bluuebunny/crossref_metadata_2025_split huggingface dataset:
Complete coverage by examinations: relationship to colorectal cancer burden and the COVID-19
Authors: Ngo O , Kouril J , Suchanek S , Dusek L , Seifert B , Zavoral M , Majek O 
Published: October 2022

Abstract

Background
Colorectal cancer (CRC) is among the most common cancers and cancer causes of death worldwide. CRC screening and early detection is essential to reduce CRC incidence and mortality. CRC screening has been initiated in the Czech Republic in 2000 for persons over 50 and currently offers a faecal occult blood test (FOBT) or screening colonoscopy (CS). The aim of our study was to present complete coverage by examinations in relation to the trends in CRC burden and impact of COVID-19.

Methods
We defined the complete coverage by examinations as the proportion of persons aged over 50 undergoing examination with CRC early detection potential (FOBT or CS for any indication) during past 3 years. Standardized incidence and mortality rates were used to assess epidemiological trends. The impact of COVID-19 was assessed for 2020 and 2021 by comparing the volume of examinations with 2019. We used national health registries (National Registry of Reimbursed Health Services, Czech National Cancer Registry) as the source of data.

Results
Complete coverage was increasing over time and reached around 50% in recent years (target population is more than 4 million persons, most of the performed examinations were screening FOBT). However, coverage has decreased to 47.9% in 2020. In 2020 and 2021, the number of tests performed decreased by 16.9% and 5.5%, respectively, compared to 2019. CRC incidence and mortality rates have decreased by more than 20% and almost 30%, respectively, in the last decade.

Conclusions
Complete coverage has reached a satisfactory level and has likely a positive impact on the epidemiological trends. However, further action is needed to increase coverage, recently affected by COVID-19 pandemic, when non-acute health care may have been neglected.

Key messages
• The long-term high level of coverage by examinations likely has a positive impact on CRC burden.
• The observed decrease in coverage caused by COVID-19 needs to be appropriately compensated.
Digital transformation of public health systems: strengthening to take rights seriously
Authors: Macedo Silva A , Ventura M 
Published: October 2022

Abstract

The expansion of digital public health, with the use of data in digital systems for planning and operation of public health policy, presents itself as strategic for the public and digital future of Public Health Systems, such as Brazilian Sistema Único de Saúde/SUS, as well as for the effectiveness of the right to healthcare and expansion of the access to public health services (with the experience of COVID-19 highlighting the importance of digital health, as well as fostering its accelerated expansion). Such digital expansion will increasingly stress the fundamental right to the protection of personal data, and it is therefore important to strengthen the regulatory and care response of SUS in the field of digital public health, both for the preservation of its regulatory capacity in digital public health (facing market private interests of Big Tech for example), but also to guarantee the protection of fundamental rights, such as the protection of personal data. The theory of fundamental rights and the dogmatics on personal data protection offer support to solve the tensions to the right to data protection arising from the expansion of digital health, with consideration between the rights of patients-data subjects and the needs of managing and planning public health policy

Key messages
• The intense use of data and digital systems in public health policy is strategic to strengthen public health systems.
• The enhancement of Public Health Systems’ regulatory capacity in digital transformation is important to protect right to health and data protection.
Socio-demographic and socio-economic disparities in medical rehabilitation in Germany in 2019
Authors: Kniffert S , Stamm O , Heimann- Steinert A 
Published: October 2022

Abstract

Medical rehabilitation is a valuable component to restore physical and mental health, to prevent social isolation and to ensure a return to work. Due to the demographic change and the still increasing number of Post-Covid-19 patients, the demand for rehabilitation is still increasing. Latest, the COVID-19 pandemic elucidated that especially people from lower socio-economic backgrounds are disproportionally affected by health crisis. The aim of this study was to determine the influence of socio-demographic and socio-economic factors on quantitative exercise therapy in medical rehabilitation and to clarify the divergence of existing research findings. In our study we used data from 824.606 rehabilitation cases (German Federal Pension Insurance) and investigated the role of age and gender, marital status, social status and location towards inequalities in access to medical rehabilitation. Multiple linear regression and effect size calculation were used to show associations and to discuss the relation to clinical relevance. We were able to show a highly significant difference (P &lt; 0.001) in access to exercise therapy in our study group. Patients aged 65+, women, single or widowed people, rehabilitants of low socioeconomic status or people located in the new federal states in Germany received shorter and less frequent exercise therapy. There are differences of up to 3.5 hours of treatment duration and 4.25 treatments per week, when disadvantaged social factors accumulate. However, despite the presented differences, the received treatments for the disadvantaged groups are still in the range of suggested minimum therapeutic requirements by the German Federal Pension Insurance. We could show a significant difference in rehabilitative therapy, which is solely based on social factors. There is an urgent need to draw special attention to the here discussed inequalities in access to medical rehabilitation for socially disadvantaged population and the overarching impact on society.

Key messages
• The social inequality in medical rehabilitation to the detriment of the socially disadvantaged population that we have identified must give rise to clear changes in order to establish social justice.
• Equal opportunities and health quality assurance that address the individual needs of each patient should be the focus of socio-medical, policy development.
Vocational training of health mediators of primary care teams improves their sense of coherence
Authors: Kósa K , Katona C , Bíró É , Vincze S 
Published: October 2022

Abstract

Background
A Primary Care Model Programme had been implemented in Hungary between 2013-2017 in which group practices were established that employed - among others - nonprofessional health workers (health mediators, similar to community health workers) to facilitate access for the most disadvantaged population groups. The health of mediators, themselves mostly disadvantaged ethnic Roma, was monitored every odd year of the Programme.

Methods
A repeated cross-sectional health interview survey had been implemented inviting all health mediators who were employed at the time of the survey. The same questionnaire was used in all 3 surveys with items from the European Health Interview Survey 2009 and validated versions of other scales.

Results
Positive changes occurred in the health status of mediators during 5 years of follow-up. Significant improvement in mental health occurred among those who completed on-the-job vocational training. By 2017, significant increase in sense of coherence was observed among those who obtained vocational qualification as opposed to those who did not. The proportion of highly stressed mediators showed a significant increase among those with no vocational training. Improvement was detected in all mediators in health awareness, dysfunctional attitudes, psychological stress and smoking prevalence.

Conclusions
Significant improvement in mental status among those who obtained on-the-job vocational qualification were observed during follow-up of ethnic Roma health mediators in the programme in which they were equal members of the primary health care team. Employment of health mediators in primary care teams not only contributed to improving access to care for disadvantaged groups but also improved the mental health of mediators themselves.

Key messages
• Nonprofessional health mediators are important members of primary care teams servicing disadvantaged populations.
• Significant improvement in mental status during 5 years of follow-up occurred among Roma health mediators who received vocational training and were equal members of primary health care teams.
The EU response to NCDs: a content analysis on building resilient post-COVID health systems
Authors: Paric M , Orhan R , Czabanowska K 
Published: October 2022

Abstract

Background
Non-communicable diseases (NCDs) impose a heavy burden on healthcare systems of countries in the European Union (EU). An estimated 91.3% of all deaths and 86.6% of DALYs in the EU-28 were attributable to NCDs. It is imperative that the EU act on mitigating this challenging health issue and help create trajectories for building resilient health systems. Using qualitative analysis, this study examines the question of how the European Commission 2019-2024 is planning to mitigate the impact of NCDs on health systems, while taking into account the COVID-19 pandemic.

Methods
Content analysis was applied to understand how NCDs are framed and how an EU narrative is constructed to mitigate the impact of NCDs on health systems by the European Commission. A total of 44 documents were analysed, including speeches, press releases, newsletters, statements and policy documents. In vivo coding was performed using the software package ATLAS.ti 9. Unique codes were simplified and clustered into descriptive themes with a high level of abstraction.

Results
This study identified five main themes: ‘health plan', ‘COVID-19', ‘future direction', ‘collaboration and solidarity', and ‘persuasion'. Themes show that the Commission is emphasising the impact of the pandemic and the relevance of policies tackling NCDs for developing EU-wide resilient health systems. By calling for more cross- and multi-sectoral collaboration, like creating a European Health Union, the Commission hopes to create the right climate for a European framework for cooperation, which can help develop harmonised and resilient EU health systems.

Conclusions
Although increasing health systems resilience is high on the Commission’s agenda, it seems that there are no actionable points for Member States in terms of addressing national health policy. We recommend the Commission looks towards eliminating this observed disconnect and creating actionable points in line with Member States’ health systems’ capabilities.

Key messages
• Our findings show emphasis is placed on EU-wide health policies, more robust health systems, and the collective power of the EU. However, there are no concrete actions coupled with these concepts.
• COVID-19 highlighted the limitations of national policy for protecting health systems against cross-border health threats. It tested the Commission’s resolve in pushing for more European cooperation.
Public Health benefits by implementing digital symptom diaries for COVID patients from Cologne
Authors: Gruene B , Kugler S , Kuefer-Weiß A , Wolff A , Kossow A , Nießen J , Neuhann F , Ginzel S , Buess M 
Published: October 2022

Abstract

Background
High rate of people infected with SARS-CoV-2 and their contacts in Cologne, Germany required innovative tools for notification, monitoring and reporting. The digital tool for COVID19 (DiKoMa) provides self-service symptom diaries allowing (a) the stratification for prioritized telephone contact by the health authority and (b) training a machine learning (ML) model that predicts infections with prevailing dominant variant (PDV) from early symptom profiles (SP).

Methods
Pseudononymized SP covering the first week of diary recordings were included for training (16646 index, 11582 contacts). A balanced random forest (BRF) model was trained to differentiate early predictive symptom patterns of different PDV and contact persons. Model evaluation was performed using sex and age stratified cross validation (CV), the model was validated on SP recorded from days 1 and 6.

Results
From 03/20 to 02/22, 90478 indeces and 75444 contact persons reported symptoms and health status, covering 46% and 42% of all reported cases, respectively. Diaries contained between 1-52 entries (566791, median 2). Daily analysis of entries, prioritized according to age, prevalent co-morbidities and detoriation of symptoms allowed risk adjusted follow up even during phases with high case notification rates. The top 5 predictive factors of the BRF were immunization, cough, dysgeusia and dysnosmia, fatigue, and sniffles to differentiate infection between wildtype, three PDV and contact persons (CV AUC 80.6%, Validation AUC 77.1%).

Conclusions
The use of digital symptom diary surveillance helps to provide appropriate medical support for patients on a large scale. Machine learning shows potential for symptom based risk assessment to differentiate PDV for future outbreaks and can thus become a valuable tool alongside specific laboratory diagnostics.

Key messages
• Digital symptom diaries are a powerful and widely accepted tool to attend COVID19 patients in isolation. They allow risk stratification for follow up and are a low-threshold service.
• Machine learning supports index case identification by symptom analysis and can thus become a valuable tool alongside specific laboratory diagnostics.
Analysis of a test system for the detection of SARS-CoV-2 in children attending school
Authors: Boietti E , Bert F , Lo Moro G , Barbaro S , Barbero S , Minutiello E , Sinigaglia T , Fagioli F , Siliquini R 
Published: October 2022

Abstract

Background
During the COVID-19 pandemic, in order to keep schools open and reduce SARS-CoV spreading, SARS-CoV-2 positive paediatric patients (PP) need to be isolated early. The aim of this study was to describe the appropriateness of school hot spot (HS) for SARS-CoV 2 testing based on open access of PP in a paediatric hospital in Turin, Italy.

Methods
A cross-sectional study was performed between September 2020 and March 2021. The data collected included: date of swab execution, type of swab, execution setting of the swab, result of the swab, sex, age of PP and the mean value of the Rt (reproductive number) of pandemic in the Piedmont region. We collected data about PP from four different hospital settings (HS, Emergency department, day hospital and hospital wards) of Regina Margherita Children’s Hospital (Turin, Italy). We analyzed a sample of 13,283 PP (aged 0-19 years) testing for SARS-CoV-2. The main outcome was the likelihood of testing positive in different settings and in different age groups.

Results
In Our sample, females were 45.8%. The median age was 6.8 years (IQR 3.0-11.2). The swabs executed in all the hospital settings had a lower likelihood of resulting positive compared with the school HS setting. Newborns below 3 months (adj OR 1.85, 95%CI 1.14 - 3) and patients aged between 11 and 13 years old (adj OR 1.32, 95%CI 1.07 - 1.63) reported a higher probability of a swab tested positive compared to adolescents. Instead, children aged between 3 months and 2 years (adj OR 0.77, 95%CI 0.61 - 0.96) and aged between 3 years and 5 years (adj OR 0.66, 95%CI 0.53 - 0.83) were less likely to result positive.

Conclusions
We found a high prevalence of PP positive to the test for the detection of SARS-CoV-2 at the school hot spot compared with other settings. The open access modality to the nasopharyngeal swab was effective in identifying PP with COVID-19. Public health authorities should implement this testing modality in order to reduce SARS-CoV-2 infections in PP.

Key messages
• Open access testing system to detect SARS-CoV-2 is important to do as many tests as possible to identify COVID-19 patients and isolate them in the pediatric population.
• The open access testing modality to detect COVID-19 patients saves time for doctors who, instead of carrying out the patient history, can devote themselves to other clinical activities.
First year of the pandemic: Years of Life Lost due to COVID-19 in Serbia
Authors: Stevanović A , Todorović J , Rosić N , Bjelobrk G , Mandić-Rajčević S , Šantrić-Milićević M , Bjegović-Mikanović V 
Published: October 2022

Abstract

Background
The first case of COVID-19 in Serbia was reported on 6th March 2020. Since then, Serbia has registered several epidemic peaks, which have led to a considerable increase in premature mortality. Basic evaluation of COVID-19 premature mortality burden needs to include frequency of COVID-19 deaths among different age-groups.

Methods
All-cause mortality data disaggregated by age and sex, population estimates and remaining life expectancy for different age-groups were acquired from the Statistical Office of the Republic of Serbia. Years of Life Lost (YLL) due to COVID-19 were calculated for the period from March to December 2020. European Standard Population was used for calculating age-standardized mortality rates. We acknowledge the support from the BoCO-19 - The Burden of Disease due to COVID-19 project coordinated/led by Robert Koch Institute and supported by the WHO Regional Office for Europe.

Results
In 2020, there were 127,572 YLLs due to COVID-19, with 81,147 of YLLs (63.6%) attributable to men and 46,425 (36.4%) to women. Contribution of COVID-19 to the total all-cause YLL was also higher in men comparing to women: 11.39% and 7.80%, respectively. Three epidemic peaks were observed in 2020, together composing two thirds (65.6%) of total YLLs due to COVID-19. December was the month with the greatest burden, accounting for 45.8% of all YLLs due to COVID-19. Crude YLL rate for COVID-19 was 1849.1 per 100,000, or 1733.5 per 100,000 after standardization.

Conclusions
Registered COVID-19 deaths accounted for one tenth of total YLLs in Serbia in 2020, with men contributing almost twice as much to that number compared to women. On average, 12.32 YLLs originated from each registered COVID-19 death. Further studies need to assess the impact of the COVID-19 epidemic on avoidable mortality trends in Serbia.

Key messages
• COVID-19 deaths comprised one tenth of all-cause YLLs, with two-thirds of COVID-19 YLLs attributable to men.
• To reduce premature mortality burden, epidemic peaks need to be prevented.
Integrating mental health into emergency preparedness and response: lessons learned from Covid-19
Authors: Alkasaby MA , Baingana F , Bosu WK , Abdulaziz M , Mwaisaka R , Kakunze A , Keita N , Saeed K , Eaton J , Walker I 
Published: October 2022

Abstract

Introduction
The COVID-19 crisis has disrupted health systems all over the world. In a survey by the WHO, 93% of the countries reported disruption in their mental health services. This research assessed the extent to which mental health was included in the national response to the COVID-19 pandemic in African countries. It also explored barriers and enablers to mental health integration into the COVID-19 response. Lessons learned from COVID-19 can help improve the response to future public health emergencies.

Methods
A web-based survey was sent to mental health focal points in 55 African countries. The survey assessed the perceived degree of implementation of the Inter-Agency Standing Committee (IASC) “14 Globally Recommended Activities” for mental health response to COVID-19. This was followed by in-depth interviews to explore barriers and enablers to mental health integration into the COVID-19 response.

Results
Responses were received from 28 countries. Lack of political will, poor funding, limited human resources, and weak pre-existing mental health systems were the key challenges in addressing mental health needs during COVID-19. Participants highlighted the need to capitalize on the increased attention to mental health during COVID-19 to support its integration into the emergency preparedness and response plans and strengthen health systems in the longer term. They have also stressed the importance of sustaining and strengthening the new partnerships and service delivery models that emerged during the COVID-19 pandemic.

Conclusions
The number of recommended mental health activities implemented during the COVID-19 pandemic varied considerably across African countries. Several factors limit mental health integration into emergency response. However, there are signs of optimism, as mental health gained some attention during COVID-19, which can be built on to integrate mental health into emergency response and strengthen health systems in the long term.

Key messages
• Capitalize on the increased attention to mental health during COVID-19 to support its integration into the emergency preparedness and response plans and strengthen health systems in the long term.
• Sustain and strengthen the new partnerships and service delivery models that emerged during the COVID-19 pandemic.
Civil-military cooperation to contain COVID-19 epidemic in Israel- Lesson learned
Authors: Mor Z , Davidi N , Alroy Preis S 
Published: October 2022

Abstract

Issue
Public Health Services (PHS) has a major role in controlling COVID-19. As the epidemic propagated, and due to limited resources, PHS in Israel reached it capacity to contain the outbreak. Following a political decision in June 2020, the Home Front Command (HFC) of the Israeli Army was assigned to integrate in operating the National epidemiological efforts, while the PHS remained responsible for policy, setting guidelines and supervision.

Problem
The civilian PHS and the military HFC had to establish cooperation, institute new hierarchical structure and divide the responsibility, despite the differences in organizational cultures, financial and human resources. Additionally, inter and intra organizational interests had to be resolved.

Results
Formal and informal efforts were needed to bridge between the two organizations, while utilizing the comparative advantage of each agency. PHS has experience in controlling outbreaks, well-established intra-organizational communication, high professional identity, commitment and familiarity with different populations in Israel. HFC is a flexible, creative, learning and fast-responding organ, experienced in controlling emergencies and has well-established chains of command. HFC is supported by IT and intelligence officers. Organizational disadvantages had to be resolved. PHS is deficient in resources, has limited capacity in operating staff during irregular hours, and is obliged to share the health leadership and authority with the army. HFC has to confront high rotation of its manpower, difficulty in succumbing to non-military guidelines and regulations and possible mistrust between the army and special populations, such as Arabs or ultra-religious Jews.

Lessons
Civil-military epidemiological cooperation can boost the National response in containing epidemics. Policymakers from each agency should use leadership skills to encourage integration while being sensitive to the needs and expectations of all participants.

Key messages
• Civil–military epidemiological cooperation boosts the National response in containing epidemic. Mutual organizational sensitivity is crucial for constructive integration by leaders from each agency.
• Civil–military epidemiological cooperation boosts the National response in containing epidemic. Mutual organizational sensitivity is crucial for constructive integration by leaders from each agency.