 /95,7%000 in Georgia, and 85.3%000 /123,6%000 - in Tbilisi. According to the SRR, incidence of breast cancer in Tbilisi was 1.4 times higher than general incidence of breast cancer in Georgia. In 2015-2019, compared to 1988-1992, i.e., in 27-year dynamics, rate of breast cancer in Tbilisi according to the SRR increased 2.4 times, and according to SIR- by 140,2% in dynamics. ASR of breast cancer deaths in Tbilisi in 2015-2019 annually made up 112,2%000. According to the SRR, in 2015-2019, the rate of breast cancer deaths in Tbilisi increased by 3.4 times, compared to 2002-2004. In 13-year dynamics, the incidence of breast cancer deaths according to SMR increased by 238%.

Conclusions
In order to advocate for breast cancer control it is recommended to develop regional and municipal screening programs based epidemiological maps of cancer and ensure effective screening services for each woman through the State program prevention guideline.

Key messages
• Epidemiological maps of breast cancer are recommended for use in planning regional and municipal programs of cancer control, including screening which will help breast cancer control advocacy.
• Ensure effectiveness of screening services for each woman through the State program prevention guideline.
Enhancing COVID 19 vaccination coverage in Sierra Leone
Authors: Moretti R , Scognamiglio T , Zoli A , Miozzo A , Lansana P , Nunie A 
Published: October 2022

Abstract

The project aim to support Sierra Leone in enhancing vaccination coverage. BACKGROUND In November 2021, the vaccination coverage rate was 7% for one dose and 4% for two. According with EPI program, the main problem was not the lack of vaccines (already provided by different donors) but the need of support (training, motivation, allowances) to health personnel. Lombardy project involved 31 local vaccination teams performing a refresh training, followed, by micro-planning meetings. SIGNIFICANCE The Covid epidemiology in SL is not well known, but the possible new waves makes this intervention a high public health priority. USEFULNESS. The model is based on training, motivation, follow up and a very simple monetary allowance system based on performance. An online daily report available on smartphone was provided to follow up performances and manage allowances system. PROBLEM The objective was a donation of vaccines, but after a short assessment the issue changed to the need of supporting the local health staff. The goal shifted to train, give incentives for health workers, support to micro-planification and also to work on timely reporting to follow up the project results. QUESTIONS ANSWERED. Can support to microplanning be effective in enhancing vaccination numbers? Can monetary incentives to personnel based on performances enhance vaccination numbers? Can a setting approach (school, workplaces,..) enhance vaccinations numbers? RESULTS the numbers of vaccination Increased from an average of 5 per team by day in early December (after the refresh training) up to an average of 15 by day after the support to micro-planning, the monetary progressive incentives based on performance and the introduction of settings approach. Up to 85.000 doses was performed in 4 months.

Key messages
• Planning, performance based payement and training can enhance vaccination coverage.
• African countries can performe good vaccination programs if supported in organization and non only in vaccine donation.
Factors associated with hospitalization for aortic stenosis in Portugal from 2015 to 2017
Authors: Avelar FG , Alves J 
Published: October 2022

Abstract

Background
Severe aortic stenosis prevalence has been growing worldwide and constitutes a public health challenge. The gold-standard treatment is Surgical Aortic Valve Replacement (SAVR) however Transcatheter Aortic Valve Implantation (TAVI) has been increasing, especially in high-risk surgical patients. This study aims identifying the factors associated to the implementation of TAVI to minimize possible disparities in access to health services.

Methods
This study used data on inpatient discharges from the Portuguese NHS, from 2015 to 2017. SAVR and TAVI, were classified according to the International Classification of Diseases (ICD). Chi-square test and independent T-tests with 1% significance level in the SPSS® were performed to identify the factors associated with both interventions.

Results
A total of 8398 hospitalizations were analysed, 88.5% SAVR and 11.5% TAVI. The mean (SD) age for SAVR was 70 (±11) years old and 81 (±7) years old for TAVI (p &lt; 0.001), 56.9% were male among SAVR and 44.6% among TAVI (p &lt; 0.001). Year (p &lt; 0.001), type of admission (p &lt; 0.001), geographic location (p &lt; 0.001), severity (p &lt; 0.001) and Charlson Comorbidity Index (CCI) (p &lt; 0.001) were associated with the type of intervention.

Conclusions
TAVI was performed in more severe patients and there was an increase in TAVI over the years, which is consistent with the growing use of the technology among other patients, e.g., the high-risk surgical patients. We also found a geographic pattern in the use of SAVR and TAVI. This might reveal the existence of geographic disparities regarding availability and access to health services.

Key messages
• In Portugal, there is an increase in the performance of TAVI, with geographical concentration that reflects on access.
• TAVI is more often performed in more severe patients as an alternative to SAVR with similar discharge outcomes.
Towards Better Oral Health Prevention: the Value for Money of Fluoride Toothpaste
Authors: Hofbauer T , Coughlan J , Gierth J , Gkekas N , Listl S , Pattamatta M , Põld A 
Published: October 2022

Abstract

Background
Although largely preventable, tooth decay (dental caries) is among the most common health conditions worldwide and contributes to substantial dental treatment expenditures. While Fluoride Toothpaste (FT) is considered an essential strategy for oral health prevention, its market price has been shown to vary substantially across various settings. Against this background, the present study aimed to develop a decision analytical model to evaluate the cost-effectiveness of FT in various settings.

Methods
Leaning on WHO CHOICE methodology, evidence scoping and an expert consensus were facilitated to extract model input parameters which were then fed into cost-effectiveness-analyses (CEA) for FT. The cost-effectiveness of the interventions was expressed as cost per Disability-Adjusted Life Year (DALY) averted.

Results
The CEA identified a high likelihood for FT to be a cost-efficient treatment strategy in settings with comparably low market prices for FT. FT was less likely to be a cost-efficient treatment strategy in settings with comparably high market prices for FT.

Conclusions
The developed decision analytical model is suitable to inform policymakers about the extent to which FT represents good value-for-money under different market prices.

Key messages
• Fluoride toothpaste can provide high value for money as an oral health preventive strategy.
• Policymakers need to ensure the affordability of fluoride toothpaste in order to harvest relevant efficiency gains.
Implementation of “COVID-19 case investigation and contact tracing” training program in Armenia
Authors: Grigoryan Z , Musheghyan L , Abrahamian D , Petrosyan V , Dorian A 
Published: October 2022

Abstract

Background
Comprehensive contact tracing and case identification (CICT) is key to preventing the SARS-COV-2 transmission. During the COVID-19 waves in Armenia, the effectiveness of CICT practices was suboptimal due to weak capacity of evidence-based CICT. The American University of Armenia and the University of California, Los Angeles offered a continuous education program for the public health workforce in Armenia which is relevant for any country aiming to improve its CICT capacities.

Objectives
We developed and implemented a fully remote yet synchronous ‘COVID-19 case investigation and contact tracing” training program through didactic lectures, demonstrations of CICT interviews, small-group skill labs, and opinion polls. It covered the basic principles of public health and epidemiology, the main methods of CICT in relation to COVID-19, and health coaching techniques. We evaluated the knowledge improvement through a pre-experimental evaluation design at baseline and follow-up. The training sessions were held from November 2020 to June 2021. The participants received 10 CME credits upon completion of the training course.

Results
The online modality allowed to reach professionals across the country, though affected the participation in the evaluation surveys. Overall, 93 professionals participated in the training program, yet only 57 returned completed surveys. The paired analysis showed an increase in the mean knowledge scores (0-24) at baseline and follow-up (14.5 vs 15.82 (p = 0.0083). A more notable increase was detected on questions that measured knowledge of health coaching techniques (0-6) (2.76 vs 3.44 (p = 0.0052)).

Conclusions
New knowledge and skills penetrated into daily CICT practices across Armenia. This was a good example of a quick mobilization of local and international expertise to assist the national efforts in responding to a public health emergency by utilizing evidence-based approaches and lessons learned from the past infectious diseases’ outbreaks.

Key messages
• Our training program strengthened the human resource capacities of Armenia’s existing public health system and assisted Armenia’s COVID-19 response efforts.
• The model of our training program can be effectively adapted and extrapolated for various countries and settings which aim to improve response capacities to other threats of public health importance.