A cross-country comparison of Covid-19 containment measures and their effects on the epidemic curves.

BACKGROUND: European countries are still searching to eliminate or contain the Covid-19 pandemic. A variety of approaches have achieved different levels of success in limiting the spread of the disease early and preventing avoidable deaths. Governmental policy responses may explain these differences and this study aims to describe evidence about the effectiveness of containment measures throughout the course of the pandemic in five European countries (France, Germany, Italy, Spain and the UK). METHODS: The research approach adopted consisted of three steps: 1) Build a Containment Index (C.I.) that considers nine parameters to make an assessment on the strength of measures; 2) Develop dynamic epidemiological models for forecasting purposes; 3) Predict case numbers by assuming containment measures remain constant for a period of 30 days. RESULTS: Our analysis revealed that in the five European countries we compared, the use of different approaches definitively affected the effectiveness of containment measures for the Covid-19 pandemic. CONCLUSION: The evidence found in our research can be useful to inform policy makers' decisions when deciding to introduce or relax containment measures and their timing, both during the current pandemic or in addressing possible future health crises.

Impact of the COVID pandemic on mental health and training opportunities of Public Health Residents from 4 European countries: A cross-sectional study.

Objectives: There is little evidence on the impact of the COVID-19 pandemic on Public Health Residents' (PHR) mental health (MH). This study aims at assessing prevalence and risk factors for depression, anxiety and stress in European PHR during the COVID-19 pandemic. Methods: Between March and April 2021, an online survey was administered to PHR from France, Italy, Portugal and Spain. The survey assessed COVID-19 related changes in working conditions, training opportunities and evaluated MH outcomes using the Depression Anxiety Stress Scales-21. Multivariable logistic regressions were applied to identify risk factors. Results: Among the 443 respondents, many showed symptoms of depression (60.5%), anxiety (43.1%) and stress (61.2%). The main outcome predictors were: female gender for depression (adjOR = 1.59, 95%CI [1.05-2.42]), anxiety (adjOR = 2.03, 95%CI [1.33-3.08]), and stress (adjOR = 2.35, 95%CI [1.53-3.61]); loss of research opportunities for anxiety (adjOR = 1.94, 95%CI [1.28-2.93]) and stress (adjOR = 1.98, 95%CI [1.26-3.11]); and COVID-19 impact on training (adjOR = 1.78, 95%CI [1.12-2.80]) for depression. Conclusions: The pandemic had a significant impact on PHR in terms of depression, anxiety and stress, especially for women and who lost work-related opportunities. Training programs should offer PHR appropriate MH support and training opportunities.

The cost-effectiveness of digital health interventions: A systematic review of the literature.

Background: Digital health interventions have significant potential to improve safety, efficacy, and quality of care, reducing waste in healthcare costs. Despite these premises, the evidence regarding cost and effectiveness of digital tools in health is scarce and limited. Objectives: The aim of this systematic review is to summarize the evidence on the cost-effectiveness of digital health interventions and to assess whether the studies meet the established quality criteria. Methods: We queried PubMed, Scopus and Web of Science databases for articles in English published from January 1, 2016 to December 31, 2020 that performed economic evaluations of digital health technologies. The methodological rigorousness of studies was assessed with the Consolidated Health Economic Evaluation Reporting Standards (CHEERS). The review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) 2009 checklist. Results: Search identified 1,476 results, 552 of which were selected for abstract and 35 were included in this review. The studies were heterogeneous by country (mostly conducted in upper and upper-middle income countries), type of eHealth intervention, method of implementation, and reporting perspectives. The qualitative analysis identified the economic and effectiveness evaluation of six different types of interventions: (1) seventeen studies on new video-monitoring service systems; (2) five studies on text messaging interventions; (3) five studies on web platforms and digital health portals; (4) two studies on telephone support; (5) three studies on new mobile phone-based systems and applications; and (6) three studies on digital technologies and innovations. Conclusion: Findings on cost-effectiveness of digital interventions showed a growing body of evidence and suggested a generally favorable effect in terms of costs and health outcomes. However, due to the heterogeneity across study methods, the comparison between interventions still remains difficult. Further research based on a standardized approach is needed in order to methodically analyze incremental cost-effectiveness ratios, costs, and health benefits.

Approaches to priority identification in digital health in ten countries of the Global Digital Health Partnership.

Background: To promote shared digital health best practices in a global context, as agreed within the Global Digital Health Partnership (GDHP), one of the most important topics to evaluate is the ability to detect what participating countries believe to be priorities suitable to improve their healthcare systems. No previously published scientific papers investigated these aspects as a cross-country comparison. Objective: The aim of this paper is to present results concerning the priorities identification section of the Evidence and Evaluation survey addressed to GDHP members in 2021, comparing countries' initiatives and perspectives for the future of digital health based on internationally agreed developments. Methods: This survey followed a cross-sectional study approach. An online survey was addressed to the stakeholders of 29 major countries. Results: Ten out of 29 countries answered the survey. The mean global score of 3.54 out of 5, calculated on the whole data set, demonstrates how the global attention to a digital evolution in health is shared by most of the evaluated countries. Conclusion: The resulting insights on the differences between digital health priority identification among different GDHP countries serves as a starting point to coordinate further progress on digital health worldwide and foster evidence-based collaboration.

Social media and attitudes towards a COVID-19 vaccination: A systematic review of the literature.

Background: Vaccine hesitancy continues to limit global efforts in combatting the COVID-19 pandemic. Emerging research demonstrates the role of social media in disseminating information and potentially influencing people's attitudes towards public health campaigns. This systematic review sought to synthesize the current evidence regarding the potential role of social media in shaping COVID-19 vaccination attitudes, and to explore its potential for shaping public health interventions to address the issue of vaccine hesitancy. Methods: We performed a systematic review of the studies published from inception to 13 of March2022 by searching PubMed, Web of Science, Embase, PsychNET, Scopus, CINAHL, and MEDLINE. Studies that reported outcomes related to coronavirus disease 2019 (COVID-19) vaccine (attitudes, opinion, etc.) gathered from the social media platforms, and those analyzing the relationship between social media use and COVID-19 hesitancy/acceptance were included. Studies that reported no outcome of interest or analyzed data from sources other than social media (websites, newspapers, etc.) will be excluded. The Newcastle Ottawa Scale (NOS) was used to assess the quality of all cross-sectional studies included in this review. This study is registered with PROSPERO (CRD42021283219). Findings: Of the 2539 records identified, a total of 156 articles fully met the inclusion criteria. Overall, the quality of the cross-sectional studies was moderate - 2 studies received 10 stars, 5 studies received 9 stars, 9 studies were evaluated with 8, 12 studies with 7,16 studies with 6, 11 studies with 5, and 6 studies with 4 stars. The included studies were categorized into four categories. Cross-sectional studies reporting the association between reliance on social media and vaccine intentions mainly observed a negative relationship. Studies that performed thematic analyses of extracted social media data, mainly observed a domination of vaccine hesitant topics. Studies that explored the degree of polarization of specific social media contents related to COVID-19 vaccines observed a similar degree of content for both positive and negative tone posted on different social media platforms. Finally, studies that explored the fluctuations of vaccination attitudes/opinions gathered from social media identified specific events as significant cofactors that affect and shape vaccination intentions of individuals. Interpretation: This thorough examination of the various roles social media can play in disseminating information to the public, as well as how individuals behave on social media in the context of public health events, articulates the potential of social media as a platform of public health intervention to address vaccine hesitancy. Funding: None.

Attitudes, acceptance and hesitancy among the general population worldwide to receive the COVID-19 vaccines and their contributing factors: A systematic review.

BACKGROUND: High rates of vaccination worldwide are required to establish a herd immunity and stop the current COVID-19 pandemic evolution. Vaccine hesitancy is a major barrier in achieving herd immunity across different populations. This study sought to conduct a systematic review of the current literature regarding attitudes and hesitancy to receiving COVID-19 vaccination worldwide. METHODS: A systematic literature search of PubMed and Web of Science was performed on July 5th, 2021, using developed keywords. Inclusion criteria required the study to (1) be conducted in English; (2) investigate attitudes, hesitancy, and/or barriers to COVID-19 vaccine acceptability among a given population; (3) utilize validated measurement techniques; (4) have the full text paper available and be peer-reviewed prior to final publication. FINDINGS: Following PRISMA guidelines, 209 studies were included. The Newcastle Ottawa (NOS) scale for cross-sectional studies was used to assess the quality of the studies.Overall, vaccine acceptance rates ranged considerably between countries and between different time points, with Arabian countries showing the highest hesitancy rates compared with other parts of the world. INTERPRETATION: A variety of different factors contributed to increased hesitancy, including having negative perception of vaccine efficacy, safety, convenience, and price. Some of the consistent socio-demographic groups that were identified to be associated with increased hesitancy included: women, younger participants, and people who were less educated, had lower income, had no insurance, living in a rural area, and self-identified as a racial/ethnic minority.

Developing a Data-Driven Approach in Order to Improve the Safety and Quality of Patient Care.

Objective: To improve the safety and quality of patient care in hospitals by shaping clinical pathways throughout the patient journey. Study Setting: A risk model designed for healthcare organizations in the context of the challenges arising from comorbidity and other treatment-related complexities. Study Design: The core of the model is the patient and his intra-hospital journey, which is analyzed using a data-driven approach. The structure of a predictive model to support organizational and clinical decision-making activities is explained. Data relating to each step of the intra-hospital journey (from hospital admission to discharge) are extracted from clinical records. Principal Findings: The proposed approach is feasible and can be used effectively to improve safety and quality. It enables the evaluation of clinical risks at each step of the patient journey. Conclusion: Based on data from real cases, the model can record and calculate, over time, variables and behaviors that affect the safety and quality of healthcare organizations. This provides a greater understanding of healthcare processes and their complexity which can, in turn, advance research relating to clinical pathways and improve strategies adopted by organizations.