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Willeit P, Kimpel J, Winner H, Harthaller T, Schäfer H, Bante D, Falkensammer B, Rössler A, Riepler L, Ower C, Sacher M, von Laer D, Borena W. Seroprevalence of SARS-CoV-2 infection in the Tyrolean district of Schwaz at the time of the rapid mass vaccination in March 2021 following B.1.351-variant outbreak. Front Public Health 2022; 10:989337. [PMID: 36159252 PMCID: PMC9500479 DOI: 10.3389/fpubh.2022.989337] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 08/17/2022] [Indexed: 01/26/2023] Open
Abstract
In order to curb the rapid dissemination of the B.1.351 variant of SARS-CoV-2 in the district of Schwaz and beyond, the EU allocated additional vaccine doses at the beginning of March 2021 to implement a rapid mass vaccination of the population (16+). The aim of our study was to determine the seroprevalence of SARS-CoV-2 among the adult population in the district of Schwaz at the time of the implementation. Data on previous history of infections, symptoms and immunization status were collected using a structured questionnaire. Blood samples were used to determine SARS-CoV-2 specific anti-spike, anti-nucleocapsid and neutralizing antibodies. We recruited 2,474 individuals with a median age (IQR) of 42 (31-54) years. Using the official data on distribution of age and sex, we found a standardized prevalence of undocumented infections at 15.0% (95% CI: 13.2-16.7). Taken together with the officially documented infections, we estimated that 24.0% (95% CI: 22.5-25.6) of the adult population had prior SARS-CoV-2 infection. Hence, the proportion of undocumented infections identified by our study was 55.8% (95% CI: 52.7-58.5). With a vaccination coverage of 10% among the adults population at that time, we imply that a minimum of two-thirds of the target popuation was susceptible to the circulating threat when this unique campaign started.
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Affiliation(s)
- Peter Willeit
- Clinical Epidemiology Team, Medical University of Innsbruck, Innsbruck, Austria,Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Janine Kimpel
- Department of Hygiene, Microbiology and Public Health, Institute of Virology, Medical University of Innsbruck, Innsbruck, Austria
| | - Hannes Winner
- Department of Economics, University of Salzburg, Salzburg, Austria
| | - Teresa Harthaller
- Department of Hygiene, Microbiology and Public Health, Institute of Virology, Medical University of Innsbruck, Innsbruck, Austria
| | - Helena Schäfer
- Department of Hygiene, Microbiology and Public Health, Institute of Virology, Medical University of Innsbruck, Innsbruck, Austria
| | - David Bante
- Department of Hygiene, Microbiology and Public Health, Institute of Virology, Medical University of Innsbruck, Innsbruck, Austria
| | - Barbara Falkensammer
- Department of Hygiene, Microbiology and Public Health, Institute of Virology, Medical University of Innsbruck, Innsbruck, Austria
| | - Annika Rössler
- Department of Hygiene, Microbiology and Public Health, Institute of Virology, Medical University of Innsbruck, Innsbruck, Austria
| | - Lydia Riepler
- Department of Hygiene, Microbiology and Public Health, Institute of Virology, Medical University of Innsbruck, Innsbruck, Austria
| | - Cornelia Ower
- Department of Surgery, University Hospital of Trauma Surgery, Medical University of Innsbruck, Innsbruck, Austria
| | - Magdalena Sacher
- Department of Visceral, Transplant and Thoracic Surgery, Center of Operative Medicine, Medical University of Innsbruck, Innsbruck, Austria
| | - Dorothee von Laer
- Department of Hygiene, Microbiology and Public Health, Institute of Virology, Medical University of Innsbruck, Innsbruck, Austria
| | - Wegene Borena
- Department of Hygiene, Microbiology and Public Health, Institute of Virology, Medical University of Innsbruck, Innsbruck, Austria,*Correspondence: Wegene Borena
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Winner H, Kimpel J, Krammer F, von Laer D, Paetzold J. Can high COVID-19 vaccination rates in adults help protect unvaccinated children? Evidence from a unique mass vaccination campaign, Schwaz/Austria, March 2021. Euro Surveill 2022; 27. [PMID: 36177866 PMCID: PMC9524054 DOI: 10.2807/1560-7917.es.2022.27.39.2101027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Background After an outbreak of the SARS-CoV-2 Beta variant in the district of Schwaz/Austria, vaccination with Comirnaty vaccine (BNT162b2 mRNA, BioNTech-Pfizer) had been offered to all adult inhabitants (≥ 16 years) in March 2021. This made Schwaz one of the most vaccinated regions in Europe at that time (70% of the adult population took up the offer). In contrast, all other Austrian districts remained with low vaccine coverage. Aim We studied whether this rapid mass vaccination campaign provided indirect protection to unvaccinated individuals such as children (< 16 years) living in the same district. Methods To study the effect of the campaign we used two complementary approaches. We compared infection rates among the population of children (< 16 years) in Schwaz with (i) the child population from similar districts (using the synthetic control method), and (ii) with the child population from municipalities along the border of Schwaz not included in the campaign (using an event study approach). Results Before the campaign, we observed very similar infection spread across the cohort of children in Schwaz and the control regions. After the campaign, we found a significant reduction of new cases among children of −64.5% (95%-CI: −82.0 to −30.2%) relative to adjacent border municipalities (using the event study model). Employing the synthetic control method, we observed a significant reduction of −42.8% in the same cohort. Conclusion Our results constitute novel evidence of an indirect protection effect from a group of vaccinated individuals to an unvaccinated group.
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Affiliation(s)
- Hannes Winner
- University of Salzburg, Department of Economics, Salzburg, Austria
| | - Janine Kimpel
- Institute of Virology, Department of Hygiene, Microbiology and Public Health, Medical University of Innsbruck, Innsbruck, Austria
| | - Florian Krammer
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, United States
| | - Dorothee von Laer
- Institute of Virology, Department of Hygiene, Microbiology and Public Health, Medical University of Innsbruck, Innsbruck, Austria
| | - Jörg Paetzold
- University of Salzburg, Department of Economics, Salzburg, Austria
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Dzien C, Unterberger P, Hofmarcher P, Winner H, Lechleitner M. Detecting disabilities in everyday life: evidence from a geriatric assessment. BMC Geriatr 2022; 22:717. [PMID: 36042419 PMCID: PMC9429328 DOI: 10.1186/s12877-022-03368-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 08/03/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The activities of daily living (ADL) score is a widely used index to establish the degree of independence from any help in everyday life situations. Measuring ADL accurately is time-consuming and costly. This paper presents a framework to approximate ADL via variables usually collected in comprehensive geriatric assessments. We show that the selected variables serve as good indicators in explaining the physical disabilities of older patients. METHODS Our sample included information from a geriatric assessment of 326 patients aged between 64 and 99 years in a hospital in Tyrol, Austria. In addition to ADL, 23 variables reflecting the physical and mental status of these patients were recorded during the assessment. We performed least absolute shrinkage and selection operator (LASSO) to determine which of these variables had the highest impact on explaining ADL. Then, we used receiver operating characteristic (ROC) analysis and logistic regression techniques to validate our model performance. Finally, we calculated cut-off points for each of the selected variables to show the values at which ADL fall below a certain threshold. RESULTS Mobility, urinary incontinence, nutritional status and cognitive function were most closely related to ADL and, therefore, to geriatric patients' functional limitations. Jointly, the selected variables were able to detect neediness with high accuracy (area under the ROC curve (AUC) = 0.89 and 0.91, respectively). If a patient had a limitation in one of these variables, the probability of everyday life disability increased with a statistically significant factor between 2.4 (nutritional status, 95%-CI 1.5-3.9) and 15.1 (urinary incontinence, 95%-CI 3.6-63.4). CONCLUSIONS Our study highlights the most important impairments of everyday life to facilitate more efficient use of clinical resources, which in turn allows for more targeted treatment of geriatric patients. At the patient level, our approach enables early detection of functional limitations and timely indications of a possible need for assistance in everyday life.
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Affiliation(s)
- Cornelius Dzien
- Landeskrankenhaus Hochzirl - Natters, In der Stille 20, Natters, 6161, Austria
| | | | - Paul Hofmarcher
- University of Salzburg, Mönchsberg 2a, Salzburg, 5020, Austria
| | - Hannes Winner
- University of Salzburg, Mönchsberg 2a, Salzburg, 5020, Austria
| | - Monika Lechleitner
- Landeskrankenhaus Hochzirl - Natters, In der Stille 20, Natters, 6161, Austria
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Paetzold J, Kimpel J, Bates K, Hummer M, Krammer F, von Laer D, Winner H. Impacts of rapid mass vaccination against SARS-CoV2 in an early variant of concern hotspot. Nat Commun 2022; 13:612. [PMID: 35105889 PMCID: PMC8807735 DOI: 10.1038/s41467-022-28233-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 01/10/2022] [Indexed: 11/25/2022] Open
Abstract
We study the real-life effect of an unprecedented rapid mass vaccination campaign. Following a large outbreak of the Beta variant in the district of Schwaz/Austria, 100,000 doses of BNT162b2 (Pfizer/BioNTech) were procured to mass vaccinate the entire adult population of the district between the 11th and 16th of March 2021. This made the district the first widely inoculated region in Europe. We examine the effect of this campaign on the number of infections, cases of variants of concern, hospital and ICU admissions. We compare Schwaz with (i) a control group of highly similar districts, and (ii) with populations residing in municipalities along the border of Schwaz which were just excluded from the campaign. We find large and significant decreases for all outcomes after the campaign. Our results suggest that rapid mass vaccination is an effective tool to curb the spread of SARS-CoV-2.
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Affiliation(s)
- Jörg Paetzold
- University of Salzburg, Department of Economics, Residenzplatz 9, A-5010, Salzburg, Austria.
| | - Janine Kimpel
- Institute of Virology, Department of Hygiene, Microbiology and Public Health, Medical University of Innsbruck, Peter-Mayr-Str. 4b, 6020, Innsbruck, Austria
| | - Katie Bates
- Department of Medical Statistics, Informatics and Health Economics, Medical University of Innsbruck, Innsbruck, Austria
| | - Michael Hummer
- The Austrian National Public Health Institute (Gesundheit Österreich GmbH, GÖG), Stubenring 6, 1010, Vienna, Austria
| | - Florian Krammer
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1124, New York, NY, 10029, USA
| | - Dorothee von Laer
- Institute of Virology, Department of Hygiene, Microbiology and Public Health, Medical University of Innsbruck, Peter-Mayr-Str. 4b, 6020, Innsbruck, Austria
| | - Hannes Winner
- University of Salzburg, Department of Economics, Residenzplatz 9, A-5010, Salzburg, Austria
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Juranek S, Paetzold J, Winner H, Zoutman F. Labor market effects of COVID-19 in Sweden and its neighbors: Evidence from administrative data. Kyklos (Oxford) 2021; 74:512-526. [PMID: 34908590 PMCID: PMC8661996 DOI: 10.1111/kykl.12282] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 05/29/2021] [Accepted: 07/05/2021] [Indexed: 05/17/2023]
Abstract
This paper studies the labor market effects of non-pharmaceutical interventions (NPIs) to combat the COVID-19 pandemic. We focus on the Nordic countries which showed one of the highest variations in NPIs despite having similar community spread of COVID-19 at the onset of the pandemic: While Denmark, Finland and Norway imposed strict measures ('lockdowns'), Sweden decided for much lighter restrictions. Empirically, we use novel administrative data on weekly new unemployment and furlough spells from all 56 regions of the Nordic countries to compare the labor market outcomes of Sweden with the ones of its neighbors. Our evidence suggests that the labor markets of all countries were severely hit by the pandemic, although Sweden performed slightly better than its neighbors. Specifically, we find the worsening of the Swedish labor market to occur around 2 to 3 weeks later than in the other Nordic countries, and that its cumulative sum of new unemployment and furlough spells remained significantly lower (about 20-25%) during the time period of our study (up to week 21 of 2020).
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Affiliation(s)
| | | | - Hannes Winner
- University of Salzburg Austria
- Austrian Institute of Economic Research Vienna Austria
| | - Floris Zoutman
- NHH Norwegian School of Economics Norway
- NoCeT Norway
- CESifo Germany
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Borena W, Bánki Z, Bates K, Winner H, Riepler L, Rössler A, Pipperger L, Theurl I, Falkensammer B, Ulmer H, Walser A, Pichler D, Baumgartner M, Schönherr S, Forer L, Knabl L, Würzner R, von Laer D, Paetzold J, Kimpel J. Persistence of immunity to SARS-CoV-2 over time in the ski resort Ischgl. EBioMedicine 2021; 70:103534. [PMID: 34392147 PMCID: PMC8358264 DOI: 10.1016/j.ebiom.2021.103534] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 07/27/2021] [Accepted: 07/27/2021] [Indexed: 11/22/2022] Open
Abstract
Background In early March 2020, a SARS-CoV-2 outbreak in the ski resort Ischgl in Austria triggered the spread of SARS-CoV-2 throughout Austria and Northern Europe. In a previous study, we found that the seroprevalence in the adult population of Ischgl had reached 45% by the end of April, representing an exceptionally high level of local seropositivity in Europe. We performed a follow-up study in Ischgl, which is the first to show persistence of immunity and protection against SARS-CoV-2 and some of its variants at a community level. Methods Of the 1259 adults that participated in the baseline study, 801 have been included in the follow-up in November 2020. The study involved the analysis of binding and neutralizing antibodies and T cell responses. In addition, the incidence of SARS-CoV-2 and its variants in Ischgl was compared to the incidence in similar municipalities in Tyrol until April 2021. Findings For the 801 individuals that participated in both studies, the seroprevalence declined from 51.4% (95% confidence interval (CI) 47.9-54.9) to 45.4% (95% CI 42.0-49.0). Median antibody concentrations dropped considerably (5.345, 95% CI 4.833 - 6.123 to 2.298, 95% CI 2.141 - 2.527) but antibody avidity increased (17.02, 95% CI 16.49 - 17.94 to 42.46, 95% CI 41.06 - 46.26). Only one person had lost detectable antibodies and T cell responses. In parallel to this persistent immunity, we observed that Ischgl was relatively spared, compared to similar municipalities, from the prominent second COVID-19 wave that hit Austria in November 2020. In addition, we used sequencing data to show that the local immunity acquired from wild-type infections also helped to curb infections from variants of SARS-CoV-2 which spread in Austria since January 2021. Interpretation The relatively high level of seroprevalence (40-45%) in Ischgl persisted and might have been associated with the observed protection of Ischgl residents against virus infection during the second COVID-19 wave as well as against variant spread in 2021. Funding Funding was provided by the government of Tyrol and the FWF Austrian Science Fund.
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Affiliation(s)
- Wegene Borena
- Institute of Virology, Department of Hygiene, Microbiology and Public Health, Medical University of Innsbruck, Peter-Mayr-Str. 4b, Innsbruck 6020, Austria
| | - Zoltán Bánki
- Institute of Virology, Department of Hygiene, Microbiology and Public Health, Medical University of Innsbruck, Peter-Mayr-Str. 4b, Innsbruck 6020, Austria
| | - Katie Bates
- Department of Medical Statistics, Informatics and Health Economics, Medical University of Innsbruck, Austria
| | - Hannes Winner
- University of Salzburg, Department of Economics, Residenzplatz 9, Salzburg A-5010, Austria
| | - Lydia Riepler
- Institute of Virology, Department of Hygiene, Microbiology and Public Health, Medical University of Innsbruck, Peter-Mayr-Str. 4b, Innsbruck 6020, Austria
| | - Annika Rössler
- Institute of Virology, Department of Hygiene, Microbiology and Public Health, Medical University of Innsbruck, Peter-Mayr-Str. 4b, Innsbruck 6020, Austria
| | - Lisa Pipperger
- Institute of Virology, Department of Hygiene, Microbiology and Public Health, Medical University of Innsbruck, Peter-Mayr-Str. 4b, Innsbruck 6020, Austria
| | - Igor Theurl
- Labor Dr. Theurl, Franz-Fischerstr.7b, Innsbruck, Austria
| | - Barbara Falkensammer
- Institute of Virology, Department of Hygiene, Microbiology and Public Health, Medical University of Innsbruck, Peter-Mayr-Str. 4b, Innsbruck 6020, Austria
| | - Hanno Ulmer
- Department of Medical Statistics, Informatics and Health Economics, Medical University of Innsbruck, Austria
| | | | - Daniel Pichler
- Department of Hygiene, Microbiology and Public Health, Medical University of Innsbruck, Innsbruck 6020, Austria
| | - Matthias Baumgartner
- Department of Hygiene, Microbiology and Public Health, Medical University of Innsbruck, Innsbruck 6020, Austria
| | | | - Lukas Forer
- Institute of Genetic Epidemiology, Medical University of Innsbruck, Austria
| | - Ludwig Knabl
- Institute of Virology, Department of Hygiene, Microbiology and Public Health, Medical University of Innsbruck, Peter-Mayr-Str. 4b, Innsbruck 6020, Austria
| | - Reinhard Würzner
- Department of Hygiene, Microbiology and Public Health, Medical University of Innsbruck, Innsbruck 6020, Austria
| | - Dorothee von Laer
- Institute of Virology, Department of Hygiene, Microbiology and Public Health, Medical University of Innsbruck, Peter-Mayr-Str. 4b, Innsbruck 6020, Austria
| | - Jörg Paetzold
- University of Salzburg, Department of Economics, Residenzplatz 9, Salzburg A-5010, Austria.
| | - Janine Kimpel
- Institute of Virology, Department of Hygiene, Microbiology and Public Health, Medical University of Innsbruck, Peter-Mayr-Str. 4b, Innsbruck 6020, Austria.
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Schnitzer M, Winner H, Tappeiner G. Overtourism and support for sports mega events. Ann Tour Res 2021; 88:103065. [PMID: 33071393 PMCID: PMC7548119 DOI: 10.1016/j.annals.2020.103065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 07/29/2020] [Accepted: 08/27/2020] [Indexed: 06/11/2023]
Affiliation(s)
- Martin Schnitzer
- Department of Sport Science, University of Innsbruck, Fuerstenweg 185, A-6020 Innsbruck, Austria
| | - Hannes Winner
- Department of Social Sciences and Economics, University of Salzburg, Residenzplatz 9, A-5010 Salzburg, Austria
| | - Gottfried Tappeiner
- Department of Economic Theory, Policy and History, University of Innsbruck, Universitaetsstrasse 15, A-6020 Innsbruck, Austria
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Dzien C, Halder W, Winner H, Lechleitner M. Covid-19 screening: are forehead temperature measurements during cold outdoor temperatures really helpful? Wien Klin Wochenschr 2020; 133:331-335. [PMID: 33095321 PMCID: PMC7582437 DOI: 10.1007/s00508-020-01754-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 09/28/2020] [Indexed: 01/08/2023]
Abstract
Background Body temperature control is a frequently used screening test for infectious diseases, such as Covid-19 (Sars-CoV-2). We used this procedure to test the body temperature of staff members in a hospital in Tyrol (Austria), where the Covid-19 disease occurred in March 2020. The hospital is located in a mountain area at 995 m above sea level with low outdoor temperatures during early spring season. Under these conditions, we analyzed whether forehead temperature control offers a sufficient screening tool for infectious diseases. Methods Forehead temperature of 101 healthy male and female employees was measured with an infrared thermometer directly after entering the hospital (0 min), followed by further controls after 1 min, 3 min, 5 min and 60 min. We also tracked the outside temperature and the temperature at the entrance hall of the hospital. Results Complete data of body temperature were available for 46 female and 46 male study participants. The average forehead temperature measured directly after entrance to the hospital was the lowest (0 min) 33.17 ± 1.45 °C, and increased constantly to 34.90 ± 1.49 °C after 1 min, 35.77 ± 1.10 °C after 3 min, 36.08 ± 0.79 °C after 5 min, and 36.6 ± 0.24 °C after 60 min. The outside temperature ranged between −5.5 °C and 0 °C, the indoor temperature had a constant value of 20.5 °C. Conclusion Our results indicate that forehead infrared temperature control is not an appropriate tool to screen for infectious disease directly at the entrance of a building, at least during early spring season with cold outdoor temperatures.
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Affiliation(s)
- Cornelius Dzien
- Internal Medicine, Landeskrankenhaus Hochzirl-Natters, Hochzirl 1, 6170, Zirl, Austria.
| | - Wolfgang Halder
- Internal Medicine, Landeskrankenhaus Hochzirl-Natters, Hochzirl 1, 6170, Zirl, Austria
| | - Hannes Winner
- Department of Economics, University of Salzburg, 5010, Salzburg, Austria
| | - Monika Lechleitner
- Internal Medicine, Landeskrankenhaus Hochzirl-Natters, Hochzirl 1, 6170, Zirl, Austria
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Penuelas J, Krisztin T, Obersteiner M, Huber F, Winner H, Janssens IA, Ciais P, Sardans J. Country-Level Relationships of the Human Intake of N and P, Animal and Vegetable Food, and Alcoholic Beverages with Cancer and Life Expectancy. Int J Environ Res Public Health 2020; 17:E7240. [PMID: 33022999 PMCID: PMC7579602 DOI: 10.3390/ijerph17197240] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 09/27/2020] [Accepted: 09/28/2020] [Indexed: 01/26/2023]
Abstract
BACKGROUND The quantity, quality, and type (e.g., animal and vegetable) of human food have been correlated with human health, although with some contradictory or neutral results. We aimed to shed light on this association by using the integrated data at country level. METHODS We correlated elemental (nitrogen (N) and phosphorus (P)) compositions and stoichiometries (N:P ratios), molecular (proteins) and energetic traits (kilocalories) of food of animal (terrestrial or aquatic) and vegetable origin, and alcoholic beverages with cancer prevalence and mortality and life expectancy (LE) at birth at the country level. We used the official databases of United Nations (UN), Food and Agriculture Organization of the United Nations (FAO), Organization for Economic Co-operation and Development (OECD), World Bank, World Health Organization (WHO), U.S. Department of Agriculture, U.S. Department of Health, and Eurobarometer, while also considering other possibly involved variables such as income, mean age, or human development index of each country. RESULTS The per capita intakes of N, P, protein, and total intake from terrestrial animals, and especially alcohol were significantly and positively associated with prevalence and mortality from total, colon, lung, breast, and prostate cancers. In contrast, high per capita intakes of vegetable N, P, N:P, protein, and total plant intake exhibited negative relationships with cancer prevalence and mortality. However, a high LE at birth, especially in underdeveloped countries was more strongly correlated with a higher intake of food, independent of its animal or vegetable origin, than with other variables, such as higher income or the human development index. CONCLUSIONS Our analyses, thus, yielded four generally consistent conclusions. First, the excessive intake of terrestrial animal food, especially the levels of protein, N, and P, is associated with higher prevalence of cancer, whereas equivalent intake from vegetables is associated with lower prevalence. Second, no consistent relationship was found for food N:P ratio and cancer prevalence. Third, the consumption of alcoholic beverages correlates with prevalence and mortality by malignant neoplasms. Fourth, in underdeveloped countries, reducing famine has a greater positive impact on health and LE than a healthier diet.
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Affiliation(s)
- Josep Penuelas
- CSIC, Global Ecology Unit CREAF-CSIC-UAB, 08193 Cerdanyola del Vallès, Spain;
- CREAF, 08193 Cerdanyola del Vallès, Spain
| | - Tamás Krisztin
- International Institute for Applied Systems Analysis (IIASA), Ecosystems Services and Management, Schlossplatz 1, A-2361 Laxenburg, Austria; (T.K.); (M.O.)
| | - Michael Obersteiner
- International Institute for Applied Systems Analysis (IIASA), Ecosystems Services and Management, Schlossplatz 1, A-2361 Laxenburg, Austria; (T.K.); (M.O.)
| | - Florian Huber
- Paris Lodron University of Salzburg, Mönchsberg 2a, A-5020 Salzburg, Austria; (F.H.); (H.W.)
| | - Hannes Winner
- Paris Lodron University of Salzburg, Mönchsberg 2a, A-5020 Salzburg, Austria; (F.H.); (H.W.)
- Austrian Institute of Economic Research (WIFO), Arsenal Objekt 20, A-1030 Vienna, Austria
| | - Ivan A. Janssens
- Research Group Plants and Ecosystems (PLECO), Department of Biology, University of Antwerp, B-2610 Wilrijk, Belgium;
| | - Philippe Ciais
- Laboratoire des Sciences du Climat et de l’Environnement, IPSL, 91191 Gif-sur-Yvette, France;
| | - Jordi Sardans
- CSIC, Global Ecology Unit CREAF-CSIC-UAB, 08193 Cerdanyola del Vallès, Spain;
- CREAF, 08193 Cerdanyola del Vallès, Spain
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Dzien A, Dzien-Bischinger C, Lechleitner M, Winner H, Weiss G. Will the COVID-19 pandemic slow down in the Northern hemisphere by the onset of summer? An epidemiological hypothesis. Infection 2020; 48:627-629. [PMID: 32578052 PMCID: PMC7309422 DOI: 10.1007/s15010-020-01460-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 05/30/2020] [Indexed: 01/05/2023]
Abstract
The COVID-19 pandemic has affected most countries of the world. As corona viruses are highly prevalent in the cold season, the question remains whether or not the pandemic will improve with increasing temperatures in the Northern hemisphere. We use data from a primary care registry of almost 15,000 patients over 20 years to retrieve information on viral respiratory infection outbreaks. Our analysis suggests that the severity of the pandemic will be softened by the seasonal change to summer.
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Affiliation(s)
| | | | - Monika Lechleitner
- Department of Internal Medicine, District Hospital Hochzirl-Natters, Innsbruck, Austria
| | - Hannes Winner
- Department of Social Sciences and Economics, University of Salzburg, Salzburg, Austria
| | - Günter Weiss
- Department of Internal Medicine II, Medical University of Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria.
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Dzien A, Winner H, Theurl E, Dzien-Bischinger C, Lechleitner M. Ageing and fasting glucose values – the role of cardiovascular events. Eur Geriatr Med 2015. [DOI: 10.1016/j.eurger.2015.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Gächter M, Schwazer P, Theurl E, Winner H. Regional density of private dentists: empirical evidence from Austria. Community Dent Oral Epidemiol 2013; 42:20-9. [DOI: 10.1111/cdoe.12054] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2012] [Accepted: 04/29/2013] [Indexed: 11/28/2022]
Affiliation(s)
- Martin Gächter
- Department of Economics and Statistics; University of Innsbruck; Innsbruck Austria
| | - Peter Schwazer
- Department of Economics and Statistics; University of Innsbruck; Innsbruck Austria
| | - Engelbert Theurl
- Department of Economics and Statistics; University of Innsbruck; Innsbruck Austria
| | - Hannes Winner
- Department of Economics and Social Sciences; University of Salzburg and Austrian Institute for Economic Research; Salzburg Austria
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Dzien A, Winner H, Theurl E, Dzien-Bischinger C, Lechleitner M. Fat-free mass and fasting glucose values in patients with and without statin therapy assigned to age groups between <60 and >75 years. Obes Facts 2013; 6:9-16. [PMID: 23434893 PMCID: PMC5644737 DOI: 10.1159/000348573] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2012] [Accepted: 07/25/2012] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVE The aging-associated changes in body composition result in an increased cardiometabolic risk. A tremendous reduction of cardiovascular morbidity and mortality can be obtained by statin therapy. Statins are well tolerated, with myopathy as the most serious negative side effect. Some recently published studies indicate that the incidence of type 2 diabetes might be increased during intensified statin therapy. The aim of our study was to investigate whether statin therapy has an influence on the aging-associated changes in fat-free mass (FFM). METHODS A total of 3,280 persons attending a medical outdoor center between January 2005 and July 2011 were assigned to 3 age groups from <60 to >75 years. Clinical data, body mass index (BMI), and body composition were evaluated in the different age groups in patients with and without statin therapy. To analyze the impact of statin use on FFM, we regressed a patient's FFM on an interaction term between statin use and age and other control variables. RESULTS Aging was associated with a decrease in BMI and FFM, while fat mass continuously increased up to the age of >75 years. This was paralleled by a continuous increase in fasting glucose levels in patients with and without statin therapy. The loss of FFM between the age group <60 years and >75 years was more pronounced in statin-treated patients (10.88%) than in non-statin users (8.47%). Creatine phosphokinase values revealed a decrease of 7.77 U/l between the age groups <60 and >75 years in non-statin users and of 14.75 U/l in statin users. Statistical analysis indicated that the effect of statin therapy on FFM is more pronounced in younger than in older patients. CONCLUSIONS Patients under statin therapy seem to be more vulnerable to the aging-associated lowering of FFM. Diagnostic procedures and interventions to prevent a loss of muscle mass might be of particular advantage in elderly patients under statin therapy.
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Affiliation(s)
- Alexander Dzien
- Medical Center Hentschelhof, Innsbruck, University of Salzburg, Salzburg, Austria
| | - Hannes Winner
- Department of Economics and Social Sciences, University of Salzburg, Salzburg, Austria
| | - Engelbert Theurl
- Department of Public Economics, University of Innsbruck, Innsbruck, Zirl, Austria
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Abstract
We investigate the density of non-contract (private) physicians in a two-tiered health care system, i.e., one with co-existing public and private health care providers. In particular, we analyze how the densities of private and public suppliers of outpatient health care (general practitioners and specialists) are related to each other. Using a panel of 121 Austrian districts between 2002 and 2008, we apply a Hausman-Taylor estimator, which allows to treat each of these densities as endogenous. We find that the density of non-contract specialists is positively associated with the density of non-contract general practitioners, but not significantly related to the density of contract general practitioners. We also observe a negative relationship between the densities of non-contract and contract general practitioners and the ones of non-contract and contract specialists, indicating competitive forces between the private and the public sector of the outpatient health care provision in Austria. Our results contribute to the ongoing debate on the role of non-contract physicians for health care provision in Austria.
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Affiliation(s)
- Martin Gächter
- Department of Economics and Statistics, University of Innsbruck, Universitätsstrasse 15, A-6020 Innsbruck, Austria.
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Theurl E, Winner H. The male-female gap in physician earnings: evidence from a public health insurance system. Health Econ 2011; 20:1184-200. [PMID: 20853520 DOI: 10.1002/hec.1663] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2007] [Revised: 07/25/2010] [Accepted: 08/04/2010] [Indexed: 05/21/2023]
Abstract
Empirical evidence from US studies suggests that female physicians earn less than their male counterparts, on average. The earnings gap does not disappear when individual and market characteristics are controlled for. This paper investigates whether a gender earnings difference can also be observed in a health-care system predominantly financed by public insurance companies. Using a unique data set of physicians' earnings recorded by a public social security agency in an Austrian province between 2000 and 2004, we find a gender gap in average earnings of about 32%. A substantial share of this gap (20-47%) cannot be explained by individual and market characteristics, leaving labor market discrimination as one possible explanation for the observed gender earnings difference of physicians.
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Affiliation(s)
- Engelbert Theurl
- Department of Economics and Statistics, University of Innsbruck, Austria.
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Dzien A, Winner H, Theurl E, Dzien-Bischinger C, Lechleitner M. Body mass index in a large cohort of patients assigned to age decades between <20 and ≥80 years: relationship with cardiovascular morbidity and medication. J Nutr Health Aging 2011; 15:536-41. [PMID: 21808931 DOI: 10.1007/s12603-011-0055-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE There is an ongoing debate about the relationship between obesity and morbidity in the elderly, the clinical relevance of overweight and obesity in older patients and the need or harms of treatment. The main purpose of our study was to investigate whether a higher BMI is associated with a worse cardiovascular risk in all age groups, especially in the older ones. SUBJECTS AND DESIGN We performed a retrospective evaluation of clinical data from 3926 patients who visited a medical outdoor center for diagnostic and/or therapeutic interventions in the period from January 1995 to July 2010. Patients were assigned to eight age groups of one decade from <20 years to ≥80 years. RESULTS The Body Mass Index (BMI) of our patients showed a continuous increase with increasing age with peak values in the age decade 61-70 years (26.29 ±4.42 kg/m2). This was paralleled by an increase in cardiovascular events and need for continuous medication, demonstrating peak values in the age decade 61-70 years (22.3% in the female and 24.7% in the male group). In all age decades up to 80 years the BMI values were higher in patients with events compared to those without it. multivariable linear regression analysis - including confounding variables (blood pressure, fasting glucose, HDL-cholesterol, triglycerides, physical activity, smoking) - revealed for all age groups a strong positive relation of BMI and a negative relation of fat free mass (FFM) to the probability for a cardiovascular event and need for medication. CONCLUSION In all age groups, the percentage of cardiovascular events was directly correlated with the BMI. Having in mind the transition to an aging society, therapeutic and preventive strategies should, therefore, include weight management strategies also for the elderly.
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Affiliation(s)
- A Dzien
- Medical Center Hentschelhof, Buergerstrasse, Innsbruck, Austria
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Theurl E, Winner H. The impact of hospital financing on the length of stay: evidence from Austria. Health Policy 2006; 82:375-89. [PMID: 17166618 DOI: 10.1016/j.healthpol.2006.11.001] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2006] [Revised: 10/08/2006] [Accepted: 11/01/2006] [Indexed: 11/17/2022]
Abstract
In 1997, Austria has changed the hospital financing system from a per diem-based payment scheme to a per case-based one. This paper assesses whether this reform has influenced the hospital length of stay. Empirically, we use data for 20 diagnostic groups (according to the ICD10) from the nine Austrian provinces (Bundesländer) between 1989 and 2003. Our findings suggest that the change of the hospital financing system has induced a substantial decrease in the average hospital length of stay. This effect is more pronounced for diagnostic groups with a longer length of stay.
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Affiliation(s)
- Engelbert Theurl
- Department of Economics and Statistics, University of Innsbruck, Universitaetsstrasse 15, A-6020 Innsbruck, Austria.
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