Preparing correctional settings for the next pandemic: a modeling study of COVID-19 outbreaks in two high-income countries.

Introduction: Correctional facilities are high-priority settings for coordinated public health responses to the COVID-19 pandemic. These facilities are at high risk of disease transmission due to close contacts between people in prison and with the wider community. People in prison are also vulnerable to severe disease given their high burden of co-morbidities. Methods: We developed a mathematical model to evaluate the effect of various public health interventions, including vaccination, on the mitigation of COVID-19 outbreaks, applying it to prisons in Australia and Canada. Results: We found that, in the absence of any intervention, an outbreak would occur and infect almost 100% of people in prison within 20 days of the index case. However, the rapid rollout of vaccines with other non-pharmaceutical interventions would almost eliminate the risk of an outbreak. Discussion: Our study highlights that high vaccination coverage is required for variants with high transmission probability to completely mitigate the outbreak risk in prisons.

Economic Evaluation of COVID-19 Screening Tests and Surveillance Strategies in Low-Income, Middle-Income, and High-Income Countries: A Systematic Review.

BACKGROUND Economic evaluation of the testing strategies to control transmission and monitor the severity of COVID-19 after the pandemic is essential. This study aimed to review the economic evaluation of COVID-19 tests and to construct a model with outcomes in terms of cost and test acceptability for surveillance in the post-pandemic period in low-income, middle-income, and high-income countries. MATERIAL AND METHODS We performed the systematic review following PRISMA guidelines through MEDLINE and EMBASE databases. We included the relevant studies that reported the economic evaluation of COVID-19 tests for surveillance. Also, we input current probability, sensitivity, and specificity for COVID-19 surveillance in the post-pandemic period. RESULTS A total of 104 articles met the eligibility criteria, and 8 articles were reviewed and assessed for quality. The specificity and sensitivity of COVID-19 screening tests were reported as 80% to 90% and 40% to 90%, respectively. The target population presented a mortality rate between 0.2% and 19.2% in the post-pandemic period. The implementation model of COVID-19 screening tests for surveillance with a cost mean for molecular and antigen tests was US$ 46.64 (min-max US $0.25-$105.39) and US $6.15 (min-max US $2-$10), respectively. CONCLUSIONS For the allocation budget for the COVID-19 surveillance test, it is essential to consider the incidence and mortality of the post-pandemic period in low-income, middle-income, and high-income countries. A robust method to evaluate outcomes is needed to prevent increasing COVID-19 incidents earlier.

France needs a chief science adviser.

France is at a crossroads, facing environmental and social challenges that are profoundly altering its society. Yet, the French government keeps prioritizing short-term political gains over long-term evidence-based planning for major transitions that France, like most countries, will undergo over the next 20 years. There is an urgent need for France to implement long-term science-informed policy-making.

Clean energy transition and climate vulnerabilities: A comparative analysis of European and non-European developed countries.

Currently, the world faces an existential threat of climate change, and every government across the globe is trying to come up with strategies to tackle the severity of climate change in every way possible. To this end, the use of clean energy rather than fossil fuel energy sources is critical, as it can reduce greenhouse gas emissions and pave the way for carbon neutrality. This study examines the impact of the energy cleanability gap on four different climate vulnerabilities, such as ecosystem, food, health, and housing vulnerabilities, considering 47 European and non-European high-income countries. The study considers samples from 2002 to 2019. This study precedes the empirical analysis in the context of a quadratic relationship between the energy cleanability gap and climate vulnerability. The study uses system-generalized methods of the moment as the main technique, while panel quantile regression is a robustness analysis. Fixed effect and random effect models have also been incorporated. The study finds that the energy cleanability gap and all four climate vulnerabilities demonstrate a U-shaped relationship in both European and non-European countries, implying that when the energy cleanability gap increases, climate vulnerability decreases, but after reaching a certain threshold, it starts to increase. Development expenditure is found to be negatively affecting food and health vulnerabilities in European nations, while it increases food vulnerability and decreases health vulnerability in non-European nations. Regarding industrialization's impact on climate vulnerabilities, the study finds opposite effects for the European and non-European economies. On the other hand, for both groups, trade openness decreases climate vulnerabilities. Based on these results, the study recommends speeding up the energy transition process from fossil fuel energy resources towards clean energy resources to obtain carbon neutrality in both European and non-European groups.

Teleintervention's effects on breastfeeding in low-income women in high income countries: a systematic review and meta-analysis.

BACKGROUND: Many mothers in high-income countries (HIC) do not breastfeed to the World Health Organisation's recommendation of two years. This is particularly true for low-income women (LIW). They often face additional socio-structural barriers that encourage early discontinuation and are inadequately supported by current healthcare interventions. Teleinterventions are flexible and widely used following the global pandemic and increase maternal autonomy over intervention delivery. They show promise in improving other maternal conditions in LIW, including postpartum depression. Teleinterventions can increase breastfeeding rates in the wider maternal population, however their efficacy for this underserved population has not yet been systematically assessed. This meta-analysis aimed to identify if teleinterventions increase 'exclusive' or 'any' breastfeeding by LIW in HIC at 1-, 3-4, and 6-months postpartum. METHODS: We searched five online databases for randomised controlled trials assessing breastfeeding teleinterventions for LIW in HIC. Risk ratios (RR) were used to calculate the average effect of teleinterventions on 'any' and 'exclusive' breastfeeding at at 1-, 3-4, and 6-months postpartum using random effects meta-analysis. Study bias was assessed using the Revised Cochrane risk-of-bias tool for randomised trials (RoB2), and outcome quality was evaluated against GRADE criteria. RESULTS: Nine studies met inclusion criteria: six providing telephone calls, two text messages and one an online support group. All the studies were conducted in the United States, with small sample sizes and a high risk of bias. Pooled results indicate teleinterventions modestly increase 'any' and 'exclusive' breastfeeding at all time points, with a statistically significant increase in 'exclusive' breastfeeding after 3-4 months (RR 1.12, 95% CI [1.00,1.25]). At 3-4 months teleinterventions providing peer support were more effective than educational teleinterventions at promoting any and exclusive breastfeeding. Evidence for all outcomes were rated 'low' or 'very low' quality using the GRADE tool, mainly due to high attrition and low power. CONCLUSIONS: Despite insufficient high-quality research into breastfeeding teleinterventions for LIW, our results suggest teleinterventions may improve exclusive and any breastfeeding. Given breastfeeding is particularly low in LIW population from HIC, our findings are promising and require further exploration by larger, methodologically sound trials in other HIC.

Pregnant and postpartum women's experiences of the indirect impacts of the COVID-19 pandemic in high-income countries: a qualitative evidence synthesis.

BACKGROUND: Pregnant and postpartum women's experiences of the COVID-19 pandemic, as well as the emotional and psychosocial impact of COVID-19 on perinatal health, has been well-documented across high-income countries. Increased anxiety and fear, isolation, as well as a disrupted pregnancy and postnatal period are widely described in many studies. The aim of this study was to explore, describe and synthesise studies that addressed the experiences of pregnant and postpartum women in high-income countries during the first two years of the pandemic. METHODS: A qualitative evidence synthesis of studies relating to women's experiences in high-income countries during the pandemic were included. Two reviewers extracted the data using a thematic synthesis approach and NVivo 20 software. The GRADE-CERQual (Confidence in the Evidence from Reviews of Qualitative research) was used to assess confidence in review findings. RESULTS: Sixty-eight studies were eligible and subjected to a sampling framework to ensure data richness. In total, 36 sampled studies contributed to the development of themes, sub-themes and review findings. There were six over-arching themes: (1) dealing with public health restrictions; (2) navigating changing health policies; (3) adapting to alternative ways of receiving social support; (4) dealing with impacts on their own mental health; (5) managing the new and changing information; and (6) being resilient and optimistic. Seventeen review findings were developed under these themes with high to moderate confidence according to the GRADE-CERQual assessment. CONCLUSIONS: The findings from this synthesis offer different strategies for practice and policy makers to better support women, babies and their families in future emergency responses. These strategies include optimising care delivery, enhancing communication, and supporting social and mental wellbeing.

Do positive and negative shocks of tourism development affect income inequality in a developed country?

Income inequality is an essential cause of violence, stagnant development, and political instability. This study will examine the positive and negative shocks in tourism development, and the distribution of the interaction between tourism development, economic growth, human capital, globalization, and income inequality will be discussed in Singapore, a developed and top-visited country. By adopting autoregressive distributed lag and non-linear autoregressive distributed lag approaches for panel data from 1978 to 2022, the results indicate an asymmetric cointegration among variables, and positive and negative changes in tourism development lead to decreased income inequality. More specifically, the asymmetric effect of tourism is found both in the short- and long-term, and positive shock has a greater impact than negative shock. At the same time, the findings also reveal that economic growth and globalization enhance, while human capital negatively affects income inequality in Singapore. These findings strengthen the belief of Singapore policy-makers and recommend several significant lessons for developing countries to promote tourism, sustainable development, and reduce income inequality.

COVID-19 vaccine acceptance in the general population and under-resourced communities from high-income countries: realist review.

OBJECTIVE: To compare vaccination willingness before rollout and 1 year post-rollout uptake among the general population and under-resourced communities in high-income countries. DESIGN: A realist review. DATA SOURCES: Embase, PubMed, Dimensions ai and Google Scholar. SETTING: High-income countries. DEFINITIONS: We defined vaccination willingness as the proportion of participants willing or intending to receive vaccines prior to availability. We defined vaccine uptake as the real proportion of the population with complete vaccination as reported by each country until November 2021. RESULTS: We included data from 62 studies and 18 high-income countries. For studies conducted among general populations, the proportion of vaccination willingness was 67% (95% CI 62% to 72%). In real-world settings, the overall proportion of vaccine uptake among those countries was 73% (95% CI 69% to 76%). 17 studies reported pre-rollout willingness for under-resourced communities. The summary proportion of vaccination willingness from studies reporting results among people from under-resourced communities was 52% (95% CI 0.46% to 0.57%). Real-world evidence about vaccine uptake after rollout among under-resourced communities was limited. CONCLUSION: Our review emphasises the importance of realist reviews for assessing vaccine acceptance. Limited real-world evidence about vaccine uptake among under-resourced communities in high-income countries is a call to context-specific actions and reporting.

Regional variations in vaccination against COVID-19 in Germany.

Vaccination willingness against COVID-19 is generally perceived as low. Moreover, there is large heterogeneity across and within countries. As a whole, Germany has average vaccination rates compared to other industrialized countries. However, vaccination rates in the 16 different German federal states differ by more than 20 percentage points. We describe variation in vaccination rates on the level of the 400 German counties using data on all vaccinations carried out until December 2022. Around 52-72% of that variation can be explained by regional differences in demographic characteristics, housing, education and political party preferences. We find indications that the remaining part may be due to differences in soft factors such as risk aversion, trust in the German government, trust in science, and beliefs in conspiracy theories regarding the origins of the Corona virus. We conclude that improving the trust in science and the fight against conspiracy theories may possibly be effective tools to improve vaccination rates and effectively fight pandemics.

Language distance and labor market integration of migrants: Gendered perspective.

This paper examines the distinct effects of linguistics distance and language literacy on the labor market integration of migrant men and women. Using data from the Programme for International Assessment of Adult Competencies (PIAAC) 2018 in 16 countries of destination mainly from Europe and more than 110 languages of origin, we assess migrant labor force participation, employment, working hours, and occupational prestige. The study finds that linguistics distance of the first language studied has a significant negative association with labor force participation, employment, and working hours of migrant women, even after controlling for their abilities in their destination language, education, and cultural distance between the country of origin and destination. In contrast, linguistics distance is only negatively associated with migrant men's working hours. This suggests that linguistic distance serves as a proxy for cultural aspects, which are not captured by cultural distance and hence shape the labor market integration of migrant women due to cultural factors rather than human capital. We suggest that the gender aspect of the effect of language proximity is essential in understanding the intersectional position of migrant women in the labor force.

Is economic growth enough to propel rehabilitation expenditures? An empirical analysis of country panel data and policy implications.

PURPOSE: Rehabilitation is a set of services designed to increase functioning and improve wellbeing across the life course. Despite being a core part of Universal Health Coverage, rehabilitation services often receive limited public expenditure, especially in lower income countries. This leads to limited service availability and high out of pocket payments for populations in need of care. The purpose of this research was to assess the association between macroeconomic conditions and rehabilitation expenditures across low-, middle-, and high-income countries and to understand its implications for overall rehabilitation expenditure trajectory across countries. MATERIALS AND METHODS: We utilized a panel data set from the World Health Organization's Global Health Expenditure Database comprising the total rehabilitation expenditure for 88 countries from 2016 to 2018. Basic macroeconomic and population data served as control variables. Multiple regression models were implemented to measure the relationship between macroeconomic conditions and rehabilitation expenditures. We used four different model specifications to check the robustness of our estimates: pooled data models (or naïve model) without control, pooled data models with controls (or expanded naïve model), fixed effect models with all controls, and lag models with all controls. Log-log specifications using fixed effects and lag-dependent variable models were deemed the most appropriate and controlled for time-invariant differences. RESULTS: Our regression models indicate that, with a 1% increase in economic growth, rehabilitation expenditure would be associated with a 0.9% and 1.3% increase in expenditure. Given low baseline levels of existing rehabilitation expenditure, we anticipate that predicted increases in rehabilitation expenditure due to economic growth may be insufficient to meet the growing demand for rehabilitation services. Existing expenditures may also be vulnerable during periods of economic recession. CONCLUSION: This is the first known estimation of the association between rehabilitation expenditure and macroeconomic conditions. Our findings demonstrate that rehabilitation is sensitive to macroeconomic fluctuations and the path dependency of past expenditures. This would suggest the importance of increased financial prioritization of rehabilitation services and improved institutional strengthening to expand access to rehabilitation services for populations.

The Influence of Sex and/or Gender on the Occurrence of Colorectal Cancer in the General Population in Developed Countries: A Scoping Review.

Objective: Gender as the "sociocultural role of sex" is underrepresented in colorectal cancer incidence studies, potentially resulting in underestimated risk factors' consequences and inequalities men/women. We aim to explore how literature focusing on differences between men and women in the incidence of colorectal cancer interprets these differences: through sex- or gender-related mechanisms, or both? Methods: We conducted a scoping review using PubMed and Google Scholar. We categorized studies based on their definitions of sex and/or gender variables. Results: We reviewed 99 studies, with 7 articles included in the analysis. All observed differences between men and women. Six articles examined colorectal cancer incidence by gender, but only 2 used the term "gender" to define exposure. One article defined its "sex" exposure variable as gender-related mechanisms, and two articles used "sex" and "gender" interchangeably to explain these inequalities. Gender mechanisms frequently manifest through health behaviors. Conclusion: Our results underscore the need for an explicit conceptual framework to disentangle sex and/or gender mechanisms in colorectal cancer incidence. Such understanding would contribute to the reduction and prevention of social health inequalities.

Patient-Centered Chronic Wound Care Mobile Apps: Systematic Identification, Analysis, and Assessment.

Background: The prevalence of chronic wounds is predicted to increase within the aging populations in industrialized countries. Patients experience significant distress due to pain, wound secretions, and the resulting immobilization. As the number of wounds continues to rise, their adequate care becomes increasingly costly in terms of health care resources worldwide. eHealth support systems are being increasingly integrated into patient care. However, to date, no systematic analysis of such apps for chronic wounds has been published. Objective: The aims of this study were to systematically identify and subjectively assess publicly available German- or English-language mobile apps for patients with chronic wounds, with quality assessments performed by both patients and physicians. Methods: Two reviewers independently conducted a systematic search and assessment of German- or English-language mobile apps for patients with chronic wounds that were available in the Google Play Store and Apple App Store from April 2022 to May 2022. In total, 3 apps met the inclusion and exclusion criteria and were reviewed independently by 10 physicians using the German Mobile App Rating Scale (MARS) and the System Usability Scale (SUS). The app with the highest mean MARS score was subsequently reviewed by 11 patients with chronic wounds using the German user version of the MARS (uMARS) and the SUS. Additionally, Affinity for Technology Interaction (ATI) scale scores were collected from both patients and physicians. Results: This study assessed mobile apps for patients with chronic wounds that were selected from a pool of 118 identified apps. Of the 73 apps available in both app stores, 10 were patient oriented. After excluding apps with advertisements or costs, 3 apps were evaluated by 10 physicians. Mean MARS scores ranged from 2.64 (SD 0.65) to 3.88 (SD 0.65) out of 5, and mean SUS scores ranged from 50.75 (SD 27) to 80.5 (SD 17.7) out of 100. WUND APP received the highest mean MARS score (mean 3.88, SD 0.65 out of 5) among physicians. Hence, it was subsequently assessed by 11 patients and achieved a similar rating (uMARS score: mean 3.89, SD 0.4 out of 5). Technical affinity, as measured with the ATI scale, was slightly lower in patients (score: mean 3.62, SD 1.35 out of 6) compared to physicians (score: mean 3.88, SD 1.03 out 6). Conclusions: The quality ratings from physicians and patients were comparable and indicated mediocre app quality. Technical affinity, as assessed by using the ATI scale, was slightly lower for patients. Adequate apps for patients with chronic wounds remain limited, emphasizing the need for improved app development to meet patient needs. The ATI scale proved valuable for assessing technical affinity among different user groups.

Barriers to Adopting a Plant-Based Diet in High-Income Countries: A Systematic Review.

Adopting a plant-based diet (PBD) has been shown to reduce the risk of developing certain diseases and is linked to environmental benefits. This review synthesises the evidence on the barriers adults aged 18 to 65 living in high-income countries (HIC) may experience when adopting a PBD. A systematic literature review was conducted using four search databases: Medline, Embase, Global Health, and Web of Science. Barriers were mapped to behaviour change strategies using the COM-B model. Ten studies were included in the final review, including 1740 participants. Five were qualitative, four were cross-sectional, and one was a pre- and-post-intervention study. In total, 40 barriers were identified and synthesised into 11 themes: financial, lack of knowledge, emotional, health, convenience, social, enjoyment of meat, environmental, accessibility, personal ability, and media. Of the 40 barriers, nutritional intake/requirements (categorised into the "health" theme) had the most evidence. This barrier encompassed concerns around being able to meet nutritional needs if an individual were to adopt a PBD. Habits (in the "personal ability" theme), which included established eating habits and habitual behaviours relating to animal-source foods, had the second most evidence alongside the barrier of not knowing what to eat as part of a PBD (in the "lack of knowledge" theme). Education interventions and communication/marketing policies were the behaviour change mechanisms mapped onto these barriers. Future interventions should focus on informing individuals about what to consume as part of a nutritionally balanced PBD and facilitating habitual dietary change.

Factors influencing the effects of policies and interventions to promote the appropriate use of medicines in high-income countries: A rapid realist review.

BACKGROUND: The appropriate use of medicines has long been recognized as a fundamental component of medicine policies. We aimed to extract lessons from published research on how policy contexts and mechanisms can affect the outcomes of national- or health-system level interventions to promote appropriate medicine use (defined as an increase in underutilized medications or decrease in inappropriate medication use). METHODS: We conducted a rapid realist review of published evidence concerning system-level policies to promote the appropriate use of medicines in high-income countries with universal prescription drug coverage. We searched MEDLINE and Embase to identify relevant publications. We used a realist evaluation framework to identify contexts, mechanisms, and outcomes for each intervention and to hypothesize which policy contexts and mechanisms supported successful outcomes in terms of relative changes in the prevalence of use of the specific medication classes targeted. RESULTS: From 1,318 identified studies, 18 met our inclusion criteria. 13 distinct policies were identified. Three main policy-related factors underpinned successful interventions: involving providers and patients through program interventions; central coordination through national agencies dedicated to medicine policies; and the establishment of an explicit and integrated national medicine policy strategy. CONCLUSION: Policymakers can improve coordination of national pharmaceutical policies to reduce harms from inappropriate medicines use, thus improving health outcomes through cost-effective programs.

Higher total energy costs strain the elderly, especially low-income, across 31 developed countries.

Addressing the total energy cost burden of elderly people is essential for designing equitable and effective energy policies, especially in responding to energy crisis in an aging society. It is due to the double impact of energy price hikes on households-through direct impact on fuel bills and indirect impact on the prices of goods and services consumed. However, while examining the household energy cost burden of the elderly, their indirect energy consumption and associated cost burden remain poorly understood. This study quantifies and compares the direct and indirect energy footprints and associated total energy cost burdens for different age groups across 31 developed countries. It reveals that the elderly have larger per capita energy footprints, resulting from higher levels of both direct and indirect energy consumption compared with the younger age groups. More importantly, the elderly, especially the low-income elderly, have a higher total energy cost burden rate. As the share of elderly in the total population rapidly grows in these countries, the larger per capita energy footprint and associated cost burden rate of elderly people would make these aging countries more vulnerable in times of energy crises. It is therefore crucial to develop policies that aim to reduce energy consumption and costs, improve energy efficiency, and support low-income elderly populations. Such policies are necessary to reduce the vulnerability of these aging countries to the energy crisis.

The Grandchildren of Immigrants in Western Europe: Patterns of Assimilation Among the Emerging Third Generation.

Migration scholars have long regarded the trajectory of the third generation as a critical test of assimilation; however, scholarship to date has been limited and largely focused on socioeconomic attainment. In this article, we rely on a large dataset of adolescent respondents in England, Germany, and the Netherlands to compare the second and third generations in terms of their social networks and cultural identities. The third generation shows stronger ties to the native fourth-plus generation alongside weaker ties to coethnics. We document comparable, albeit more moderate, dynamics of assimilation over generations in regard to national and ethnic identification, along with substantial variation by country of destination and ethnic origin group. Our results point to a dominant trend of assimilation at the third generation and suggest future challenges to provide a more durable assessment of postwar migration waves two generations after settlement.

Who continues to work after retirement age?

BACKGROUND: Demographic changes in all industrialized countries have led to a keen interest in extending working lives for older workers. To achieve this goal, it is essential to understand the patterns of retirement and specifically what characterizes individuals who continue to work beyond retirement age. Thus, the aim of this paper was to contribute to the international body of empirical knowledge about individuals who continue in the workforce after retirement age. We present evidence from Denmark and examine what characterizes individuals who continue in the workforce after retirement age and investigate the likelihood of continued work after retirement age while controlling for a set of socio-economic and lifestyle factors. METHODS: The study population consisted of 5,474 respondents to the Copenhagen Aging and Midlife Biobank (CAMB) 2021 survey, divided into two groups. The first group included subjects (n = 1,293) who stayed longer in the workforce even though they had the possibility to retire. The second group consisted of subjects who had retired full-time at the time of the survey (n = 4,181). Survey data was linked to register data to provide a broader dataset. In order to investigate the heterogeneity between the two groups in terms of important socio-economic, work-related and health-related variables, t-test, Mann-Whitney U (Wilcoxon Rank) test, and chi-square tests were employed. Further, to examine the probability of an individual working after retirement age a logit model with step-wise inclusion was utilized. RESULTS: Overall, individuals who continue to work even though they could retire tend to be wealthier, healthier, and males compared to individuals who are retired full-time. Further, there are more older workers who have partners and are co-habitants than retirees. The likelihood of continuing in the workforce past retirement age is affected by several work-related factors as well as life-style factors. The likelihood of working past retirement age decreases by years spent in the workforce (marginal effect of -0.003), if you have a partner (-0.080) and if your partner is outside of the workforce (marginal effect of -0.106). The likelihood increases by health (marginal effect of -0.044 of moving from excellent/very good health to good health or to fair/poor health, physical working capability (marginal effect of -0.083 of moving from no/some problems to severe problems or cannot work at all) and income (marginal effect of 0.083 from moving from the lowest income-quantile to higher quantiles). CONCLUSION: These results are in line with the previous literature and suggest the importance of designing retirement policies that tailor the transition toward retirement according to specific characteristics of both the individual and the segment of occupation.