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Nørgaard SK, Nielsen J, Nordholm AC, Richter L, Chalupka A, Sierra NB, Braeye T, Athanasiadou M, Lytras T, Denissov G, Luomala O, Fouillet A, Pontais I, An der Heiden M, Zacher B, Weigel A, Foppa I, Gkolfinopoulou K, Panagoulias I, Paldy A, Malnasi T, Domegan L, Kelly E, Rotem N, Rakhlin O, de'Donato FK, Di Blasi C, Hoffmann P, Velez T, England K, Calleja N, van Asten L, Jongenotter F, Rodrigues AP, Silva S, Klepac P, Gomez-Barroso D, Gomez IL, Galanis I, Farah A, Weitkunat R, Fehst K, Andrews N, Clare T, Bradley DT, O'Doherty MG, William N, Hamilton M, Søborg B, Krause TG, Bundle N, Vestergaard LS. Excess mortality in Europe coincides with peaks of COVID-19, influenza and respiratory syncytial virus (RSV), November 2023 to February 2024. Euro Surveill 2024; 29:2400178. [PMID: 38606570 PMCID: PMC11010589 DOI: 10.2807/1560-7917.es.2024.29.15.2400178] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Accepted: 04/11/2024] [Indexed: 04/13/2024] Open
Abstract
Since the end of November 2023, the European Mortality Monitoring Network (EuroMOMO) has observed excess mortality in Europe. During weeks 48 2023-6 2024, preliminary results show a substantially increased rate of 95.3 (95% CI: 91.7-98.9) excess all-cause deaths per 100,000 person-years for all ages. This excess mortality is seen in adults aged 45 years and older, and coincides with widespread presence of COVID-19, influenza and respiratory syncytial virus (RSV) observed in many European countries during the 2023/24 winter season.
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Affiliation(s)
- Sarah K Nørgaard
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
| | - Jens Nielsen
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
| | - Anne Christine Nordholm
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
| | - Lukas Richter
- Austrian Agency for Health and Food Safety, Vienna, Austria
| | - Alena Chalupka
- Austrian Agency for Health and Food Safety, Vienna, Austria
| | | | | | | | - Theodore Lytras
- School of Medicine, European University Cyprus, Nicosia, Cyprus
| | - Gleb Denissov
- National Institute for Health Development, Tallinn, Estonia
| | - Oskari Luomala
- Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | | | | | | | | | - Alina Weigel
- Hessisches Landesamt für Gesundheit und Pflege, Dillenburg, Germany
| | - Ivo Foppa
- Hessisches Landesamt für Gesundheit und Pflege, Dillenburg, Germany
| | | | | | - Anna Paldy
- National Center for Public Health and Pharmacy, Budapest, Hungary
| | - Tibor Malnasi
- National Center for Public Health and Pharmacy, Budapest, Hungary
| | - Lisa Domegan
- Health-Service Executive - Health Protection Surveillance Centre, Dublin, Ireland
| | - Eva Kelly
- Health-Service Executive - Health Protection Surveillance Centre, Dublin, Ireland
| | - Naama Rotem
- Central Bureau of Statistics, Jerusalem, Israel
| | | | | | - Chiara Di Blasi
- Department of Epidemiology Lazio Regional Health System - ASL Roma 1, Rome, Italy
| | | | | | | | - Neville Calleja
- Directorate for Health Information and Research, Pieta, Malta
| | - Liselotte van Asten
- Centre for Infectious Disease Control Netherlands, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Femke Jongenotter
- Centre for Infectious Disease Control Netherlands, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Ana Paula Rodrigues
- Department of Epidemiology, Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisbon, Portugal
| | - Susana Silva
- Department of Epidemiology, Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisbon, Portugal
| | - Petra Klepac
- Communicable Diseases Centre, National Institute of Public Health, Ljubljana, Slovenia
| | - Diana Gomez-Barroso
- National Centre of Epidemiology, CIBER Epidemiología y Salud Pública (CIBERESP), Carlos III Health Institute, Madrid, Spain
| | - Inmaculada Leon Gomez
- National Centre of Epidemiology, CIBER Epidemiología y Salud Pública (CIBERESP), Carlos III Health Institute, Madrid, Spain
| | | | - Ahmed Farah
- Public Health Agency of Sweden, Stockholm, Sweden
| | | | | | - Nick Andrews
- UK Health Security Agency, London, United Kingdom
| | - Tom Clare
- UK Health Security Agency, London, United Kingdom
| | | | | | | | | | - Bolette Søborg
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
| | - Tyra G Krause
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
| | - Nick Bundle
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Lasse S Vestergaard
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
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Abstract
BACKGROUND CHD refers to structural cardiac abnormalities which comprise the commonest group of congenital malformations. Malta is a small island in the central Mediterranean with excellent diagnostic and therapeutic facilities. It is unique in the European population as termination of pregnancy is illegal. This study was carried out to ascertain patterns in CHD prevalence in comparison with EUROCAT data (European Surveillance of Congenital Anomalies). METHODS Anonymised data were obtained from the EUROCAT website for 1993-2020. RESULTS There were a total of 22,833,032 births from all EUROCAT Registries, of which 121,697 were from Malta. The prevalence rate for Malta CHD was 32.38/10,000 births (at the higher end of the range). Malta had a significant excess of commoner, comparatively non-severe CHDs. For most of the severe lesions analysed rates reported were higher than EUROCAT average, however, apart from Ebstein's anomaly, they all fell within the ranges reported from the different registries. DISCUSSION Wide variations in reported CHD prevalence are known, and the Malta rates may be higher for milder defects due to quicker pickup prior to spontaneous resolution. There may also be a higher pickup of milder forms of more severe conditions. For the more severe conditions, lack of termination may be the explanation. These factors may result in the higher neonatal mortality observed in Malta.
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Affiliation(s)
- Victor Grech
- Paediatric Department, Mater Dei Hospital, Tal-Qroqq, Malta
| | - Miriam Gatt
- Department of Health Information and Research Guardamangia, Health Ministry, Guardamangia, Malta
| | - Neville Calleja
- Department of Health Information and Research Guardamangia, Health Ministry, Guardamangia, Malta
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Cauchi JP, Dziugyte A, Borg ML, Melillo T, Zahra G, Barbara C, Souness J, Agius S, Calleja N, Gauci C, Vassallo P, Baruch J. Hybrid immunity and protection against infection during the Omicron wave in Malta. Emerg Microbes Infect 2023; 12:e2156814. [PMID: 36510837 PMCID: PMC9817114 DOI: 10.1080/22221751.2022.2156814] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
By December 2021, administration of the third dose of COVID-19 vaccinations coincided with the spread of the Omicron variant in Europe. Questions had been raised on protection against infection conferred by previous vaccination and/or infection. Our study population included 252,433 participants from the COVID-19 vaccination registry in Malta. Data were then matched with the national testing database. We collected vaccination status, vaccine brand, vaccination date, infection history, and age. Using logistic regression, we examined different combinations of vaccine dose, prior infection status and time, and the odds of infection during the period when the Omicron variant was the dominant variant in Malta. Participants infected with Sars-Cov-2 prior to the Omicron wave had a significantly lower odds of being infected with the Omicron variant. Additionally, the more recent the infection and the more recent the vaccination, the lower the odds of infection. Receiving a third dose within 20 weeks of the start of the Omicron wave in Malta offered similar odds of infection as receiving a second dose within the same period. Time since vaccination was a strong determinant against infection, as was previous infection status and the number of doses taken. This finding reinforces the importance of future booster dose provision especially to vulnerable populations.
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Affiliation(s)
- John Paul Cauchi
- Infectious Disease Prevention and Control Unit (IDCU), Health Promotion and Disease Prevention, Msida, Malta, John Paul Cauchi
| | - Ausra Dziugyte
- Infectious Disease Prevention and Control Unit (IDCU), Health Promotion and Disease Prevention, Msida, Malta
| | - Maria-Louise Borg
- Infectious Disease Prevention and Control Unit (IDCU), Health Promotion and Disease Prevention, Msida, Malta
| | - Tanya Melillo
- Infectious Disease Prevention and Control Unit (IDCU), Health Promotion and Disease Prevention, Msida, Malta
| | - Graziella Zahra
- Molecular Diagnostics Pathology Department, Mater Dei Hospital, Msida, Malta
| | - Christopher Barbara
- Molecular Diagnostics Pathology Department, Mater Dei Hospital, Msida, Malta
| | | | | | | | - Charmaine Gauci
- Ministry for Health, Superintendent of Public Health, Msida, Malta
| | - Pauline Vassallo
- Infectious Disease Prevention and Control Unit (IDCU), Health Promotion and Disease Prevention, Msida, Malta
| | - Joaquin Baruch
- Infectious Disease Prevention and Control Unit (IDCU), Health Promotion and Disease Prevention, Msida, Malta,EPIET Programme, European Centre for Disease Prevention and Control, Solna, Sweden
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4
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Stafoggia M, Michelozzi P, Schneider A, Armstrong B, Scortichini M, Rai M, Achilleos S, Alahmad B, Analitis A, Åström C, Bell ML, Calleja N, Krage Carlsen H, Carrasco G, Paul Cauchi J, Dszs Coelho M, Correa PM, Diaz MH, Entezari A, Forsberg B, Garland RM, Leon Guo Y, Guo Y, Hashizume M, Holobaca IH, Íñiguez C, Jaakkola JJK, Kan H, Katsouyanni K, Kim H, Kyselý J, Lavigne E, Lee W, Li S, Maasikmets M, Madureira J, Mayvaneh F, Fook Sheng Ng C, Nunes B, Orru H, V Ortega N, Osorio S, Palomares ADL, Pan SC, Pascal M, Ragettli MS, Rao S, Raz R, Roye D, Ryti N, Hn Saldiva P, Samoli E, Schwartz J, Scovronick N, Sera F, Tobias A, Tong S, Dlc Valencia C, Maria Vicedo-Cabrera A, Urban A, Gasparrini A, Breitner S, De' Donato FK. Joint effect of heat and air pollution on mortality in 620 cities of 36 countries. Environ Int 2023; 181:108258. [PMID: 37837748 PMCID: PMC10702017 DOI: 10.1016/j.envint.2023.108258] [Citation(s) in RCA: 3] [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] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Revised: 09/08/2023] [Accepted: 10/09/2023] [Indexed: 10/16/2023]
Abstract
BACKGROUND The epidemiological evidence on the interaction between heat and ambient air pollution on mortality is still inconsistent. OBJECTIVES To investigate the interaction between heat and ambient air pollution on daily mortality in a large dataset of 620 cities from 36 countries. METHODS We used daily data on all-cause mortality, air temperature, particulate matter ≤ 10 μm (PM10), PM ≤ 2.5 μm (PM2.5), nitrogen dioxide (NO2), and ozone (O3) from 620 cities in 36 countries in the period 1995-2020. We restricted the analysis to the six consecutive warmest months in each city. City-specific data were analysed with over-dispersed Poisson regression models, followed by a multilevel random-effects meta-analysis. The joint association between air temperature and air pollutants was modelled with product terms between non-linear functions for air temperature and linear functions for air pollutants. RESULTS We analyzed 22,630,598 deaths. An increase in mean temperature from the 75th to the 99th percentile of city-specific distributions was associated with an average 8.9 % (95 % confidence interval: 7.1 %, 10.7 %) mortality increment, ranging between 5.3 % (3.8 %, 6.9 %) and 12.8 % (8.7 %, 17.0 %), when daily PM10 was equal to 10 or 90 μg/m3, respectively. Corresponding estimates when daily O3 concentrations were 40 or 160 μg/m3 were 2.9 % (1.1 %, 4.7 %) and 12.5 % (6.9 %, 18.5 %), respectively. Similarly, a 10 μg/m3 increment in PM10 was associated with a 0.54 % (0.10 %, 0.98 %) and 1.21 % (0.69 %, 1.72 %) increase in mortality when daily air temperature was set to the 1st and 99th city-specific percentiles, respectively. Corresponding mortality estimate for O3 across these temperature percentiles were 0.00 % (-0.44 %, 0.44 %) and 0.53 % (0.38 %, 0.68 %). Similar effect modification results, although slightly weaker, were found for PM2.5 and NO2. CONCLUSIONS Suggestive evidence of effect modification between air temperature and air pollutants on mortality during the warm period was found in a global dataset of 620 cities.
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Affiliation(s)
- Massimo Stafoggia
- Department of Epidemiology, Lazio Region Health Service / ASL Roma 1, Via C. Colombo 112, 00147 Rome, Italy.
| | - Paola Michelozzi
- Department of Epidemiology, Lazio Region Health Service / ASL Roma 1, Via C. Colombo 112, 00147 Rome, Italy
| | - Alexandra Schneider
- Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health (GmbH), Neuherberg, Germany
| | - Ben Armstrong
- Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Matteo Scortichini
- Department of Epidemiology, Lazio Region Health Service / ASL Roma 1, Via C. Colombo 112, 00147 Rome, Italy
| | - Masna Rai
- Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health (GmbH), Neuherberg, Germany
| | - Souzana Achilleos
- Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus
| | - Barrak Alahmad
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Antonis Analitis
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Greece
| | - Christofer Åström
- Department of Public Health and Clinical Medicine, Umeå University, Sweden
| | - Michelle L Bell
- School of the Environment, Yale University, New Haven CT, USA
| | | | - Hanne Krage Carlsen
- School of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Gabriel Carrasco
- Institute of Tropical Medicine "Alexander von Humboldt", Universidad Peruana Cayetano Heredia, Lima, Peru
| | | | - Micheline Dszs Coelho
- Department of Pathology, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Patricia M Correa
- Department of Public Health, Universidad de los Andes, Santiago, Chile
| | - Magali H Diaz
- Department of Environmental Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Alireza Entezari
- Faculty of Geography and Environmental Sciences, Hakim Sabzevari University, Sabzevar 9617916487, Khorasan Razavi, Iran
| | - Bertil Forsberg
- Department of Public Health and Clinical Medicine, Umeå University, Sweden
| | - Rebecca M Garland
- Department of Geography, Geoinformatics and Meteorology, University of Pretoria, Pretoria, South Africa
| | - Yue Leon Guo
- Environmental and Occupational Medicine, and Institute of Environmental and Occupational Health Sciences, National Taiwan University (NTU) and NTU Hospital, Taipei, Taiwan
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Masahiro Hashizume
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | | | - Carmen Íñiguez
- Department of Statistics and Computational Research, Universitat de València, València, Spain
| | - Jouni J K Jaakkola
- Center for Environmental and Respiratory Health Research (CERH), University of Oulu, Oulu, Finland
| | - Haidong Kan
- Department of Environmental Health, School of Public Health, Fudan University, Shanghai, China
| | - Klea Katsouyanni
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Greece; Environmental Research Group, School of Public Health, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Ho Kim
- Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Jan Kyselý
- Institute of Atmospheric Physics, Czech Academy of Sciences, Prague, Czech Republic; Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic
| | - Eric Lavigne
- School of Epidemiology & Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada; Environmental Health Science and Research Bureau, Health Canada, Ottawa, Canada
| | - Whanhee Lee
- School of the Environment, Yale University, New Haven CT, USA
| | - Shanshan Li
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | | | - Joana Madureira
- Department of Environmental Health, Instituto Nacional de Saúde Dr. Ricardo Jorge, Porto, Portugal; EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
| | - Fatemeh Mayvaneh
- Faculty of Geography and Environmental Sciences, Hakim Sabzevari University, Sabzevar 9617916487, Khorasan Razavi, Iran
| | - Chris Fook Sheng Ng
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Baltazar Nunes
- Department of Epidemiology, Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisbon, Portugal
| | - Hans Orru
- Department of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Nicolás V Ortega
- Department of Public Health, Universidad de los Andes, Santiago, Chile
| | - Samuel Osorio
- Department of Environmental Health, University of São Paulo, São Paulo, Brazil
| | | | - Shih-Chun Pan
- National Institute of Environmental Health Science, National Health Research Institutes, Zhunan, Taiwan
| | - Mathilde Pascal
- Santé Publique France, Department of Environmental Health, French National Public Health Agency, Saint Maurice, France
| | | | - Shilpa Rao
- Norwegian Institute of Public Health, Oslo, Norway
| | - Raanan Raz
- Braun School of Public Health and Community Medicine, The Hebrew University of Jerusalem, Israel
| | - Dominic Roye
- Climate Research Foundation, Madrid, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain
| | - Niilo Ryti
- Center for Environmental and Respiratory Health Research (CERH), University of Oulu, Oulu, Finland
| | - Paulo Hn Saldiva
- Department of Pathology, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Evangelia Samoli
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Greece
| | - Joel Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Noah Scovronick
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, USA
| | - Francesco Sera
- Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, United Kingdom; Department of Statistics, Computer Science and Applications "G. Parenti", University of Florence, Florence, Italy
| | - Aurelio Tobias
- Institute of Environmental Assessment and Water Research (IDAEA), Spanish Council for Scientific Research (CSIC), Barcelona, Spain
| | - Shilu Tong
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| | - César Dlc Valencia
- Department of Environmental Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Ana Maria Vicedo-Cabrera
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland; Oeschger Center for Climate Change Research, University of Bern, Bern, Switzerland
| | - Aleš Urban
- Institute of Atmospheric Physics, Czech Academy of Sciences, Prague, Czech Republic; Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic
| | - Antonio Gasparrini
- Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | | | - Francesca K De' Donato
- Department of Epidemiology, Lazio Region Health Service / ASL Roma 1, Via C. Colombo 112, 00147 Rome, Italy
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5
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Girardi F, Matz M, Stiller C, You H, Marcos Gragera R, Valkov MY, Bulliard JL, De P, Morrison D, Wanner M, O'Brian DK, Saint-Jacques N, Coleman MP, Allemani C, Hamdi-Chérif M, Kara L, Meguenni K, Regagba D, Bayo S, Cheick Bougadari T, Manraj SS, Bendahhou K, Ladipo A, Ogunbiyi OJ, Somdyala NIM, Chaplin MA, Moreno F, Calabrano GH, Espinola SB, Carballo Quintero B, Fita R, Laspada WD, Ibañez SG, Lima CA, Da Costa AM, De Souza PCF, Chaves J, Laporte CA, Curado MP, de Oliveira JC, Veneziano CLA, Veneziano DB, Almeida ABM, Latorre MRDO, Rebelo MS, Santos MO, Azevedo e Silva G, Galaz JC, Aparicio Aravena M, Sanhueza Monsalve J, Herrmann DA, Vargas S, Herrera VM, Uribe CJ, Bravo LE, Garcia LS, Arias-Ortiz NE, Morantes D, Jurado DM, Yépez Chamorro MC, Delgado S, Ramirez M, Galán Alvarez YH, Torres P, Martínez-Reyes F, Jaramillo L, Quinto R, Castillo J, Mendoza M, Cueva P, Yépez JG, Bhakkan B, Deloumeaux J, Joachim C, Macni J, Carrillo R, Shalkow Klincovstein J, Rivera Gomez R, Perez P, Poquioma E, Tortolero-Luna G, Zavala D, Alonso R, Barrios E, Eckstrand A, Nikiforuk C, Woods RR, Noonan G, Turner D, Kumar E, Zhang B, Dowden JJ, Doyle GP, Saint-Jacques N, Walsh G, Anam A, De P, McClure CA, Vriends KA, Bertrand C, Ramanakumar AV, Davis L, Kozie S, Freeman T, George JT, Avila RM, O’Brien DK, Holt A, Almon L, Kwong S, Morris C, Rycroft R, Mueller L, Phillips CE, Brown H, Cromartie B, Ruterbusch J, Schwartz AG, Levin GM, Wohler B, Bayakly R, Ward KC, Gomez SL, McKinley M, Cress R, Davis J, Hernandez B, Johnson CJ, Morawski BM, Ruppert LP, Bentler S, Charlton ME, Huang B, Tucker TC, Deapen D, Liu L, Hsieh MC, Wu XC, Schwenn M, Stern K, Gershman ST, Knowlton RC, Alverson G, Weaver T, Desai J, Rogers DB, Jackson-Thompson J, Lemons D, Zimmerman HJ, Hood M, Roberts-Johnson J, Hammond W, Rees JR, Pawlish KS, Stroup A, Key C, Wiggins C, Kahn AR, Schymura MJ, Radhakrishnan S, Rao C, Giljahn LK, Slocumb RM, Dabbs C, Espinoza RE, Aird KG, Beran T, Rubertone JJ, Slack SJ, Oh J, Janes TA, Schwartz SM, Chiodini SC, Hurley DM, Whiteside MA, Rai S, Williams MA, Herget K, Sweeney C, Kachajian J, Keitheri Cheteri MB, Migliore Santiago P, Blankenship SE, Conaway JL, Borchers R, Malicki R, Espinoza J, Grandpre J, Weir HK, Wilson R, Edwards BK, Mariotto A, Rodriguez-Galindo C, Wang N, Yang L, Chen JS, Zhou Y, He YT, Song GH, Gu XP, Mei D, Mu HJ, Ge HM, Wu TH, Li YY, Zhao DL, Jin F, Zhang JH, Zhu FD, Junhua Q, Yang YL, Jiang CX, Biao W, Wang J, Li QL, Yi H, Zhou X, Dong J, Li W, Fu FX, Liu SZ, Chen JG, Zhu J, Li YH, Lu YQ, Fan M, Huang SQ, Guo GP, Zhaolai H, Wei K, Chen WQ, Wei W, Zeng H, Demetriou AV, Mang WK, Ngan KC, Kataki AC, Krishnatreya M, Jayalekshmi PA, Sebastian P, George PS, Mathew A, Nandakumar A, Malekzadeh R, Roshandel G, Keinan-Boker L, Silverman BG, Ito H, Koyanagi Y, Sato M, Tobori F, Nakata I, Teramoto N, Hattori M, Kaizaki Y, Moki F, Sugiyama H, Utada M, Nishimura M, Yoshida K, Kurosawa K, Nemoto Y, Narimatsu H, Sakaguchi M, Kanemura S, Naito M, Narisawa R, Miyashiro I, Nakata K, Mori D, Yoshitake M, Oki I, Fukushima N, Shibata A, Iwasa K, Ono C, Matsuda T, Nimri O, Jung KW, Won YJ, Alawadhi E, Elbasmi A, Ab Manan A, Adam F, Nansalmaa E, Tudev U, Ochir C, Al Khater AM, El Mistiri MM, Lim GH, Teo YY, Chiang CJ, Lee WC, Buasom R, Sangrajrang S, Suwanrungruang K, Vatanasapt P, Daoprasert K, Pongnikorn D, Leklob A, Sangkitipaiboon S, Geater SL, Sriplung H, Ceylan O, Kög I, Dirican O, Köse T, Gurbuz T, Karaşahin FE, Turhan D, Aktaş U, Halat Y, Eser S, Yakut CI, Altinisik M, Cavusoglu Y, Türkköylü A, Üçüncü N, Hackl M, Zborovskaya AA, Aleinikova OV, Henau K, Van Eycken L, Atanasov TY, Valerianova Z, Šekerija M, Dušek L, Zvolský M, Steinrud Mørch L, Storm H, Wessel Skovlund C, Innos K, Mägi M, Malila N, Seppä K, Jégu J, Velten M, Cornet E, Troussard X, Bouvier AM, Guizard AV, Bouvier V, Launoy G, Dabakuyo Yonli S, Poillot ML, Maynadié M, Mounier M, Vaconnet L, Woronoff AS, Daoulas M, Robaszkiewicz M, Clavel J, Poulalhon C, Desandes E, Lacour B, Baldi I, Amadeo B, Coureau G, Monnereau A, Orazio S, Audoin M, D’Almeida TC, Boyer S, Hammas K, Trétarre B, Colonna M, Delafosse P, Plouvier S, Cowppli-Bony A, Molinié F, Bara S, Ganry O, Lapôtre-Ledoux B, Daubisse-Marliac L, Bossard N, Uhry Z, Estève J, Stabenow R, Wilsdorf-Köhler H, Eberle A, Luttmann S, Löhden I, Nennecke AL, Kieschke J, Sirri E, Justenhoven C, Reinwald F, Holleczek B, Eisemann N, Katalinic A, Asquez RA, Kumar V, Petridou E, Ólafsdóttir EJ, Tryggvadóttir L, Murray DE, Walsh PM, Sundseth H, Harney M, Mazzoleni G, Vittadello F, Coviello E, Cuccaro F, Galasso R, Sampietro G, Giacomin A, Magoni M, Ardizzone A, D’Argenzio A, Di Prima AA, Ippolito A, Lavecchia AM, Sutera Sardo A, Gola G, Ballotari P, Giacomazzi E, Ferretti S, Dal Maso L, Serraino D, Celesia MV, Filiberti RA, Pannozzo F, Melcarne A, Quarta F, Andreano A, Russo AG, Carrozzi G, Cirilli C, Cavalieri d’Oro L, Rognoni M, Fusco M, Vitale MF, Usala M, Cusimano R, Mazzucco W, Michiara M, Sgargi P, Boschetti L, Marguati S, Chiaranda G, Seghini P, Maule MM, Merletti F, Spata E, Tumino R, Mancuso P, Cassetti T, Sassatelli R, Falcini F, Giorgetti S, Caiazzo AL, Cavallo R, Piras D, Bella F, Madeddu A, Fanetti AC, Maspero S, Carone S, Mincuzzi A, Candela G, Scuderi T, Gentilini MA, Rizzello R, Rosso S, Caldarella A, Intrieri T, Bianconi F, Contiero P, Tagliabue G, Rugge M, Zorzi M, Beggiato S, Brustolin A, Gatta G, De Angelis R, Vicentini M, Zanetti R, Stracci F, Maurina A, Oniščuka M, Mousavi M, Steponaviciene L, Vincerževskienė I, Azzopardi MJ, Calleja N, Siesling S, Visser O, Johannesen TB, Larønningen S, Trojanowski M, Macek P, Mierzwa T, Rachtan J, Rosińska A, Kępska K, Kościańska B, Barna K, Sulkowska U, Gebauer T, Łapińska JB, Wójcik-Tomaszewska J, Motnyk M, Patro A, Gos A, Sikorska K, Bielska-Lasota M, Didkowska JA, Wojciechowska U, Forjaz de Lacerda G, Rego RA, Carrito B, Pais A, Bento MJ, Rodrigues J, Lourenço A, Mayer-da-Silva A, Coza D, Todescu AI, Valkov MY, Gusenkova L, Lazarevich O, Prudnikova O, Vjushkov DM, Egorova A, Orlov A, Pikalova LV, Zhuikova LD, Adamcik J, Safaei Diba C, Zadnik V, Žagar T, De-La-Cruz M, Lopez-de-Munain A, Aleman A, Rojas D, Chillarón RJ, Navarro AIM, Marcos-Gragera R, Puigdemont M, Rodríguez-Barranco M, Sánchez Perez MJ, Franch Sureda P, Ramos Montserrat M, Chirlaque López MD, Sánchez Gil A, Ardanaz E, Guevara M, Cañete-Nieto A, Peris-Bonet R, Carulla M, Galceran J, Almela F, Sabater C, Khan S, Pettersson D, Dickman P, Staehelin K, Struchen B, Egger Hayoz C, Rapiti E, Schaffar R, Went P, Mousavi SM, Bulliard JL, Maspoli-Conconi M, Kuehni CE, Redmond SM, Bordoni A, Ortelli L, Chiolero A, Konzelmann I, Rohrmann S, Wanner M, Broggio J, Rashbass J, Stiller C, Fitzpatrick D, Gavin A, Morrison DS, Thomson CS, Greene G, Huws DW, Grayson M, Rawcliffe H, Allemani C, Coleman MP, Di Carlo V, Girardi F, Matz M, Minicozzi P, Sanz N, Ssenyonga N, James D, Stephens R, Chalker E, Smith M, Gugusheff J, You H, Qin Li S, Dugdale S, Moore J, Philpot S, Pfeiffer R, Thomas H, Silva Ragaini B, Venn AJ, Evans SM, Te Marvelde L, Savietto V, Trevithick R, Aitken J, Currow D, Fowler C, Lewis C. Global survival trends for brain tumors, by histology: analysis of individual records for 556,237 adults diagnosed in 59 countries during 2000-2014 (CONCORD-3). Neuro Oncol 2023; 25:580-592. [PMID: 36355361 PMCID: PMC10013649 DOI: 10.1093/neuonc/noac217] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Survival is a key metric of the effectiveness of a health system in managing cancer. We set out to provide a comprehensive examination of worldwide variation and trends in survival from brain tumors in adults, by histology. METHODS We analyzed individual data for adults (15-99 years) diagnosed with a brain tumor (ICD-O-3 topography code C71) during 2000-2014, regardless of tumor behavior. Data underwent a 3-phase quality control as part of CONCORD-3. We estimated net survival for 11 histology groups, using the unbiased nonparametric Pohar Perme estimator. RESULTS The study included 556,237 adults. In 2010-2014, the global range in age-standardized 5-year net survival for the most common sub-types was broad: in the range 20%-38% for diffuse and anaplastic astrocytoma, from 4% to 17% for glioblastoma, and between 32% and 69% for oligodendroglioma. For patients with glioblastoma, the largest gains in survival occurred between 2000-2004 and 2005-2009. These improvements were more noticeable among adults diagnosed aged 40-70 years than among younger adults. CONCLUSIONS To the best of our knowledge, this study provides the largest account to date of global trends in population-based survival for brain tumors by histology in adults. We have highlighted remarkable gains in 5-year survival from glioblastoma since 2005, providing large-scale empirical evidence on the uptake of chemoradiation at population level. Worldwide, survival improvements have been extensive, but some countries still lag behind. Our findings may help clinicians involved in national and international tumor pathway boards to promote initiatives aimed at more extensive implementation of clinical guidelines.
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Affiliation(s)
- Fabio Girardi
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, UK.,Cancer Division, University College London Hospitals NHS Foundation Trust, London, UK.,Division of Medical Oncology 2, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Melissa Matz
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, UK
| | - Charles Stiller
- National Cancer Registration and Analysis Service, Public Health England, London, UK
| | - Hui You
- Cancer Information Analysis Unit, Cancer Institute NSW, St Leonards, New South Wales, Australia
| | - Rafael Marcos Gragera
- Epidemiology Unit and Girona Cancer Registry, Catalan Institute of Oncology, Girona, Spain
| | - Mikhail Y Valkov
- Department of Radiology, Radiotherapy and Oncology, Northern State Medical University, Arkhangelsk, Russia
| | - Jean-Luc Bulliard
- Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland.,Neuchâtel and Jura Tumour Registry, Neuchâtel, Switzerland
| | - Prithwish De
- Surveillance and Cancer Registry, and Research Office, Clinical Institutes and Quality Programs, Ontario Health, Toronto, Ontario, Canada
| | - David Morrison
- Scottish Cancer Registry, Public Health Scotland, Edinburgh, UK
| | - Miriam Wanner
- Cancer Registry Zürich, Zug, Schaffhausen and Schwyz, University Hospital Zürich, Zürich, Switzerland
| | - David K O'Brian
- Alaska Cancer Registry, Alaska Department of Health and Social Services, Anchorage, Alaska, USA
| | - Nathalie Saint-Jacques
- Department of Medicine and Community Health and Epidemiology, Centre for Clinical Research, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Michel P Coleman
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, UK.,Cancer Division, University College London Hospitals NHS Foundation Trust, London, UK
| | - Claudia Allemani
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, UK
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Wilhelm E, Ballalai I, Belanger ME, Benjamin P, Bertrand-Ferrandis C, Bezbaruah S, Briand S, Brooks I, Bruns R, Bucci LM, Calleja N, Chiou H, Devaria A, Dini L, D'Souza H, Dunn AG, Eichstaedt JC, Evers SMAA, Gobat N, Gissler M, Gonzales IC, Gruzd A, Hess S, Ishizumi A, John O, Joshi A, Kaluza B, Khamis N, Kosinska M, Kulkarni S, Lingri D, Ludolph R, Mackey T, Mandić-Rajčević S, Menczer F, Mudaliar V, Murthy S, Nazakat S, Nguyen T, Nilsen J, Pallari E, Pasternak Taschner N, Petelos E, Prinstein MJ, Roozenbeek J, Schneider A, Srinivasan V, Stevanović A, Strahwald B, Syed Abdul S, Varaidzo Machiri S, van der Linden S, Voegeli C, Wardle C, Wegwarth O, White BK, Willie E, Yau B, Purnat TD. Measuring the Burden of Infodemics: Summary of the Methods and Results of the Fifth WHO Infodemic Management Conference. JMIR Infodemiology 2023; 3:e44207. [PMID: 37012998 PMCID: PMC9989916 DOI: 10.2196/44207] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 01/09/2023] [Accepted: 01/26/2023] [Indexed: 01/27/2023]
Abstract
Background An infodemic is excess information, including false or misleading information, that spreads in digital and physical environments during a public health emergency. The COVID-19 pandemic has been accompanied by an unprecedented global infodemic that has led to confusion about the benefits of medical and public health interventions, with substantial impact on risk-taking and health-seeking behaviors, eroding trust in health authorities and compromising the effectiveness of public health responses and policies. Standardized measures are needed to quantify the harmful impacts of the infodemic in a systematic and methodologically robust manner, as well as harmonizing highly divergent approaches currently explored for this purpose. This can serve as a foundation for a systematic, evidence-based approach to monitoring, identifying, and mitigating future infodemic harms in emergency preparedness and prevention. Objective In this paper, we summarize the Fifth World Health Organization (WHO) Infodemic Management Conference structure, proceedings, outcomes, and proposed actions seeking to identify the interdisciplinary approaches and frameworks needed to enable the measurement of the burden of infodemics. Methods An iterative human-centered design (HCD) approach and concept mapping were used to facilitate focused discussions and allow for the generation of actionable outcomes and recommendations. The discussions included 86 participants representing diverse scientific disciplines and health authorities from 28 countries across all WHO regions, along with observers from civil society and global public health-implementing partners. A thematic map capturing the concepts matching the key contributing factors to the public health burden of infodemics was used throughout the conference to frame and contextualize discussions. Five key areas for immediate action were identified. Results The 5 key areas for the development of metrics to assess the burden of infodemics and associated interventions included (1) developing standardized definitions and ensuring the adoption thereof; (2) improving the map of concepts influencing the burden of infodemics; (3) conducting a review of evidence, tools, and data sources; (4) setting up a technical working group; and (5) addressing immediate priorities for postpandemic recovery and resilience building. The summary report consolidated group input toward a common vocabulary with standardized terms, concepts, study designs, measures, and tools to estimate the burden of infodemics and the effectiveness of infodemic management interventions. Conclusions Standardizing measurement is the basis for documenting the burden of infodemics on health systems and population health during emergencies. Investment is needed into the development of practical, affordable, evidence-based, and systematic methods that are legally and ethically balanced for monitoring infodemics; generating diagnostics, infodemic insights, and recommendations; and developing interventions, action-oriented guidance, policies, support options, mechanisms, and tools for infodemic managers and emergency program managers.
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Affiliation(s)
- Elisabeth Wilhelm
- US Centers for Disease Control and Prevention Atlanta, GA United States
| | | | - Marie-Eve Belanger
- Department of Political Science and International Relations Université de Genève Geneva Switzerland
| | | | | | - Supriya Bezbaruah
- Department of Epidemic and Pandemic Preparedness and Prevention World Health Organization Geneva Switzerland
| | - Sylvie Briand
- Department of Epidemic and Pandemic Preparedness and Prevention World Health Organization Geneva Switzerland
| | - Ian Brooks
- Center for Health Informatics School of Information Sciences University of Illinois Champaign, IL United States
| | - Richard Bruns
- Johns Hopkins Center for Health Security Baltimore, MD United States
| | - Lucie M Bucci
- Immunize Canada Canadian Public Health Association Ottawa, ON Canada
| | - Neville Calleja
- Directorate for Health Information and Research Ministry for Health Valletta Malta
| | - Howard Chiou
- US Centers for Disease Control and Prevention Atlanta, GA United States
- US Public Health Service Commissioned Corps Rockville, MD United States
| | | | - Lorena Dini
- Working Group Health Policy and Systems Research and Innovation Institute for General Practice Charité Universitätsmedizin Berlin Berlin Germany
| | - Hyjel D'Souza
- The George Institute for Global Health New Delhi India
| | - Adam G Dunn
- Biomedical Informatics and Digital Health Faculty of Medicine and Health University of Sydney Sydney Australia
| | - Johannes C Eichstaedt
- Department of Psychology Stanford University Stanford, CA United States
- Institute for Human-Centered AI Stanford University Stanford, CA United States
| | - Silvia M A A Evers
- Department of Health Services Research Maastricht University Maastricht Netherlands
| | - Nina Gobat
- Department of Country Readiness Strengthening World Health Organization Geneva Switzerland
| | - Mika Gissler
- Department of Knowledge Brokers THL Finnish Institute for Health and Welfare Helsinki Finland
| | - Ian Christian Gonzales
- Field Epidemiology Training Program Epidemiology Bureau Department of Health Manila Philippines
| | - Anatoliy Gruzd
- Ted Rogers School of Management Toronto Metropolitan University Toronto, ON Canada
| | - Sarah Hess
- Department of Epidemic and Pandemic Preparedness and Prevention World Health Organization Geneva Switzerland
| | - Atsuyoshi Ishizumi
- Department of Epidemic and Pandemic Preparedness and Prevention World Health Organization Geneva Switzerland
| | - Oommen John
- The George Institute for Global Health New Delhi India
| | - Ashish Joshi
- Department of Epidemiology and Biostatistics Graduate School of Public Health and Health Policy City University of New York New York, NY United States
| | - Benjamin Kaluza
- Department Technological Analysis and Strategic Planning Fraunhofer Institute for Technological Trend Analysis INT Euskirchen Germany
| | - Nagwa Khamis
- Infection Prevention and Control Department Children's Cancer Hospital Egypt-57357 Ain Shams University Specialized Hospital Cairo Egypt
| | - Monika Kosinska
- Department of Social Determinants World Health Organization Geneva Switzerland
| | - Shibani Kulkarni
- US Centers for Disease Control and Prevention Atlanta, GA United States
| | - Dimitra Lingri
- European Healthcare Fraud and Corruption Network Aristotle Universtity of Thessaloniki Brussels Belgium
| | - Ramona Ludolph
- Department of Epidemic and Pandemic Preparedness and Prevention World Health Organization Geneva Switzerland
| | - Tim Mackey
- Global Health Program Department of Anthropology University of California San Diego, CA United States
| | | | - Filippo Menczer
- Observatory on Social Media Luddy School of Informatics, Computing, and Engineering Indiana University Bloomington, IN United States
| | | | - Shruti Murthy
- The George Institute for Global Health New Delhi India
| | - Syed Nazakat
- DataLEADS (Health Analytics Asia) New Delhi India
| | - Tim Nguyen
- Department of Epidemic and Pandemic Preparedness and Prevention World Health Organization Geneva Switzerland
| | - Jennifer Nilsen
- Technology and Social Change Project Harvard University Cambridge, MA United States
| | - Elena Pallari
- Health Innovation Network Guy's and St Thomas' Hospital London United Kingdom
| | - Natalia Pasternak Taschner
- Center of Science and Society Columbia University New York, NY United States
- Instituto Questão de Ciência São Paulo Brazil
| | - Elena Petelos
- Department of Health Services Research Care and Public Health Research Institute Maastricht University Maastricht Netherlands
- Clinic of Social and Family Medicine Faculty of Medicine University of Crete Heraklion Greece
| | - Mitchell J Prinstein
- American Psychological Association Washington DC, DC United States
- Department of Psychology and Neuroscience University of North Carolina at Chapel Hill Chapel Hill, NC United States
| | - Jon Roozenbeek
- Department of Psychology University of Cambridge Cambridge United Kingdom
| | - Anton Schneider
- Bureau for Global Health Office of Infectious Disease United States Agency for International Development Washington DC, DC United States
| | | | - Aleksandar Stevanović
- Institute of Social Medicine Faculty of Medicine University of Belgrade Belgrade Serbia
| | - Brigitte Strahwald
- Pettenkofer School of Public Health Ludwig-Maximilians-Universität München Munich Germany
| | - Shabbir Syed Abdul
- The George Institute for Global Health New Delhi India
- Graduate Institute of Biomedical Informatics Taipei Medical University Taipei Taiwan
| | | | | | - Christopher Voegeli
- Office of the Director National Center for Immunization and Respiratory Diseases US Centers for Disease Control and Prevention Atlanta, GA United States
| | - Claire Wardle
- Information Futures Lab School of Public Health Brown University Providence, RI United States
| | - Odette Wegwarth
- Heisenberg Chair for Medical Risk Literacy & Evidence-Based Decisions Charite - Universitätsmedizin Berlin Berlin Germany
| | - Becky K White
- Department of Epidemic and Pandemic Preparedness and Prevention World Health Organization Geneva Switzerland
| | - Estelle Willie
- Communications, Policy, Advocacy The Rockefeller Foundation New York, NY United States
| | - Brian Yau
- Department of Epidemic and Pandemic Preparedness and Prevention World Health Organization Geneva Switzerland
| | - Tina D Purnat
- Department of Epidemic and Pandemic Preparedness and Prevention World Health Organization Geneva Switzerland
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Cuschieri L, Deguara M, Bartolo D, Calleja N, Gauci C. A descriptive study of COVID-19 cases in primary and secondary schools in the Maltese islands: a nationwide experience. Eur J Public Health 2023; 33:209-214. [PMID: 36773316 PMCID: PMC10066482 DOI: 10.1093/eurpub/ckad017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/13/2023] Open
Abstract
BACKGROUND As part of the measures to contain the initial cases of Coronavirus Disease (COVID-19) in 2020, all educational facilities were closed in March 2020 and remained so for the remainder of that scholastic year. When they reopened in October 2020, most educational facilities on the Maltese islands did so with various mitigation measures in place. METHODS A Schools Contact Tracing Team (SCTT) dedicated to the management of COVID-19 cases within schools was set up and networks established between the Ministries responsible for Health and Education to facilitate timely communication and, consequently, effective contact tracing. All cases pertaining to educational facilities, be they students, teaching or non-teaching staff were assessed and managed by this Team. RESULTS Between October 2020 and June 2021, the SCTT assessed 2603 COVID-19 cases within educational facilities in Malta. The highest rate of cases overall was observed in teaching staff (56.53/1000). In 72.45% of cases, no contacts were identified as high risk and thus nobody was placed in quarantine. In 3.07% of school cases >21 high-risk contacts were placed in mandatory quarantine together with their household members. Only 11% of the cases were epi-linked to another positive case within school. CONCLUSIONS The strong collaboration between the health and education authorities combined with strict measures observed in schools ensured that schools remained open throughout most of this pandemic. This study describes the processes by which contact tracing for COVID-19 cases in Maltese schools was carried out and analyses the data collected throughout the scholastic year 2020-21.
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Affiliation(s)
- Liliana Cuschieri
- Infectious Disease Prevention and Control Unit, Health Promotion and Disease Prevention Directorate, Pietà, Malta
| | - Michelle Deguara
- Health Promotion Unit, Health Promotion and Disease Prevention Directorate, Pietà, Malta
| | - Dale Bartolo
- Public Health Laboratory, Environmental Health Directorate, Valletta, Malta
| | - Neville Calleja
- Directorate for Health Information and Research, Pietà, Malta
| | - Charmaine Gauci
- Superintendence of Public Health, St. Luke's Hospital, Pietà, Malta
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Cauchi JP, Borg ML, Džiugytė A, Attard J, Melillo T, Zahra G, Barbara C, Spiteri M, Drago A, Zammit L, Debono J, Souness J, Agius S, Young S, Dimech A, Chetcuti I, Camenzuli M, Borg I, Calleja N, Tabone L, Gauci C, Vassallo P, Baruch J. Digitalizing and Upgrading Severe Acute Respiratory Infections Surveillance in Malta: System Development. JMIR Public Health Surveill 2022; 8:e37669. [PMID: 36227157 PMCID: PMC9764153 DOI: 10.2196/37669] [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] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 05/17/2022] [Accepted: 09/29/2022] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND In late 2020, the European Centre for Disease Prevention and Control and Epiconcept started implementing a surveillance system for severe acute respiratory infections (SARI) across Europe. OBJECTIVE We sought to describe the process of digitizing and upgrading SARI surveillance in Malta, an island country with a centralized health system, during the COVID-19 pandemic from February to November 2021. We described the characteristics of people included in the surveillance system and compared different SARI case definitions, including their advantages and disadvantages. This study also discusses the process, output, and future for SARI and other public health surveillance opportunities. METHODS Malta has one main public hospital where, on admission, patient data are entered into electronic records as free text. Symptoms and comorbidities are manually extracted from these records, whereas other data are collected from registers. Collected data are formatted to produce weekly and monthly reports to inform public health actions. From October 2020 to February 2021, we established an analogue incidence-based system for SARI surveillance. From February 2021 onward, we mapped key stakeholders and digitized most surveillance processes. RESULTS By November 30, 2021, 903 SARI cases were reported, with 380 (42.1%) positive for SARS-CoV-2. Of all SARI hospitalizations, 69 (7.6%) were admitted to the intensive care unit, 769 (85.2%) were discharged, 27 (3%) are still being treated, and 107 (11.8%) died. Among the 107 patients who died, 96 (89.7%) had more than one underlying condition, the most common of which were hypertension (n=57, 53.3%) and chronic heart disease (n=49, 45.8%). CONCLUSIONS The implementation of enhanced SARI surveillance in Malta was completed by the end of May 2021, allowing the monitoring of SARI incidence and patient characteristics. A future shift to register-based surveillance should improve SARI detection through automated processes.
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Affiliation(s)
- John Paul Cauchi
- Health Promotion and Disease Prevention Directorate, Msida, Malta
| | | | - Aušra Džiugytė
- Health Promotion and Disease Prevention Directorate, Msida, Malta
| | - Jessica Attard
- Health Promotion and Disease Prevention Directorate, Msida, Malta
| | - Tanya Melillo
- Health Promotion and Disease Prevention Directorate, Msida, Malta
| | - Graziella Zahra
- Molecular Dianostics Pathology Department, Mater dei Hospital, Msida, Malta
| | | | | | - Allan Drago
- Emergency Department, Mater Dei Hospital, Msida, Malta
| | - Luke Zammit
- Emergency Department, Mater Dei Hospital, Msida, Malta
| | | | | | | | | | | | | | | | | | - Neville Calleja
- Directorate for Health Information and Research, Msida, Malta
| | | | - Charmaine Gauci
- Superintendent of Public Health, Ministry of Health, Msida, Malta
| | - Pauline Vassallo
- Health Promotion and Disease Prevention Directorate, Msida, Malta
| | - Joaquin Baruch
- Health Promotion and Disease Prevention Directorate, Msida, Malta
- European Programme for Intervention Epidemiology Training program, European Centre for Disease Prevention and Control, Solna, Sweden
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9
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Sciberras M, Conti K, Elli L, Scaramella L, Riccioni ME, Marmo C, Cadoni S, McAlindon M, Sidhu R, O'hara F, McNamara D, Rondonotti E, Piccirelli S, Spada C, Bruno M, Keuchel M, Baltes P, Calleja N, Valdivia PC, de'Angelis GL, Margalit-Yehuda R, Koulaouzidis A, Dray X, Ellul P. Score reproducibility and reliability in differentiating small bowel subepithelial masses from innocent bulges. Dig Liver Dis 2022; 54:1403-1409. [PMID: 35934647 DOI: 10.1016/j.dld.2022.06.027] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 06/28/2022] [Accepted: 06/29/2022] [Indexed: 12/29/2022]
Abstract
AIMS The primary aim of this study was to assess the reliability, intra- and inter-observer variation of the SPICE, Mucosal protrusion angle (MPA) and SHYUNG scores in differentiating a subepithelial mass (SEM) from a bulge. METHODS This retrospective multicentre study analysed the 3 scores, radiological studies, enteroscopy and/or surgical findings. RESULTS 100 patients with a potential SEM (mean age 57.6years) were recruited with 75 patients having pathology. In patients with a SEM the mean SPICE score was 2.04 (95% CI 1.82-2.26) as compared to 1.16 (95% CI 0.81-1.51) without any pathology (AUC 0.74, p<0.001), with a fair intra-observer agreement (Kappa 0.3, p<0.001) and slight inter-observer agreement (Kappa 0.14, p<0.05). SPICE had a 37.3% sensitivity and 92.0% specificity in distinguishing between a SEM and bulge, whereas MPA<90˚ had 58.7% and 76.0% respectively, with poor intra-observer(p = 0.05) and interobserver agreement (p = 0.64). The SHYUNG demonstrated a moderate intra-observer (Kappa 0.44, p<0.001) and slight inter-observer reliability (Kappa 0.18, p<0.001). The sensitivity of an elevated SHYUNG score (≥4) in identifying a SEM was 18.7% with a specificity of 92.0% (AUC 0.71, p = 0.002). CONCLUSIONS Though these scores are easy to use, they have, at best, slight to moderate intra and inter-observer agreement. Their overall diagnostic performances are limited.
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Affiliation(s)
| | - Kelly Conti
- Division of Gastroenterology, Mater Dei Hospital, Malta
| | - Luca Elli
- Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Lucia Scaramella
- Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Maria Elena Riccioni
- Digestive Endoscopy Unit, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Clelia Marmo
- Digestive Endoscopy Unit, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Sergio Cadoni
- Digestive Endoscopy Unit, CTO Hospital, Iglesias (Carbonia-Iglesias), Italy
| | - Mark McAlindon
- Academic Unit of gastroenterology, Sheffield teaching hospitals NHS Trust
| | - Reena Sidhu
- Academic Unit of gastroenterology, Sheffield teaching hospitals NHS Trust; Dept of Infection, Immunity and cardiovascular diseases, University of Sheffield
| | - Fintan O'hara
- TAGG Research Centre, Department of Clinical Medicine, Trinity Centre, Tallaght University Hospital, Dublin, Ireland
| | - Deirdre McNamara
- TAGG Research Centre, Department of Clinical Medicine, Trinity Centre, Tallaght University Hospital, Dublin, Ireland
| | | | - Stefania Piccirelli
- Digestive Endoscopy Unit and Gastroenterology, Fondazione Poliambulanza, 25124 Brescia, Italy; Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Cristiano Spada
- Digestive Endoscopy Unit and Gastroenterology, Fondazione Poliambulanza, 25124 Brescia, Italy; Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Mauro Bruno
- Gastroenterology and Digestive Endoscopy Unit, "Città della Salute e della Scienza" Hospital, Torino, Italy
| | - Martin Keuchel
- Agaplesion Bethesda Krankenhaus Bergedorf, Hamburg, Germany
| | - Peter Baltes
- Agaplesion Bethesda Krankenhaus Bergedorf, Hamburg, Germany
| | - Neville Calleja
- Head, Department of Public Health, Faculty of Medicine & Surgery, University of Malta
| | - Pablo Cortegoso Valdivia
- Gastroenterology and Endoscopy Unit, University Hospital of Parma, University of Parma, Parma, Italy
| | - Gian Luigi de'Angelis
- Gastroenterology and Endoscopy Unit, University Hospital of Parma, University of Parma, Parma, Italy
| | | | - Anastasios Koulaouzidis
- Department of Medicine, OUH Svendborg Sygehus, 5700 Svendborg, Denmark; Department of Clinical Research, University of Southern Denmark (SDU), 5230 Odense, Denmark.; Surgical Research Unit, OUH, 5000 Odense, Denmark; Pomeranian Medical University, Poland
| | - Xavier Dray
- Sorbonne Université, Centre d'Endoscopie Digestive, Hôpital Saint-Antoine, APHP, Paris, France
| | - Pierre Ellul
- Division of Gastroenterology, Mater Dei Hospital, Malta
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10
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Miller V, Reedy J, Cudhea F, Zhang J, Shi P, Erndt-Marino J, Coates J, Micha R, Webb P, Mozaffarian D, Abbott P, Abdollahi M, Abedi P, Abumweis S, Adair L, Al Nsour M, Al-Daghri N, Al-Hamad N, Al-Hooti S, Al-Zenki S, Alam I, Ali JH, Alissa E, Anderson S, Anzid K, Arambepola C, Arici M, Arsenault J, Asciak R, Barbieri HE, Barengo N, Barquera S, Bas M, Becker W, Beer-Borst S, Bergman P, Biró L, Boindala S, Bovet P, Bradshaw D, Bukhary NBI, Bundhamcharoen K, Caballero M, Calleja N, Cao X, Capanzana M, Carmikle J, Castetbon K, Castro M, Cerdena C, Chang HY, Charlton K, Chen Y, Chen MF, Chiplonkar S, Cho Y, Chuah KA, Costanzo S, Cowan M, Damasceno A, Dastgiri S, De Henauw S, DeRidder K, Ding E, Dommarco R, Don R, Duante C, Duleva V, Duran Aguero S, Ekbote V, El Ati J, El Hamdouchi A, El-kour T, Eldridge A, Elmadfa I, Esteghamati A, Etemad Z, Fadzil F, Farzadfar F, Fernandez A, Fernando D, Fisberg R, Forsyth S, Gamboa-Delgado E, Garriguet D, Gaspoz JM, Gauci D, Geleijnse M, Ginnela B, Grosso G, Guessous I, Gulliford M, Gunnarsdottir I, Hadden W, Hadziomeragic A, Haerpfer C, Hakeem R, Haque A, Hashemian M, Hemalatha R, Henjum S, Hinkov H, Hjdaud Z, Hoffman D, Hopping B, Houshiar-rad A, Hsieh YT, Hung SY, Huybrechts I, Hwalla NC, Ibrahim HM, Ikeda N, Illescas-Zarate D, Inoue M, Janakiram C, Jayawardena R, Jeewon R, Jitnarin N, Johansson L, Jonsdottir O, Jundishapur A, Kally O, Kandiah M, Karupaiah T, Keinan-Boker L, Kelishadi R, Khadilkar A, Kim CI, Koksal E, Konig J, Korkalo L, Koster J, Kovalskys I, Krishnan A, Kruger H, Kuriyan-Raj R, Kweon S, Lachat C, Lai Y, Lanerolle P, Laxmaiah A, Leclercq C, Lee MS, Lee HJ, Lemming EW, Li Y, Lindström J, Ling A, Liputo NIL, Lopez-Jaramillo P, Luke A, Lukito W, Lupotto E, Ma Y, Mahdy ZA, Malekzadeh R, Manan W, Marchioni D, Marques LL, Marques-Vidal P, Martin-Prevel, Y, Mathee A, Matsumura Y, Mazumdar P, Memon A, Mensink G, Meyer A, Mirmiran P, Mirzaei M, Misra P, Misra A, Mitchell C, Mohamed HJBJ, Mohammadi-Nasrabadi F, Mohammadifard N, Moy FM, Musaiger A, Mwaniki E, Myhre J, Nagalla B, Naska A, Ng SA, Ng SW, Ngoan LTN, Noshad S, Ochoa A, Ocke M, Odenkirk J, Oh K, Oleas M, Olivares S, Orfanos P, Ortiz-Ulloa J, Otero J, Ovaskainen ML, Pakseresht M, Palacios C, Palmer P, Pan WH, Panagiotakos D, Parajuli R, Park M, Pekcan G, Petrova S, Piaseu N, Pitsavos C, Polasa K, Posada L, Pourfarzi F, Preston AM, Rached I, Rahbar AR, Rehm C, Richter A, Riley L, Salanave B, Sánchez-Romero LM, Sarrafzadegan N, Sawada N, Sekiyama M, Selamat R, Shamsuddin K, Shariff ZM, Sharma S, Sibai AM, Sinkko H, Sioen I, Sisa I, Skeaff S, Steingrimsdottir L, Strand T, Suarez-Ortegon MF, Swaminathan S, Swan G, Sygnowska E, Szabo M, Szponar L, Tan-Khouw I, Tapanainen H, Tayyem R, Tedla B, Tedstone A, Templeton R, Termote C, Thanopoulou A, Thorgeirsdottir H, Thorsdottir I, Trichopoulos D, Trichopoulou A, Tsugane S, Turrini A, van Oosterhout C, Vartiainen E, Veerman JL, Virtanen S, Vollenweider P, Vossenaar M, Waidyatilaka I, Waskiewicz A, Waterham E, Wieler L, Wondwossen T, Wu S, Yaakub R, Yap M, Yusof S, Zaghloul S, Zajkás G, Zapata M, Zarina K, Zohoori FV. Global, regional, and national consumption of animal-source foods between 1990 and 2018: findings from the Global Dietary Database. The Lancet Planetary Health 2022; 6:e243-e256. [PMID: 35278390 PMCID: PMC8926870 DOI: 10.1016/s2542-5196(21)00352-1] [Citation(s) in RCA: 48] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 11/25/2021] [Accepted: 12/08/2021] [Indexed: 02/05/2023]
Abstract
Background Methods Findings Interpretation Funding
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11
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Calleja N, Gualtieri A, Terzic N, Scoutellas V, Agius JC. Managing COVID-19 in small countries: An overview of the initial response to the pandemic. Health Policy 2022; 126:281-286. [PMID: 35101288 PMCID: PMC8776625 DOI: 10.1016/j.healthpol.2022.01.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 08/12/2021] [Accepted: 01/16/2022] [Indexed: 11/04/2022]
Abstract
The aim of this paper is to compare the impact of the COVID-19 pandemic on four small countries in the southern half of Europe with similar public health systems: San Marino, Montenegro, Malta and Cyprus, the latter two being island states. There are advantages and disadvantages in being a small nation amidst this crisis. The centralized public health administration means that small countries are faster at adapting as they learn and evolve on a weekly basis. However, small countries tend to be dependent on their bigger neighbours, and the networks they belong to, for trade, food, medical supplies as well as policies. The risk threshold taken by a small country for the transition strategy has to be less than that taken by a bigger country because if things go wrong in a border region, there is less resilience in a small country, with immediate impact on the whole country. The blow to the tourism industry, which plays a main role especially in small countries, negatively impacted the economy, and it has been a feat to reach a balance between allowing the flow of inbound tourists and keeping the local infection rates under control.
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12
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Beatrice F, Calleja N. Early warning indicators of COVID-19 burden for a prosilient European pandemic response. Eur J Public Health 2021; 31:iv21-iv26. [PMID: 34751370 PMCID: PMC8576301 DOI: 10.1093/eurpub/ckab154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The European Union has been criticized for responding to the COVID-19 pandemic in a reactive, rather than prosilient manner. For the EU bloc to be prosilient, it needs to have the right early warning indicators to allow short-term healthcare system preparedness and agile planning of the public health response. METHOD The association of COVID-19 disease burden, as measured by mortality (COVID-19 and all-cause), hospital and ICU occupancy, with incidence rate (IR), total positivity rate (TPR) and adjusted TPR as proposed by Vong and Kakkar, was investigated using Poisson regression analysis. This was carried out using both real-time data and time lags of up to 8 weeks to identify potential for early warning of spikes in disease burden. ECDC weekly figures for these indicators were used, and the analysis was repeated for the subset of data after Week 42 of 2020, when the EU Council introduced minimum COVID-19 testing rates. RESULTS TPR and IR were noted to be the most predictive of COVID-19 disease burden whilst adjusted TPR applied on weekly data was not associated. TPR behaved better at predicting all-cause mortality in both analyses. The TPR and IR were both best associated with hospital and ICU occupancy and COVID-19 mortality with a short time lag (2-3 weeks in the case of TPR with hospital occupancy and COVID-19 mortality). CONCLUSIONS Monitoring TPR can provide a 2-3-week warning of a spike in hospital occupancy and COVID-19 mortality. This time, if well utilized, could help health systems save countless lives by mobilising resources.
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Affiliation(s)
- Farrugia Beatrice
- Department of Public Health, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
| | - Neville Calleja
- Department of Public Health, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
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13
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Cuschieri S, Calleja N, Devleesschauwer B, Wyper GMA. Estimating the direct Covid-19 disability-adjusted life years impact on the Malta population for the first full year. BMC Public Health 2021; 21:1827. [PMID: 34627228 PMCID: PMC8501913 DOI: 10.1186/s12889-021-11893-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [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] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 09/28/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Disability-adjusted life years (DALYs) combine the impact of morbidity and mortality, allowing for comprehensive comparisons of the population. The aim was to estimate the DALYs due to Covid-19 in Malta (March 2020-21) and investigate its impact in relation to other causes of disease at a population level. METHODS Mortality and weekly hospital admission data were used to calculate DALYs, based on the European Burden of Disease Network consensus Covid-19 model. Covid-19 infection duration of 14 days was considered. Sensitivity analyses for different morbidity scenarios, including post-acute consequences were presented. RESULTS An estimated 70,421 people were infected (with and without symptoms) by Covid-19 in Malta (March 2020-1), out of which 1636 required hospitalisation and 331 deaths, contributing to 5478 DALYs. These DALYs positioned Covid-19 as the fourth leading cause of disease in Malta. Mortality contributed to 95% of DALYs, while post-acute consequences contributed to 60% of morbidity. CONCLUSIONS Covid-19 over 1 year has impacted substantially the population health in Malta. Post-acute consequences are the leading morbidity factors that require urgent targeted action to ensure timely multidisciplinary care. It is recommended that DALY estimations in 2021 and beyond are calculated to assess the impact of vaccine roll-out and emergence of new variants.
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Affiliation(s)
- Sarah Cuschieri
- Department of Anatomy, Faculty of Medicine and Surgery, University of Malta, Msida, Malta.
| | - Neville Calleja
- Department of Public Health, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
- Directorate for Health Information and Research, Ministry for Health, Gwardamangia, Malta
| | - Brecht Devleesschauwer
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
- Department of Veterinary Public Health and Food Safety, Ghent University, Merelbeke, Belgium
| | - Grant M A Wyper
- Public Health Adviser, Place and Wellbeing Directorate, Public Health Scotland, Glasgow, Scotland
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14
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Calleja N, AbdAllah A, Abad N, Ahmed N, Albarracin D, Altieri E, Anoko JN, Arcos R, Azlan AA, Bayer J, Bechmann A, Bezbaruah S, Briand SC, Brooks I, Bucci LM, Burzo S, Czerniak C, De Domenico M, Dunn AG, Ecker UKH, Espinosa L, Francois C, Gradon K, Gruzd A, Gülgün BS, Haydarov R, Hurley C, Astuti SI, Ishizumi A, Johnson N, Johnson Restrepo D, Kajimoto M, Koyuncu A, Kulkarni S, Lamichhane J, Lewis R, Mahajan A, Mandil A, McAweeney E, Messer M, Moy W, Ndumbi Ngamala P, Nguyen T, Nunn M, Omer SB, Pagliari C, Patel P, Phuong L, Prybylski D, Rashidian A, Rempel E, Rubinelli S, Sacco P, Schneider A, Shu K, Smith M, Sufehmi H, Tangcharoensathien V, Terry R, Thacker N, Trewinnard T, Turner S, Tworek H, Uakkas S, Vraga E, Wardle C, Wasserman H, Wilhelm E, Würz A, Yau B, Zhou L, Purnat TD. A Public Health Research Agenda for Managing Infodemics: Methods and Results of the First WHO Infodemiology Conference. ACTA ACUST UNITED AC 2021; 1:e30979. [PMID: 34604708 PMCID: PMC8448461 DOI: 10.2196/30979] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [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: 06/25/2021] [Revised: 08/23/2021] [Accepted: 08/23/2021] [Indexed: 02/05/2023]
Abstract
Background An infodemic is an overflow of information of varying quality that surges across digital and physical environments during an acute public health event. It leads to confusion, risk-taking, and behaviors that can harm health and lead to erosion of trust in health authorities and public health responses. Owing to the global scale and high stakes of the health emergency, responding to the infodemic related to the pandemic is particularly urgent. Building on diverse research disciplines and expanding the discipline of infodemiology, more evidence-based interventions are needed to design infodemic management interventions and tools and implement them by health emergency responders. Objective The World Health Organization organized the first global infodemiology conference, entirely online, during June and July 2020, with a follow-up process from August to October 2020, to review current multidisciplinary evidence, interventions, and practices that can be applied to the COVID-19 infodemic response. This resulted in the creation of a public health research agenda for managing infodemics. Methods As part of the conference, a structured expert judgment synthesis method was used to formulate a public health research agenda. A total of 110 participants represented diverse scientific disciplines from over 35 countries and global public health implementing partners. The conference used a laddered discussion sprint methodology by rotating participant teams, and a managed follow-up process was used to assemble a research agenda based on the discussion and structured expert feedback. This resulted in a five-workstream frame of the research agenda for infodemic management and 166 suggested research questions. The participants then ranked the questions for feasibility and expected public health impact. The expert consensus was summarized in a public health research agenda that included a list of priority research questions. Results The public health research agenda for infodemic management has five workstreams: (1) measuring and continuously monitoring the impact of infodemics during health emergencies; (2) detecting signals and understanding the spread and risk of infodemics; (3) responding and deploying interventions that mitigate and protect against infodemics and their harmful effects; (4) evaluating infodemic interventions and strengthening the resilience of individuals and communities to infodemics; and (5) promoting the development, adaptation, and application of interventions and toolkits for infodemic management. Each workstream identifies research questions and highlights 49 high priority research questions. Conclusions Public health authorities need to develop, validate, implement, and adapt tools and interventions for managing infodemics in acute public health events in ways that are appropriate for their countries and contexts. Infodemiology provides a scientific foundation to make this possible. This research agenda proposes a structured framework for targeted investment for the scientific community, policy makers, implementing organizations, and other stakeholders to consider.
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Affiliation(s)
- Neville Calleja
- Directorate for Health Information & Research Ministry for Health Valetta Malta
| | | | - Neetu Abad
- US Centers for Disease Control and Prevention Atlanta, GA United States
| | - Naglaa Ahmed
- WHO Regional Office for Eastern Mediterranean Cairo Egypt
| | - Dolores Albarracin
- Department of Psychology College of Liberal Arts & Sciences University of Illinois Urbana-Champaign Champaign, IL United States
| | - Elena Altieri
- Department of Communications World Health Organization Geneva Switzerland
| | | | - Ruben Arcos
- Department of Communication Sciences and Sociology Communication Sciences Faculty University Rey Juan Carlos Madrid Spain
| | - Arina Anis Azlan
- Faculty of Social Sciences and Humanities Universiti Kebangsaan Malaysia Bangi Malaysia
| | - Judit Bayer
- Department of Communication Budapest Economics University (BGE) Budapest Hungary.,Institute for Information, Telecommunications and Media Law University of Münster (WWU) Münster Germany
| | - Anja Bechmann
- DATALAB - Center for Digital Social Research School of Communication and Culture Aarhus University Aarhus Denmark
| | | | - Sylvie C Briand
- Department of Infectious Hazards Management Emergency Preparedness Division World Health Organization Geneva Switzerland
| | - Ian Brooks
- Center for Health Informatics School of Information Sciences University of Illinois at Urbana-Champaign Champaign, IL United States
| | - Lucie M Bucci
- Immunize Canada Canadian Public Health Association Ottawa, ON Canada
| | - Stefano Burzo
- Department of Political Science University of British Columbia Vancouver, BC Canada
| | - Christine Czerniak
- Department of Infectious Hazards Management Emergency Preparedness Division World Health Organization Geneva Switzerland
| | | | - Adam G Dunn
- Biomedical Informatics and Digital Health School of Medical Sciences The University of Sydney Sydney Australia
| | - Ullrich K H Ecker
- School of Psychological Science The University of Western Australia Perth Australia
| | - Laura Espinosa
- European Centre for Disease Prevention and Control Stockholm Sweden
| | | | - Kacper Gradon
- Department of Security and Crime Science University College London London United Kingdom
| | - Anatoliy Gruzd
- Ted Rogers School of Management Ryerson University Toronto, ON Canada
| | | | | | - Cherstyn Hurley
- Immunisation and Countermeasures Department Public Health England London United Kingdom
| | - Santi Indra Astuti
- The Faculty of Communication Science Bandung Islamic University (UNISBA) Bandung Indonesia
| | - Atsuyoshi Ishizumi
- US Centers for Disease Control and Prevention Atlanta, GA United States.,Oak Ridge Institute for Science and Education Oak Ridge, TN United States
| | - Neil Johnson
- Department of Physics George Washington University Washington, DC United States
| | | | - Masato Kajimoto
- Journalism and Media Studies Centre The University of Hong Kong Hong Kong China
| | - Aybüke Koyuncu
- US Centers for Disease Control and Prevention Atlanta, GA United States
| | - Shibani Kulkarni
- US Centers for Disease Control and Prevention Atlanta, GA United States.,Oak Ridge Institute for Science and Education Oak Ridge, TN United States
| | - Jaya Lamichhane
- Department of Infectious Hazards Management Emergency Preparedness Division World Health Organization Geneva Switzerland
| | - Rosamund Lewis
- Emergency Preaparedness Division World Health Organization Geneva Switzerland
| | - Avichal Mahajan
- Department of Infectious Hazards Management Emergency Preparedness Division World Health Organization Geneva Switzerland
| | - Ahmed Mandil
- WHO Regional Office for Eastern Mediterranean Cairo Egypt
| | | | - Melanie Messer
- Faculty I Department of Nursing Science II Trier University Trier Germany
| | - Wesley Moy
- Advanced Academic Programs Johns Hopkins University Washington, DC United States
| | - Patricia Ndumbi Ngamala
- Department of Digital Health and Innovation Science Division World Health Organization Geneva Switzerland
| | - Tim Nguyen
- Department of Infectious Hazards Management Emergency Preparedness Division World Health Organization Geneva Switzerland
| | - Mark Nunn
- Directorate for Health Information & Research Ministry for Health Valetta Malta.,WHO Regional Office for Africa Brazzaville Congo.,US Centers for Disease Control and Prevention Atlanta, GA United States.,WHO Regional Office for Eastern Mediterranean Cairo Egypt.,Department of Psychology College of Liberal Arts & Sciences University of Illinois Urbana-Champaign Champaign, IL United States.,Department of Communications World Health Organization Geneva Switzerland.,WHO Regional Office for Africa Dakar Senegal.,Department of Communication Sciences and Sociology Communication Sciences Faculty University Rey Juan Carlos Madrid Spain.,Faculty of Social Sciences and Humanities Universiti Kebangsaan Malaysia Bangi Malaysia.,Department of Communication Budapest Economics University (BGE) Budapest Hungary.,Institute for Information, Telecommunications and Media Law University of Münster (WWU) Münster Germany.,DATALAB - Center for Digital Social Research School of Communication and Culture Aarhus University Aarhus Denmark.,WHO Regional Office for South East Asia New Delhi India.,Department of Infectious Hazards Management Emergency Preparedness Division World Health Organization Geneva Switzerland.,Center for Health Informatics School of Information Sciences University of Illinois at Urbana-Champaign Champaign, IL United States.,Immunize Canada Canadian Public Health Association Ottawa, ON Canada.,Department of Political Science University of British Columbia Vancouver, BC Canada.,CoMuNe Lab Fondazione Bruno Kessler Povo Italy.,Biomedical Informatics and Digital Health School of Medical Sciences The University of Sydney Sydney Australia.,School of Psychological Science The University of Western Australia Perth Australia.,European Centre for Disease Prevention and Control Stockholm Sweden.,Graphika New York, NY United States.,Department of Security and Crime Science University College London London United Kingdom.,Ted Rogers School of Management Ryerson University Toronto, ON Canada.,Ministry of Health Ankara Turkey.,UNICEF Headquarters New York, NY United States.,Immunisation and Countermeasures Department Public Health England London United Kingdom.,The Faculty of Communication Science Bandung Islamic University (UNISBA) Bandung Indonesia.,Oak Ridge Institute for Science and Education Oak Ridge, TN United States.,Department of Physics George Washington University Washington, DC United States.,Journalism and Media Studies Centre The University of Hong Kong Hong Kong China.,Emergency Preaparedness Division World Health Organization Geneva Switzerland.,Faculty I Department of Nursing Science II Trier University Trier Germany.,Advanced Academic Programs Johns Hopkins University Washington, DC United States.,Department of Digital Health and Innovation Science Division World Health Organization Geneva Switzerland.,Yale Institute for Global Health Yale University New Haven, CT United States.,Usher Institute Edinburgh Medical School University of Edinburgh Edinburgh United Kingdom.,British Columbia Centre for Disease Control Vancouver, BC Canada.,Department of Health Sciences and Medicine University of Lucerne Lucerne Switzerland.,Swiss Paraplegic Research Lucerne Switzerland.,Department of Humanities Studies Free University of Languages and Communication IULM Milan Italy.,metaLAB (at) Harvard Harvard University Cambridge, MA United States.,Office of Infectious Disease Global Health Bureau United States Agency for International Development (USAID) Washington, DC United States.,Computer Science Department Illinois Institute of Technology Chicago, IL United States.,Masyarakat Anti Fitnah Indonesia (MAFINDO) Jakarta Indonesia.,International Health Policy Programme Ministry of Public Health Bangkok Thailand.,Science Division World Health Organization Geneva Switzerland.,Deep Children Hospital and Research Centre Gandhidham India.,Fathm London United Kingdom.,Public Health Association of British Columbia Victoria, BC Canada.,Vaccine Safety Net (VSN) Geneva Switzerland.,Department of History University of British Columbia Vancouver, BC Canada.,Faculty of Medicine Mohamed V University in Rabat Rabat Morocco.,Hubbard School of Journalism and Mass Communication University of Minnesota Minneapolis, MN United States.,First Draft News New York, NY United States.,Centre for Film and Media Studies University of Cape Town Cape Town South Africa.,Department of Regulation and Prequalification Access to Medicines and Health Products Division World Health Organization Geneva Switzerland.,Public Health Emergency Center Chinese Center for Disease Control and Prevention Beijing China
| | - Saad B Omer
- Yale Institute for Global Health Yale University New Haven, CT United States
| | - Claudia Pagliari
- Usher Institute Edinburgh Medical School University of Edinburgh Edinburgh United Kingdom
| | - Palak Patel
- US Centers for Disease Control and Prevention Atlanta, GA United States.,Oak Ridge Institute for Science and Education Oak Ridge, TN United States
| | - Lynette Phuong
- Department of Infectious Hazards Management Emergency Preparedness Division World Health Organization Geneva Switzerland
| | - Dimitri Prybylski
- US Centers for Disease Control and Prevention Atlanta, GA United States
| | | | - Emily Rempel
- British Columbia Centre for Disease Control Vancouver, BC Canada
| | - Sara Rubinelli
- Department of Health Sciences and Medicine University of Lucerne Lucerne Switzerland.,Swiss Paraplegic Research Lucerne Switzerland
| | - PierLuigi Sacco
- Department of Humanities Studies Free University of Languages and Communication IULM Milan Italy.,metaLAB (at) Harvard Harvard University Cambridge, MA United States
| | - Anton Schneider
- Office of Infectious Disease Global Health Bureau United States Agency for International Development (USAID) Washington, DC United States
| | - Kai Shu
- Computer Science Department Illinois Institute of Technology Chicago, IL United States
| | | | - Harry Sufehmi
- Masyarakat Anti Fitnah Indonesia (MAFINDO) Jakarta Indonesia
| | | | - Robert Terry
- Science Division World Health Organization Geneva Switzerland
| | - Naveen Thacker
- Deep Children Hospital and Research Centre Gandhidham India
| | | | - Shannon Turner
- Public Health Association of British Columbia Victoria, BC Canada.,Vaccine Safety Net (VSN) Geneva Switzerland
| | - Heidi Tworek
- Department of History University of British Columbia Vancouver, BC Canada
| | - Saad Uakkas
- Faculty of Medicine Mohamed V University in Rabat Rabat Morocco
| | - Emily Vraga
- Hubbard School of Journalism and Mass Communication University of Minnesota Minneapolis, MN United States
| | | | - Herman Wasserman
- Centre for Film and Media Studies University of Cape Town Cape Town South Africa
| | - Elisabeth Wilhelm
- US Centers for Disease Control and Prevention Atlanta, GA United States
| | - Andrea Würz
- European Centre for Disease Prevention and Control Stockholm Sweden
| | - Brian Yau
- Department of Regulation and Prequalification Access to Medicines and Health Products Division World Health Organization Geneva Switzerland
| | - Lei Zhou
- Public Health Emergency Center Chinese Center for Disease Control and Prevention Beijing China
| | - Tina D Purnat
- Department of Digital Health and Innovation Science Division World Health Organization Geneva Switzerland
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15
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Mercieca L, Aquilina S, Calleja N, Boffa MJ. Cutaneous Melanoma More Likely to Be Invasive in Fairer Skin Phototypes: A Retrospective Observational Study. Skinmed 2021; 19:280-283. [PMID: 34526202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Fitzpatrick skin phototype is one of the factors determining melanoma development, with fairer skin phototypes I and II known to be associated with a higher risk. This study aimed to identify any associations between skin phototype and the histologic subtype, Breslow's thickness, and the site of melanoma. Patients diagnosed with melanoma for over an 18-month period were included. Data were gathered from the Malta National Cancer Registry. There were 167 registered cutaneous melanoma patients, of which 135 were included in the study. Melanomas in patients with skin phototypes I and II were more likely to be invasive than in situ when compared to patients with skin phototypes III and IV (P = 0.00027). There was also an association between skin phototype and histologic type of melanoma (P = 0.005), with melanoma in situ being the most common subtype in patients with skin type III. This study confirms that fairer skin phototypes have an increased risk of melanoma. It also shows that in our population, melanoma in skin phototypes I and II is more likely to be invasive rather than in situ compared to melanoma in darker skin phototypes. Further studies are required to confirm these findings and identify possible reasons.
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Affiliation(s)
- Liam Mercieca
- Department of Dermatology, Sir Paul Boffa Hospital, Floriana, Malta;
| | - Susan Aquilina
- Department of Dermatology, Sir Paul Boffa Hospital, Floriana, Malta
| | - Neville Calleja
- Department of Public Health, University of Malta, Msida, Malta
| | - Michael J Boffa
- Department of Dermatology, Sir Paul Boffa Hospital, Floriana, Malta
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16
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Abstract
There is a significant relationship between ambient temperature and mortality. In healthy individuals with no underlying co-morbid conditions, there is an efficient heat regulation system which enables the body to effectively handle thermal stress. However, in vulnerable groups, especially in elderly over the age of 65 years, infants and individuals with co-morbid cardiovascular and/or respiratory conditions, there is a deficiency in thermoregulation. When temperatures exceed a certain limit, being cold winter spells or heat waves, there is an increase in the number of deaths. In particular, it has been shown that at temperatures above 27 °C, the daily mortality rate increases more rapidly per degree rise compared to when it drops below 27 °C. This is especially of relevance with the current emergency of global warming. Besides the direct effect of temperature rises on human health, global warming will have a negative impact on primary producers and livestock, leading to malnutrition, which will in turn lead to a myriad of health related issues. This is further exacerbated by environmental pollution. Public health measures that countries should follow should include not only health-related information strategies aiming to reduce the exposure to heat for vulnerable individuals and the community, but improved urban planning and reduction in energy consumption, among many others. This will reduce the carbon footprint and help avert global warming, thus reducing mortality.
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Affiliation(s)
- Jean Calleja-Agius
- Department of Anatomy, Faculty of Medicine and Surgery, University of Malta, Malta.
| | - Kathleen England
- Department of Health Information and Research, Ministry of Health, Malta
| | - Neville Calleja
- Department of Public Health, Faculty of Medicine and Surgery, University of Malta, Malta
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17
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Di Fiore R, Suleiman S, Ellul B, O’Toole SA, Savona-Ventura C, Felix A, Napolioni V, Conlon NT, Kahramanoglu I, Azzopardi MJ, Dalmas M, Calleja N, Brincat MR, Muscat-Baron Y, Sabol M, Dimitrievska V, Yordanov A, Vasileva-Slaveva M, von Brockdorff K, Micallef RA, Kubelac P, Achimas-Cadariu P, Vlad C, Tzortzatou O, Poka R, Giordano A, Felice A, Reed N, Herrington CS, Faraggi D, Calleja-Agius J. GYNOCARE Update: Modern Strategies to Improve Diagnosis and Treatment of Rare Gynecologic Tumors—Current Challenges and Future Directions. Cancers (Basel) 2021; 13:cancers13030493. [PMID: 33514073 PMCID: PMC7865420 DOI: 10.3390/cancers13030493] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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: 12/31/2020] [Revised: 01/19/2021] [Accepted: 01/22/2021] [Indexed: 12/11/2022] Open
Abstract
Simple Summary More than 50% of all the tumors affecting the female genital tract can be classified as rare and usually have a poor prognosis owing to delayed diagnosis and treatment. Currently, gynecologic cancer research, due to distinct scientific and technological challenges, is lagging behind. Moreover, the overall efforts for addressing these challenges are fragmented across different countries. The European Network for Gynecological Rare Cancer Research: GYNOCARE aims to address these challenges by creating a unique network between key stakeholders covering distinct domains from basic research to cure. GYNOCARE is part of a European Collaboration in Science and Technology (COST) with the aim to focus on the development of new approaches to improve the diagnosis and treatment of rare gynecological tumors. Here, we provide a brief overview describing the goals of this COST Action and its future challenges with the aim to continue fighting against this rare cancer. Abstract More than 50% of all gynecologic tumors can be classified as rare (defined as an incidence of ≤6 per 100,000 women) and usually have a poor prognosis owing to delayed diagnosis and treatment. In contrast to almost all other common solid tumors, the treatment of rare gynecologic tumors (RGT) is often based on expert opinion, retrospective studies, or extrapolation from other tumor sites with similar histology, leading to difficulty in developing guidelines for clinical practice. Currently, gynecologic cancer research, due to distinct scientific and technological challenges, is lagging behind. Moreover, the overall efforts for addressing these challenges are fragmented across different European countries and indeed, worldwide. The GYNOCARE, COST Action CA18117 (European Network for Gynecological Rare Cancer Research) programme aims to address these challenges through the creation of a unique network between key stakeholders covering distinct domains from concept to cure: basic research on RGT, biobanking, bridging with industry, and setting up the legal and regulatory requirements for international innovative clinical trials. On this basis, members of this COST Action, (Working Group 1, “Basic and Translational Research on Rare Gynecological Cancer”) have decided to focus their future efforts on the development of new approaches to improve the diagnosis and treatment of RGT. Here, we provide a brief overview of the current state-of-the-art and describe the goals of this COST Action and its future challenges with the aim to stimulate discussion and promote synergy across scientists engaged in the fight against this rare cancer worldwide.
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Affiliation(s)
- Riccardo Di Fiore
- Department of Anatomy, Faculty of Medicine and Surgery, University of Malta, MSD 2080 Msida, Malta; (R.D.F.); (S.S.)
- Center for Biotechnology, Sbarro Institute for Cancer Research and Molecular Medicine, College of Science and Technology, Temple University, Philadelphia, PA 19122, USA;
| | - Sherif Suleiman
- Department of Anatomy, Faculty of Medicine and Surgery, University of Malta, MSD 2080 Msida, Malta; (R.D.F.); (S.S.)
| | - Bridget Ellul
- Centre for Molecular Medicine & Biobanking, University of Malta, MSD 2080 Msida, Malta;
| | - Sharon A. O’Toole
- Departments of Obstetrics and Gynaecology and Histopathology, Trinity St James’s Cancer Institute, Trinity College Dublin, Dublin 8, Ireland;
| | - Charles Savona-Ventura
- Department of Obstetrics and Gynaecology, Faculty of Medicine and Surgery, University of Malta, MSD 2080 Msida, Malta;
| | - Ana Felix
- Department of Pathology, Campo dos Mártires da Pátria, Instituto Portugues de Oncologia de Lisboa, NOVA Medical School, UNL, 130, 1169-056 Lisboa, Portugal;
| | - Valerio Napolioni
- Genomic And Molecular Epidemiology (GAME) Lab., School of Biosciences and Veterinary Medicine, University of Camerino, 62032 Camerino, Italy;
| | - Neil T. Conlon
- National Institute for Cellular Biotechnology, Dublin City University, Glasnevin, 9 Dublin, Ireland;
| | - Ilker Kahramanoglu
- Department of Gynecologic Oncology, Emsey Hospital, Istanbul 3400, Turkey;
| | - Miriam J. Azzopardi
- Directorate for Health Information and Research, PTA 1313 G’Mangia, Malta; (M.J.A.); (N.C.)
| | - Miriam Dalmas
- Office of the Chief Medical Officer, Department of Policy in Health, Ministry for Health, 15 Merchants Street, VLT 1171 Valletta, Malta;
| | - Neville Calleja
- Directorate for Health Information and Research, PTA 1313 G’Mangia, Malta; (M.J.A.); (N.C.)
| | - Mark R. Brincat
- Department of Obstetrics and Gynaecology, Mater Dei Hospital, Triq Dun Karm, MSD 2090 Msida, Malta; (M.R.B.); (Y.M.-B.)
| | - Yves Muscat-Baron
- Department of Obstetrics and Gynaecology, Mater Dei Hospital, Triq Dun Karm, MSD 2090 Msida, Malta; (M.R.B.); (Y.M.-B.)
| | - Maja Sabol
- Laboratory for Hereditary Cancer, Division of Molecular Medicine, Ruđer Bošković Institute, 10000 Zagreb, Croatia;
| | | | - Angel Yordanov
- Department of Gynecologic Oncology, Medical University Pleven, 5800 Pleven, Bulgaria;
| | | | - Kristelle von Brockdorff
- Sir Anthony Mamo Oncology Centre, Department of Oncology and Radiotherapy, Mater Dei Hospital, MSD 2090 Msida, Malta; (K.v.B.); (R.A.M.)
| | - Rachel A. Micallef
- Sir Anthony Mamo Oncology Centre, Department of Oncology and Radiotherapy, Mater Dei Hospital, MSD 2090 Msida, Malta; (K.v.B.); (R.A.M.)
| | - Paul Kubelac
- Department of Medical Oncology, The Oncology Institute “Prof. Dr. Ion Chiricuţă”. 34–36 Republicii Street, 400015 Cluj-Napoca, Romania;
- Department of Oncology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (P.A.-C.); (C.V.)
| | - Patriciu Achimas-Cadariu
- Department of Oncology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (P.A.-C.); (C.V.)
- Department of Surgical Oncology, The Oncology Institute “Prof. Dr. Ion Chiricuta”, 400015 Cluj-Napoca, Romania
| | - Catalin Vlad
- Department of Oncology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (P.A.-C.); (C.V.)
- Department of Surgery, The Oncology Institute “Prof. Dr. Ion Chiricuta”, 400015 Cluj Napoca, Romania
| | - Olga Tzortzatou
- Biomedical Research Foundation of the Academy of Athens, Soranou Efesiou 4 str., 11527 Athens, Greece;
| | - Robert Poka
- Institute of Obstetrics and Gynaecology, University of Debrecen, Nagyerdei krt. 98, 4032 Debrecen, Hungary;
| | - Antonio Giordano
- Center for Biotechnology, Sbarro Institute for Cancer Research and Molecular Medicine, College of Science and Technology, Temple University, Philadelphia, PA 19122, USA;
- Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy
| | - Alex Felice
- Centre of Molecular Medicine and BioBanking, Department of Physiology & Biochemistry, Faculty of Medicine & Surgery, University of Malta, MSD 2080 Msida, Malta;
| | - Nicholas Reed
- Beatson Oncology Centre, Gartnavel General Hospital, 1053 Great Western Road, Glasgow G12 0YN, UK;
| | - C. Simon Herrington
- Cancer Research UK Edinburgh Centre, Western General Hospital, University of Edinburgh, Crewe Road South, Edinburgh EH4 2XR, UK;
| | - David Faraggi
- Department of Statistics, University of Haifa, Haifa 31905, Israel;
| | - Jean Calleja-Agius
- Department of Anatomy, Faculty of Medicine and Surgery, University of Malta, MSD 2080 Msida, Malta; (R.D.F.); (S.S.)
- Correspondence: ; Tel.: +356-2340-1892
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18
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Nørgaard SK, Vestergaard LS, Nielsen J, Richter L, Schmid D, Bustos N, Braye T, Athanasiadou M, Lytras T, Denissov G, Veideman T, Luomala O, Möttönen T, Fouillet A, Caserio-Schönemann C, An der Heiden M, Uphoff H, Gkolfinopoulou K, Bobvos J, Paldy A, Rotem N, Kornilenko I, Domegan L, O'Donnell J, Donato FD, Scortichini M, Hoffmann P, Velez T, England K, Calleja N, van Asten L, Stoeldraijer L, White RA, Paulsen TH, da Silva SP, Rodrigues AP, Klepac P, Zaletel M, Fafangel M, Larrauri A, León I, Farah A, Galanis I, Junker C, Perisa D, Sinnathamby M, Andrews N, O'Doherty MG, Irwin D, Kennedy S, McMenamin J, Adlhoch C, Bundle N, Penttinen P, Pukkila J, Pebody R, Krause TG, Mølbak K. Real-time monitoring shows substantial excess all-cause mortality during second wave of COVID-19 in Europe, October to December 2020. ACTA ACUST UNITED AC 2021; 26. [PMID: 33446304 PMCID: PMC7809719 DOI: 10.2807/1560-7917.es.2021.26.1.2002023] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [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] [Indexed: 01/14/2023]
Abstract
The European monitoring of excess mortality for public health action (EuroMOMO) network monitors weekly excess all-cause mortality in 27 European countries or subnational areas. During the first wave of the coronavirus disease (COVID-19) pandemic in Europe in spring 2020, several countries experienced extraordinarily high levels of excess mortality. Europe is currently seeing another upsurge in COVID-19 cases, and EuroMOMO is again witnessing a substantial excess all-cause mortality attributable to COVID-19.
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Affiliation(s)
| | | | - Jens Nielsen
- EuroMOMO hub, Statens Serum Institut, Copenhagen, Denmark
| | - Lukas Richter
- Austrian Agency for Health and Food Safety, Vienna, Austria
| | - Daniela Schmid
- Austrian Agency for Health and Food Safety, Vienna, Austria
| | | | | | | | | | - Gleb Denissov
- National Institute for Health Development, Tallinn, Estonia
| | | | - Oskari Luomala
- Finnish National Institute for Health and Welfare, Helsinki, Finland
| | - Teemu Möttönen
- Finnish National Institute for Health and Welfare, Helsinki, Finland
| | - Anne Fouillet
- French Public Health Agency (Santé Publique France), Saint-Maurice, France
| | | | | | - Helmut Uphoff
- Hessisches Landesprüfungs- und Untersuchungsamt im Gesundheitswesen, Dillenburg, Germany
| | | | - Janos Bobvos
- National Public Health Center, Budapest, Hungary
| | - Anna Paldy
- National Public Health Center, Budapest, Hungary
| | - Naama Rotem
- Health & Vital Statistics Sector, Central Bureau of Statistics, Jerusalem, Israel
| | - Irene Kornilenko
- Health & Vital Statistics Sector, Central Bureau of Statistics, Jerusalem, Israel
| | - Lisa Domegan
- Health Service Executive - Health Protection Surveillance Centre, Dublin, Ireland
| | - Joan O'Donnell
- Health Service Executive - Health Protection Surveillance Centre, Dublin, Ireland
| | | | | | - Patrick Hoffmann
- Health Directorate Luxembourg - Division de l'inspection sanitaire, Luxembourg, Luxembourg
| | - Telma Velez
- Health Directorate Luxembourg - Division de l'inspection sanitaire, Luxembourg, Luxembourg
| | | | - Neville Calleja
- Directorate for Health Information and Research, Pieta, Malta
| | - Liselotte van Asten
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | | | | | | | | | - Ana P Rodrigues
- Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisboa, Portugal
| | - Petra Klepac
- National Institute of Public Health, Ljubljana, Slovenia
| | - Metka Zaletel
- National Institute of Public Health, Ljubljana, Slovenia
| | - Mario Fafangel
- National Institute of Public Health, Ljubljana, Slovenia
| | - Amparo Larrauri
- National Centre of Epidemiology, CIBER Epidemiología y Salud Pública (CIBERESP), Carlos III Health Institute, Madrid, Spain
| | - Inmaculada León
- National Centre of Epidemiology, CIBER Epidemiología y Salud Pública (CIBERESP), Carlos III Health Institute, Madrid, Spain
| | - Ahmed Farah
- Public Health Agency of Sweden, Stockholm, Sweden
| | | | | | - Damir Perisa
- Federal Office of Public Health, Bern, Switzerland
| | - Mary Sinnathamby
- Public Health England, Colindale, United Kingdom of Great Britain and Northern Ireland
| | - Nick Andrews
- Public Health England, Colindale, United Kingdom of Great Britain and Northern Ireland
| | - Mark G O'Doherty
- Public Health Agency, Northern Ireland, United Kingdom of Great Britain and Northern Ireland
| | - David Irwin
- Public Health Agency, Northern Ireland, United Kingdom of Great Britain and Northern Ireland
| | - Sharon Kennedy
- Public Health Scotland, Glasgow, United Kingdom of Great Britain and Northern Ireland
| | - Jim McMenamin
- Public Health Scotland, Glasgow, United Kingdom of Great Britain and Northern Ireland
| | - Cornelia Adlhoch
- European Centre for Disease Prevention and Control, Solna, Sweden
| | - Nick Bundle
- European Centre for Disease Prevention and Control, Solna, Sweden
| | - Pasi Penttinen
- European Centre for Disease Prevention and Control, Solna, Sweden
| | - Jukka Pukkila
- World Health Organization, Regional Office for Europe, Copenhagen, Denmark
| | - Richard Pebody
- World Health Organization, Regional Office for Europe, Copenhagen, Denmark
| | - Tyra G Krause
- EuroMOMO hub, Statens Serum Institut, Copenhagen, Denmark
| | - Kåre Mølbak
- Department of Veterinary and Animal Science, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark.,EuroMOMO hub, Statens Serum Institut, Copenhagen, Denmark
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19
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Cardona T, Calleja N, Pullicino G. Urban-suburban differences in the demographics and clinical profiles of type 2 diabetic patients attending primary healthcare centres in Malta. Rural Remote Health 2020; 20:5666. [PMID: 33207913 DOI: 10.22605/rrh5666] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Social factors might bring about health inequities. Vulnerable population groups, including those suffering from non-communicable diseases such as type 2 diabetes and depression, might be more prone to suffering the effects of such inequities. This study aimed to identify patients with type 2 diabetes with depression in a primary care setting, with the objective of describing health inequities among urban and suburban dwellers. METHODS A quantitative, retrospective and descriptive study was carried out among patients with diabetes attending public primary healthcare centres in different regions of Malta. Participants completed a self-administered questionnaire to identify patient and disease characteristics. Convenience sampling was used. RESULTS The logistic regression model predicting the likelihood of different factors occurring with suburban patients with diabetes as opposed to those residing in urban areas contained five independent variables (severity of depression, monthly income, blood capillary glucose readings, weight and nationality). The full model containing all predictors was statistically significant, c2 (5, n=400), p<0.001, indicating that the model was able to distinguish between urban and suburban areas. The model as a whole explained between 10% (Cox and Snell R2) and 20% (Nagelkerke R2) of the variance in urban and suburban areas, and correctly classified 73.8% of cases. All five of the independent variables made a unique, statistically significant contribution to the model. Elevated blood glucose and obesity tended to be more prevalent in suburban respondents than in urban participants. Conversely, participants with diabetes living in urban areas were more likely to be depressed, non-Maltese and have a higher income. CONCLUSION Despite the small size of the Maltese islands and the expected social homogeneity, health inequities still exist, highlighting the importance of social factors in the epidemiology of disease. This study provides information for healthcare professionals and policy-makers to mitigate the effects of social inequities on vulnerable population groups.
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Affiliation(s)
- Tania Cardona
- Department of Family Medicine, University of Malta, Tal-Qroqq, Msida, MSD 2080, Malta
| | - Neville Calleja
- Directorate for Information and Research, 95, Telgha ta' Gwardamangia, Tal-Pieta, PTA 1313, Malta
| | - Glorianne Pullicino
- Department of Family Medicine, University of Malta, Tal-Qroqq, Msida, MSD 2080, Malta
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20
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Calleja-Agius J, Calleja N. Domestic violence among the elderly during the COVID-19 pandemic. Rev Esp Geriatr Gerontol 2020; 56:64. [PMID: 33069483 PMCID: PMC7269947 DOI: 10.1016/j.regg.2020.05.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 05/16/2020] [Indexed: 11/13/2022]
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21
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Grech J, Sammut R, Buontempo MB, Vassallo P, Calleja N. Brief tobacco cessation interventions: Practices, opinions, and attitudes of healthcare professionals. Tob Prev Cessat 2020; 6:48. [PMID: 32954061 PMCID: PMC7493645 DOI: 10.18332/tpc/125353] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 06/30/2020] [Accepted: 07/13/2020] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Although brief smoking cessation interventions that follow the 5As algorithm (Ask, Advise, Assess, Assist, Arrange) can trigger smokers to quit, routine delivery remains low in Europe. This study aimed to identify the extent of smoking cessation practices of healthcare professionals interested in tobacco cessation, and their opinions and attitudes. METHODS A quantitative, cross-sectional survey design was adopted. Healthcare professionals (n=133) who attended one of ten training sessions on brief interventions for smoking cessation, held every month between September 2018 and June 2019 in Malta, were recruited. Univariate logistic regression and non-parametric tests were carried out to identify associations by participants’ characteristics. Potential confounders were ruled out following multivariate analyses. RESULTS Most participants were female nurses who had never smoked. While most professionals reportedly asked (76.3%), advised (83.5%) and assessed (70.5%) patients for cessation, fewer provided assistance (40.9%) and arranged followup (24.2%). Compared to other participants, doctors were more likely to have counselled patients over the previous week. Most professionals were favourably disposed towards counselling patients to quit, however, they claimed they had insufficient time to do so. Although most found it difficult to get clients to quit, former smokers were more likely to disagree when compared to those who never smoked (OR=6.86; 95% CI: 2.17–21.71; p=0.001). CONCLUSIONS While more initiatives to train healthcare professionals in providing smoking cessation interventions are recommended, lack of sufficient time, being an organisational barrier, requires healthcare management exploration and action. Given that former smokers were more confident in helping patients quit, engaging them in training activities would be of added value.
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Affiliation(s)
- Joseph Grech
- Institute of Applied Sciences, Malta College of Arts, Science and Technology, Paola, Malta.,Department of Nursing, Faculty of Health Sciences, University of Malta, Msida, Malta.,Department for Health Regulation, Health Promotion and Disease Prevention Directorate, Ministry for Health, Pietà, Malta
| | - Roberta Sammut
- Department of Nursing, Faculty of Health Sciences, University of Malta, Msida, Malta
| | - Mariella B Buontempo
- Department for Health Regulation, Health Promotion and Disease Prevention Directorate, Ministry for Health, Pietà, Malta
| | - Pauline Vassallo
- Department for Health Regulation, Health Promotion and Disease Prevention Directorate, Ministry for Health, Pietà, Malta
| | - Neville Calleja
- Department for Policy in Health, Directorate for Health Information and Research, Ministry for Health, Pietà, Malta
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22
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Cuschieri S, Calleja N, Gorasso V, Devleesschauwer B. The burden of low back pain in Malta at a population level. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Low back pain (LBP) is a leading global cause of all-age years lived with disability (YLD). Studies conducted in Malta reported that musculoskeletal complaints were the commonest in primary care. The aim was to estimate for the first time the burden of LBP at population level in Malta in terms of disability-adjusted life years (DALYs) and compare to estimates obtained by the Global Burden of Disease (GBD) study.
Methods
LBP prevalence data were obtained from the Maltese European Health Interview Survey dataset for 2015 through representative self-reported history of chronic LBP for 12 months in combination to the extent of daily activities limitation. Proportions of LBP severity (with and without leg pain -mild, moderate, severe and most severe) and their corresponding disability weights followed values reported in GBD study. YLDs for LBP were estimated for the whole population by sex. Since LBP does not carry any mortality, YLDs reflected DALYs. The estimated local DALYs per100,000 were compared to the GBD study for Malta for the same year.
Results
Point prevalence of LBP causing a limitation was of 6.3% (5.6% males; 7.0% females), contributing to a total of 27,006 Maltese suffering from LBP. Global LBP DALYs were of 783 per100,000. Females experienced higher LBP burden per100,000 (876 DALYs) than males (689 DALYs). On comparing these DALYs to those reported by GBD study, a discrepancy was observed per 100,000 (Global LBP 1,828 DALYs; Males 1,657 DALYs; Females 1,999 DALYs).
Conclusions
LBP imposes substantial burden in Malta, which is expected to increase with the ageing population. Since etiology of LBP is multifactorial, it is suggested that a multi-disciplinary targeted preventive and management approach is considered. Differences observed between local estimates and those of the GBD study suggest the integration of locally sourced data into the model in order to improve the DALYs estimates of each country.
Key messages
Low back pain is a public health burden. Locally sourced data is suggested to be integrated with the GBD study to improve the DALYs estimation for each country.
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Affiliation(s)
| | - N Calleja
- Public Health, University of Malta, Msida, Malta
- Health Information and Research, Ministry of Health, Gwardamangia, Malta
| | - V Gorasso
- Epidemiology and Public Health, Sciensano, Brussels, Belgium
- Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - B Devleesschauwer
- Epidemiology and Public Health, Sciensano, Brussels, Belgium
- Veterinary Public Health and Food Safety, Ghent University, Merelbeke, Belgium
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Calleja N, Gatt M, Azzopardi M, Xuereb E, GrechMercieca E, Micallef R, Buttigieg D, Camilleri L, Galea A, Gauci C. 'Cocooning' the vulnerable - a main pillar of Malta's COVID-19 response. Eur J Public Health 2020. [PMCID: PMC7543406 DOI: 10.1093/eurpub/ckaa165.211] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Issue Early epidemiology established higher risk of morbidity & mortality amongst infected older individuals or those having specific chronic diseases, consuming most hospital care. Also where demand exceeding supply of healthcare, mortality was very high. As an island nation with one central main hospital, not overwhelming the healthcare system whilst avoiding total lockdown was key. Description On the 27-03-2020, the Superintendent of Public Health enacted the Protection of Vulnerable Persons Order, specifying that these categories (or subcategories thereof) of persons are to be granted vulnerable status: age >65; pregnant; persons suffering from diabetes; immunosuppressed; cancer; end stage renal failure; respiratory disease; cardiac disease; heart failure. Such persons were entitled to stay at home, to be granted special leave from work, entitled to a monthly allowance by social services. One could go out only to attend to essential or urgent personal matters, e.g. groceries, medicines, medical needs, bank etc. with mitigation measures. Exemptions were only granted to special categories such as healthcare workers, farmers, or headship positions. In addition, the carers & staff of most nursing homes voluntarily decided to isolate themselves inside the homes for periods of 2/3 weeks. Thanks to a very active family support network, offspring, relatives or neighbours ran basic errands for them, or else organised deliveries. This legal status has been lifted on the 5th June 2020. Results This status was granted to 126 000 persons, including 14000 employed persons. Only 9 deaths occurred in Malta out of 664 cases in a population of 500000 up till 20th June 2020, with a case fatality rate of 1.35% - one of the lowest in Europe. Lessons Protection of vulnerable individuals can be a cornerstone of COVID-19 public health response if mobility is effectively restricted in this subpopulation. Key messages Protection of the vulnerable reduces healthcare & mortality burden. Effective legal & economic support measures, & extensive societal engagement required.
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Affiliation(s)
- N Calleja
- Vulnerable Population Team, COVID-19 Public Health Response Effort, G'Mangia, Malta
| | - M Gatt
- Vulnerable Population Team, COVID-19 Public Health Response Effort, G'Mangia, Malta
| | - M Azzopardi
- Vulnerable Population Team, COVID-19 Public Health Response Effort, G'Mangia, Malta
| | - E Xuereb
- Vulnerable Population Team, COVID-19 Public Health Response Effort, G'Mangia, Malta
| | - E GrechMercieca
- Vulnerable Population Team, COVID-19 Public Health Response Effort, G'Mangia, Malta
| | - R Micallef
- Vulnerable Population Team, COVID-19 Public Health Response Effort, G'Mangia, Malta
| | - D Buttigieg
- Vulnerable Population Team, COVID-19 Public Health Response Effort, G'Mangia, Malta
| | - L Camilleri
- Vulnerable Population Team, COVID-19 Public Health Response Effort, G'Mangia, Malta
| | - A Galea
- Vulnerable Population Team, COVID-19 Public Health Response Effort, G'Mangia, Malta
| | - C Gauci
- Vulnerable Population Team, COVID-19 Public Health Response Effort, G'Mangia, Malta
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24
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Borg M, Cauchi D, Calleja N, Gauci C. Addressing childhood obesity - Are we doing enough? Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.1259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The prevalence of childhood overweight and obesity is increasing worldwide, with Malta having one of the highest rates among European countries. Childhood obesity is likely to track into adulthood, and can have multiple physical and psychological health outcomes. It also causes a substantial economic burden on society. A cross-sectional study that aimed to identify barriers to maintaining a healthy weight among children attending primary school, and to assess the level of support for a range of policies aimed at addressing childhood obesity as expressed by their parents/guardians, was conducted in Malta.
Methods
Data were collected using a paper-based questionnaire that was distributed to a stratified random sample of parents whose children attended free State schools, subsidised Church schools and fee-paying Independent primary schools in Malta and Gozo in 2018. Data were analysed using SPSSv25.
Results
Responses from 1169 parents were received. There was a dissonance between the most common barriers identified, that were primarily related to the food environment, and the policies that received the most support. Providing more spaces for safe physical activity was the most supported policy (94% in favour). Participants were least supportive of taxation policies, a phenomenon also observed in other countries. The level of support for policies varied significantly by various demographic and socioeconomic factors.
Conclusions
Recommendations were developed to inform future policies and strategies to address obesity. Policymakers need to take bold, possibly controversial decisions to mitigate against the barriers faced by the population in accessing healthy food and being physically active. Given the globalised nature of media advertising and the food system, a joint international effort is necessary to address this epidemic, such as stricter audio-visual media advertising regulations, food reformulation and mandatory standardised food labels.
Key messages
The majority of participants supported most of the proposed policies to address obesity. Taxation policies received the least support. Most policies supported are trans-sectoral, therefore a health-in-all policies approach and international collaboration are necessary.
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Affiliation(s)
- M Borg
- Department of Public Health, University of Malta, Msida, Malta
| | - D Cauchi
- Department of Public Health, University of Malta, Msida, Malta
| | - N Calleja
- Department of Public Health, University of Malta, Msida, Malta
| | - C Gauci
- Department of Public Health, University of Malta, Msida, Malta
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25
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Cuschieri S, Wyper GMA, Calleja N, Gorasso V, Devleesschauwer B. Measuring disability-adjusted life years (DALYs) due to low back pain in Malta. ACTA ACUST UNITED AC 2020; 78:68. [PMID: 32760586 PMCID: PMC7379821 DOI: 10.1186/s13690-020-00451-w] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 07/17/2020] [Indexed: 12/23/2022]
Abstract
Background Low back pain (LBP) is a public health concern and a leading cause of ill health. A high prevalence of musculoskeletal complaints has been reported for Malta, a small European state. The aim was to estimate for the first time the burden of LBP at population level in Malta in terms of disability-adjusted life years (DALYs) and compare to estimates obtained by the Global Burden of Disease (GBD) study. Method The Maltese European Health Interview Survey dataset for 2015 provided the LBP prevalence data through representative self-reported history of chronic LBP within the past 12 months in combination with limitations to daily activities. Proportions of LBP severity (with and without leg pain – mild, moderate, severe and most severe) and their corresponding disability weights followed values reported in the GBD study. Years lived with disability (YLD) for LBP were estimated for the whole population by age and sex. Since LBP does not carry any mortality, YLD reflected DALYs. The estimated local DALYs per 100,000 were compared to the GBD 2017 study results for Malta for the same year. Results LBP with activity limitation gave a point prevalence of 6.4% (95% Uncertainty Interval [UI] 5.7–7.2%) (5.6% males [95% UI 4.6–6.6%]; 7.3% females [95% UI 6.2–8.4%]), contributing to a total of 23,649 (95% UI 20,974–26,463) Maltese suffering from LBP. The LBP DALYs were of 716 (95% UI 558–896) per 100,000. Females experienced higher LBP burden (739 [95% UI 575–927] DALYs per 100,000) than males (693 [95% UI 541–867] DALYs per 100,000). Our DALY estimates were lower than those reported by the GBD 2017 study (i.e., 1829 [95% UI 1300–2466] per 100,000). Conclusions LBP imposes a substantial burden on the Maltese population. Differences observed between national estimates and those of the GBD study suggest the integration of updated locally sourced data into the model and encouraging local contributors in order to improve the DALY estimates of each country.
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Affiliation(s)
- Sarah Cuschieri
- Department of Anatomy, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
| | - Grant M A Wyper
- Public Health Scotland, Meridian Court, 5 Cadogan Street, Glasgow, G2 6QE Scotland
| | - Neville Calleja
- Department of Public Health, Faculty of Medicine and Surgery, University of Malta, Msida, Malta.,Director of Directorate of Health Information and Research, Ministry of Health, Gwardamangia, Malta
| | - Vanessa Gorasso
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium.,Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Brecht Devleesschauwer
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium.,Department of Veterinary Public Health and Food Safety, Ghent University, Merelbeke, Belgium
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26
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Tangcharoensathien V, Calleja N, Nguyen T, Purnat T, D'Agostino M, Garcia-Saiso S, Landry M, Rashidian A, Hamilton C, AbdAllah A, Ghiga I, Hill A, Hougendobler D, van Andel J, Nunn M, Brooks I, Sacco PL, De Domenico M, Mai P, Gruzd A, Alaphilippe A, Briand S. Framework for Managing the COVID-19 Infodemic: Methods and Results of an Online, Crowdsourced WHO Technical Consultation. J Med Internet Res 2020; 22:e19659. [PMID: 32558655 PMCID: PMC7332158 DOI: 10.2196/19659] [Citation(s) in RCA: 236] [Impact Index Per Article: 59.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 06/18/2020] [Indexed: 11/18/2022] Open
Abstract
Background An infodemic is an overabundance of information—some accurate and some not—that occurs during an epidemic. In a similar manner to an epidemic, it spreads between humans via digital and physical information systems. It makes it hard for people to find trustworthy sources and reliable guidance when they need it. Objective A World Health Organization (WHO) technical consultation on responding to the infodemic related to the coronavirus disease (COVID-19) pandemic was held, entirely online, to crowdsource suggested actions for a framework for infodemic management. Methods A group of policy makers, public health professionals, researchers, students, and other concerned stakeholders was joined by representatives of the media, social media platforms, various private sector organizations, and civil society to suggest and discuss actions for all parts of society, and multiple related professional and scientific disciplines, methods, and technologies. A total of 594 ideas for actions were crowdsourced online during the discussions and consolidated into suggestions for an infodemic management framework. Results The analysis team distilled the suggestions into a set of 50 proposed actions for a framework for managing infodemics in health emergencies. The consultation revealed six policy implications to consider. First, interventions and messages must be based on science and evidence, and must reach citizens and enable them to make informed decisions on how to protect themselves and their communities in a health emergency. Second, knowledge should be translated into actionable behavior-change messages, presented in ways that are understood by and accessible to all individuals in all parts of all societies. Third, governments should reach out to key communities to ensure their concerns and information needs are understood, tailoring advice and messages to address the audiences they represent. Fourth, to strengthen the analysis and amplification of information impact, strategic partnerships should be formed across all sectors, including but not limited to the social media and technology sectors, academia, and civil society. Fifth, health authorities should ensure that these actions are informed by reliable information that helps them understand the circulating narratives and changes in the flow of information, questions, and misinformation in communities. Sixth, following experiences to date in responding to the COVID-19 infodemic and the lessons from other disease outbreaks, infodemic management approaches should be further developed to support preparedness and response, and to inform risk mitigation, and be enhanced through data science and sociobehavioral and other research. Conclusions The first version of this framework proposes five action areas in which WHO Member States and actors within society can apply, according to their mandate, an infodemic management approach adapted to national contexts and practices. Responses to the COVID-19 pandemic and the related infodemic require swift, regular, systematic, and coordinated action from multiple sectors of society and government. It remains crucial that we promote trusted information and fight misinformation, thereby helping save lives.
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Affiliation(s)
| | - Neville Calleja
- Directorate for Health Information and Research, Ministry for Health, Valetta, Malta
| | - Tim Nguyen
- High Impact Events Preparedness, Global Infectious Hazards Preparedness, Emergency Preparedness, Geneva, Switzerland
| | - Tina Purnat
- Department of Digital Health and Innovation, Science Division, World Health Organization, Geneva, Switzerland
| | - Marcelo D'Agostino
- Information Systems for Health, Evidence and Intelligence for Action in Health, Pan American Health Organization and World Health Organization Regional Office for the Americas, Washington DC, DC, United States
| | - Sebastian Garcia-Saiso
- Evidence and Intelligence for Action in Health, Pan American Health Organization and World Health Organization Regional Office for the Americas, Washington, DC, United States
| | - Mark Landry
- Department of Health Systems Development, Regional Office for South-East Asia, World Health Organization, New Delhi, India
| | - Arash Rashidian
- Department of Science, Information and Dissemination, Eastern Mediterranean Regional Office, World Health Organization, Cairo, Egypt
| | - Clayton Hamilton
- Division of Health Systems and Public Health, Regional Office for Europe, World Health Organization, Copenhagen, Denmark
| | - Abdelhalim AbdAllah
- Communications Department, Regional Office for Africa, World Health Organization, Brazzaville, Congo
| | - Ioana Ghiga
- Global Infectious Hazards Preparedness, Emergency Preparedness, World Health Organization, Geneva, Switzerland
| | - Alexandra Hill
- Global Infectious Hazards Preparedness, Emergency Preparedness, World Health Organization, Geneva, Switzerland
| | - Daniel Hougendobler
- Global Infectious Hazards Preparedness, Emergency Preparedness, World Health Organization, Geneva, Switzerland
| | - Judith van Andel
- Department of Digital Health and Innovation, Science Division, World Health Organization, Geneva, Switzerland
| | | | - Ian Brooks
- Center for Health Informatics, School of Information Sciences, University of Illinois, Champaign, IL, United States
| | - Pier Luigi Sacco
- Fondazione Bruno Kessler, Trento, Italy.,Venice Office, Organisation for Economic Co-operation and Development, Venice, Italy.,The University Institute for Modern Languages, Milan, Italy.,Berkman-Klein Center for Internet and Society, Harvard University, Cambridge, MA, United States
| | - Manlio De Domenico
- Complex Multilayer Networks (CoMuNe) Research, Center for Information and Communication Technology, Bruno Kessler Foundation, Trento, Italy
| | - Philip Mai
- Ted Rogers School of Management, Ryerson University, Toronto, ON, Canada
| | - Anatoliy Gruzd
- Ted Rogers School of Management, Ryerson University, Toronto, ON, Canada
| | | | - Sylvie Briand
- Global Infectious Hazards Preparedness, Emergency Preparedness, World Health Organization, Geneva, Switzerland
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27
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Abstract
Background and Objectives The incidence of glioblastoma multiforme (GBM) ranges from 0.59 to 5 per 100,000 persons, and it is on the rise in many countries. The reason for this rise is multifactorial, and possible contributing factors include an aging population, overdiagnosis, ionizing radiation, air pollution and others. The aim of this study is to conduct an epidemiological study of GBM in a well-defined population over a 10-year period and determine its significance, while comparing results with international standards. Materials and Methods All histological diagnoses of GBM in Malta from 2008 to 2017 were identified. Poisson regression was used to determine significance in incidence variation. Log-rank tests were used to compare the survival distributions of each variable. Cox regression for survival analysis with the Breslow method for ties was then performed to consider the overall model. Results A total of 100 patients (61 males; mean age 60.29±10.09 years) were diagnosed with GBM over the period 2008 to 2017. There was a significant increase in incidence from 0.73 to 4.49 per 100,000 over the 10-year period (p≤0.001). The most common presenting complaint was limb paresis (29%). Approximately 65% of patients were treated with maximum safe resection (MSR). Using Cox regression analysis, younger age at presentation and treatment with MSR significantly improved survival (p=0.026 and p≤0.001, respectively). The median survival was 10 months. Conclusions An increasing incidence of GBM is becoming evident, while the median survival remains low. This troubling trend emphasizes the importance of further research into GBM etiology and treatment.
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Affiliation(s)
- Neil Grech
- Department of Internal Medicine, Mater Dei Hospital, Msida, MLT
| | - Theresia Dalli
- Department of Internal Medicine, Mater Dei Hospital, Msida, MLT
| | - Sean Mizzi
- Department of Neurosurgery, Mater Dei Hospital, Msida, MLT
| | - Lara Meilak
- Department of Neurosurgery, Mater Dei Hospital, Msida, MLT
| | - Neville Calleja
- Department of Health Information and Research, Directorate for Health Information & Research, Pieta, MLT.,Department of Public Health, Faculty of Medicine & Surgery, University of Malta, Msida, MLT
| | - Antoine Zrinzo
- Department of Neurosurgery, Mater Dei Hospital, Msida, MLT
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28
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Seijmonsbergen-Schermers AE, van den Akker T, Rydahl E, Beeckman K, Bogaerts A, Binfa L, Frith L, Gross MM, Misselwitz B, Hálfdánsdóttir B, Daly D, Corcoran P, Calleja-Agius J, Calleja N, Gatt M, Vika Nilsen AB, Declercq E, Gissler M, Heino A, Lindgren H, de Jonge A. Variations in use of childbirth interventions in 13 high-income countries: A multinational cross-sectional study. PLoS Med 2020; 17:e1003103. [PMID: 32442207 PMCID: PMC7244098 DOI: 10.1371/journal.pmed.1003103] [Citation(s) in RCA: 87] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 04/13/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Variations in intervention rates, without subsequent reductions in adverse outcomes, can indicate overuse. We studied variations in and associations between commonly used childbirth interventions and adverse outcomes, adjusted for population characteristics. METHODS AND FINDINGS In this multinational cross-sectional study, existing data on 4,729,307 singleton births at ≥37 weeks in 2013 from Finland, Sweden, Norway, Denmark, Iceland, Ireland, England, the Netherlands, Belgium, Germany (Hesse), Malta, the United States, and Chile were used to describe variations in childbirth interventions and outcomes. Numbers of births ranged from 3,987 for Iceland to 3,500,397 for the USA. Crude data were analysed in the Netherlands, or analysed data were shared with the principal investigator. Strict variable definitions were used and information on data quality was collected. Intervention rates were described for each country and stratified by parity. Uni- and multivariable analyses were performed, adjusted for population characteristics, and associations between rates of interventions, population characteristics, and outcomes were assessed using Spearman's rank correlation coefficients. Considerable intercountry variations were found for all interventions, despite adjustments for population characteristics. Adjustments for ethnicity and body mass index changed odds ratios for augmentation of labour and episiotomy. Largest variations were found for augmentation of labour, pain relief, episiotomy, instrumental birth, and cesarean section (CS). Percentages of births at ≥42 weeks varied from 0.1% to 6.7%. Rates among nulliparous versus multiparous women varied from 56% to 80% versus 51% to 82% for spontaneous onset of labour; 14% to 36% versus 8% to 28% for induction of labour; 3% to 13% versus 7% to 26% for prelabour CS; 16% to 48% versus 12% to 50% for overall CS; 22% to 71% versus 7% to 38% for augmentation of labour; 50% to 93% versus 25% to 86% for any intrapartum pain relief, 19% to 83% versus 10% to 64% for epidural anaesthesia; 6% to 68% versus 2% to 30% for episiotomy in vaginal births; 3% to 30% versus 1% to 7% for instrumental vaginal births; and 42% to 70% versus 50% to 84% for spontaneous vaginal births. Countries with higher rates of births at ≥42 weeks had higher rates of births with a spontaneous onset (rho = 0.82 for nulliparous/rho = 0.83 for multiparous women) and instrumental (rho = 0.67) and spontaneous (rho = 0.66) vaginal births among multiparous women and lower rates of induction of labour (rho = -0.71/-0.66), prelabour CS (rho = -0.61/-0.65), overall CS (rho = -0.61/-0.67), and episiotomy (multiparous: rho = -0.67). Variation in CS rates was mainly due to prelabour CS (rho = 0.96). Countries with higher rates of births with a spontaneous onset had lower rates of emergency CS (nulliparous: rho = -0.62) and higher rates of spontaneous vaginal births (multiparous: rho = 0.70). Prelabour and emergency CS were positively correlated (nulliparous: rho = 0.74). Higher rates of obstetric anal sphincter injury following vaginal birth were found in countries with higher rates of spontaneous birth (nulliparous: rho = 0.65). In countries with higher rates of epidural anaesthesia (nulliparous) and spontaneous births (multiparous), higher rates of Apgar score < 7 were found (rhos = 0.64). No statistically significant variation was found for perinatal mortality. Main limitations were varying quality of data and missing information. CONCLUSIONS Considerable intercountry variations were found for all interventions, even after adjusting for population characteristics, indicating overuse of interventions in some countries. Multivariable analyses are essential when comparing intercountry rates. Implementation of evidence-based guidelines is crucial in optimising intervention use and improving quality of maternity care worldwide.
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Affiliation(s)
- Anna E. Seijmonsbergen-Schermers
- Department of Midwifery Science, AVAG, Amsterdam Public Health research institute, Amsterdam UMC, location VUmc, Amsterdam, the Netherlands
- * E-mail:
| | - Thomas van den Akker
- Department of Obstetrics, Leiden University Medical Center, Leiden, the Netherlands
- Athena Institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Eva Rydahl
- University College Copenhagen, Department of Midwifery, Copenhagen NV, Denmark
| | - Katrien Beeckman
- Nursing and Midwifery Research unit, faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Annick Bogaerts
- Department of Development and Regeneration KU Leuven, University of Leuven, Leuven, Belgium
- Faculty of Medicine and Health Sciences, Centre for Research and Innovation in Care (CRIC), University of Antwerp, Belgium
| | - Lorena Binfa
- Department of Women´s and Newborn Health Promotion-School of Midwifery, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Lucy Frith
- Department of Health Services Research, The University of Liverpool, Liverpool, United Kingdom
| | - Mechthild M. Gross
- Midwifery Research and Education Unit, Department of Obstetrics, Gynaecology and Reproductive Medicine, Hannover Medical School, Hannover, Germany
| | | | - Berglind Hálfdánsdóttir
- Midwifery Programme, Faculty of Nursing, School of Health Sciences, University of Iceland, Reykjavík, Iceland
| | - Deirdre Daly
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Paul Corcoran
- National Perinatal Epidemiology Centre, Department of Obstetrics and Gynaecology, University College Cork, Cork, Ireland
| | - Jean Calleja-Agius
- Department of Anatomy, Faculty of Medicine and Surgery, University of Malta, Tal-Qroqq, Msida, Malta
| | - Neville Calleja
- Directorate for Health Information and Research, Gwardamangia, Malta
- Department of Public Health Department, Faculty of Medicine and Surgery, University of Malta, Tal-Qroqq, Msida, Malta
| | - Miriam Gatt
- Directorate for Health Information and Research, Gwardamangia, Malta
| | - Anne Britt Vika Nilsen
- Western Norway University of Applied Sciences (HVL), Department of Health and Caring Sciences, Bergen, Norway
| | - Eugene Declercq
- Boston University School of Public Health, Boston, United States of America
| | - Mika Gissler
- THL Finnish Institute for Health and Welfare, Information Services Department, Helsinki, Finland
- Karolinska Institute, Department of Neurobiology, Care Sciences and Society, Huddinge, Sweden
| | - Anna Heino
- THL Finnish Institute for Health and Welfare, Information Services Department, Helsinki, Finland
| | - Helena Lindgren
- Department of Women’s and Children’s Health, Karolinska Institutet, Solna, Sweden
| | - Ank de Jonge
- Department of Midwifery Science, AVAG, Amsterdam Public Health research institute, Amsterdam UMC, location VUmc, Amsterdam, the Netherlands
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29
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Affiliation(s)
- Victor Grech
- Academic Department of Paediatrics, Medical School, Mater Dei Hospital, Malta; Department for Policy in Health - Health Information and Research, Malta.
| | - Neville Calleja
- Academic Department of Paediatrics, Medical School, Mater Dei Hospital, Malta; Department for Policy in Health - Health Information and Research, Malta.
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30
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Bogaert P, Abboud LA, Calleja N, Ziese T, Fehr A, Van Oyen H. Strengthening health information systems in Europe through peer review assessments. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz185.736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
How does your Health Information System (HIS) measure up to others in the EU? How can you empower national HIS players with an objective peer-reviewed HIS assessment? Nine InfAct partners engaged in a capacity building exercise where experts in rotating groups of three countries performed peer assessments of each other’s national HIS. Using a WHO Europe adapted and refined tool, assessors analysed the HIS of a country (data collection, processing, analysis, dissemination and use) and exchanged practices in an intensive 2-day schedule of interviews with established key stakeholders.
Objectives
The aim of the peer assessment is three-fold: to test the feasibility of a peer-review HIS assessment, to map heath information inequalities across EU MSs, and to strengthen the knowledge of HIS players.
Results
Two cycles are now complete and the feedback is overwhelmingly positive - from assessors and hosts alike. So far, the HIS assessment has been a major success in its ability to systematically and concisely analyse a HIS. It identifies gaps in the HIS through desk review and interviews, and provides a SWOT analysis and SMART recommendations to address these gaps. Additionally, this exercise has shown the ability to increase stakeholders’ awareness of their role in their national HIS, and to build new networks within and between MSs. The exercise is also perceived as an opportunity for cross-fertilisation of ideas and exploration of methodologies on how to address specific challenges. This will stimulate actions to improve national HISs, and will lead to the identification of good practices which can then be used by other EU countries.
Conclusions
By bringing together key HIS stakeholders from different countries and stimulating the improvement of HIS and the exchange of good practices, InfAct contributes to capacity building in the EU, which in turn may lead to the reduction of health information inequalities between countries.
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Affiliation(s)
- P Bogaert
- Department of Epidemiology and Public health, Sciensano, Brussels, Belgium
- School of Social and Behavioral Sciences, Tilburg University, Tilburg, Netherlands
| | - L A Abboud
- Department of Epidemiology and Public health, Sciensano, Brussels, Belgium
| | - N Calleja
- Directorate for Health Information & Research, Ministry of Health, Gwardamangia, Malta
| | - T Ziese
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - A Fehr
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - H Van Oyen
- Department of Epidemiology and Public health, Sciensano, Brussels, Belgium
- Department of Public Health, Ghent University, Ghent, Belgium
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31
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Bogaert P, Abboud LA, Calleja N, Zelviene A, Schmidt A, Rösenkotter N, Ortiz DN, Verschuuren M, van Oers H, Van Oyen H. The WHO support tool: what can you learn and how have others experienced it? Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz185.226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Issue and method
Health information systems (HIS) in Europe are complex and involve multiple stakeholders. To strategically assess HIS, a support tool has been developed by the WHO Regional Office for Europe.
It has been applied in nine countries by WHO Europe since October 2015. Additionally, nine countries are using the tool in a peer review format within the context of the Joint Action on Health Information (InfAct) between January and December 2019. What can you expect to find out during such an assessment? What are countries commonly struggling with? In this presentation, the wealth of experiences using the support tool will be shared and participants will learn about common strengths and weaknesses in HIS across Europe.
Results
While each country possesses a unique HIS, common strengths and challenges emerge from across assessments. A few major ones will be presented in this session. In many countries promising e-health developments are ongoing such as electronic health records, e-prescription and cloud solutions for data storage. There is a clear desire to shift towards e-health technologies which is a real opportunity. However, well-developed step-wise approaches in interaction with key players are sometimes lacking and sustainability in financing can be of concern. Central multisectoral coordination mechanisms are often lacking, leading to inefficiencies in bringing together data and information, and in the use of financial and human resources. Finally, in many cases data is available, but legal aspects (e.g. impact of General Data Protection Regulation) are limiting the exchange and linkage possibilities for research and monitoring.
Lessons
HIS assessments help to determine common strength and challenges. By sharing common experiences, participants are better prepared to face common hurdles in their country and will have been exposed to good practices on how to address these.
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Affiliation(s)
- P Bogaert
- Department of Epidemiology and Public health, Sciensano, Brussels, Belgium
- School of Social and Behavioral Sciences, Tilburg University, Tilburg, Netherlands
| | - L A Abboud
- Department of Epidemiology and Public health, Sciensano, Brussels, Belgium
| | - N Calleja
- Directorate for Health Information & Research, Ministry of Health, Gwardamangia, Malta
| | - A Zelviene
- Health Information Centre, Institute of Hygiene, Vilnius, Lithuania
| | - A Schmidt
- Department of Health Economics & System Analysis & Research, Gesundheit Österreich GmbH, Vienna, Austria
| | - N Rösenkotter
- Public Health Reporting, NRW Centre for Health, Bochum, Germany
| | - D Novillo Ortiz
- Division of Information, Evidence, Research and Innovation, WHO Regional Office for Europe, Copenhagen, Denmark
| | | | - H van Oers
- Chief Science Office, RIVM, Bilthoven, Netherlands
- School of Social and Behavioral Sciences, Tilburg University, Tilburg, Netherlands
| | - H Van Oyen
- Department of Epidemiology and Public health, Sciensano, Brussels, Belgium
- Department of Public Health, Ghent University, Ghent, Belgium
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Boffa MM, Calleja N, Boffa MJ. The Finger-Prick Sign of Diabetes: An Observational Study Including Dermatoscopic Features. Skinmed 2019; 17:374-378. [PMID: 31904326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
This study aimed to define the clinical features and prevalence of the finger-prick sign in a cohort of persons with diabetes mellitus (DM). One hundred and five consecutive persons with DM attending a hospital diabetes clinic (n = 44) or a dermatology out-patients clinic (n = 61) who performed self-monitoring of blood glucose (SMBG) at least once daily and 105 age- and sex-matched controls were examined for typical prick marks on any of their fingers. The sign was positive (two or more prick marks visible) in 88 participants (84%), with strong positive correlation between the stated daily SMBG frequency and the number of prick marks observed, r = 0.723, P < 0.0001. Prick mark numbers were highest for the ring followed by the little, middle, and index fingers and lowest for the thumb, and varied significantly between the different fingers (P < 0.0001). Overall, prick marks were commoner on the non-dominant hand compared to the dominant hand (P < 0.0001). None of the controls had any visible finger-prick marks. The finger-prick sign is positive in most persons with DM who perform SMBG, particularly in those who test more frequently. It is a pointer to DM that can be clinically useful, particularly in emergencies when a person's medical history is unobtainable.
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Affiliation(s)
| | - Neville Calleja
- Department of Public Health, University of Malta, Msida, Malta
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Collict M, Baron YM, Gatt M, Calleja N. Advanced maternal age and neonatal outcomes in Malta. CLIN EXP OBSTET GYN 2019. [DOI: 10.12891/ceog4624.2019] [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: 11/01/2022]
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Abstract
In the scholarly environment, research findings are disseminated as journal papers which support/dispute extant knowledge or add further to what is already known. The entire manuscript needs to be cited (in-text) and referenced (at the end of article), in order for readers to ascertain the validity of the research claim/s. This must be done in proper and accepted fashion as plagiarism is a serious misdeed and inappropriate referencing mars a paper. Recent advancements in technology have led to the development of bibliographic management software tools. These tools are available as both commercial and open source software, and constitute a database wherein researchers search, store and cite references. Furthermore, authors can not only create personalized databases but also cite stored articles when compiling a manuscript or report or indeed any other form of document. This software obviates human manual inputting errors and inaccurate referencing, while conveniently enabling citation and referencing in any referencing style required, for example, after rejection, when an author must almost perforce resubmit a prepared but rejected paper to a different journal after suitable amendments.
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Affiliation(s)
| | - Victor Grech
- University of Malta, Msida, Malta; Mater Dei Hospital, Msida, Malta.
| | - Neville Calleja
- Public Health Department, University of Malta, Msida, Malta; Directorate for Health Information and Research, Gwardamanga, Malta.
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Nicolai N, Biasoni D, Catanzaro MA, Colecchia M, Trama A, Hackl M, Eycken EV, Henau K, Dimitrova N, Sekerija M, Dušek L, Mägi M, Malila N, Leinonen M, Velten M, Troussard X, Bouvier V, Guizard AV, Bouvier AM, Arveux P, Maynadié M, Woronoff AS, Robaszkiewic M, Baldi I, Monnereau A, Tretarre B, Colonna M, Molinié F, Bara S, Schvartz C, Lapôtre-Ledoux B, Grosclaude P, Stabenow R, Luttmann S, Nennecke A, Engel J, Schubert-Fritschle G, Heidrich J, Holleczek B, Jónasson JG, Clough-Gorr K, Comber H, Mazzoleni G, Giacomin A, Sutera Sardo A, Barchielli A, Serraino D, De Angelis R, Mallone S, Tavilla A, Pierannunzio D, Rossi S, Santaquilani M, Knijn A, Pannozzo F, Gennaro V, Benfatto L, Ricci P, Autelitano M, Spagnoli G, Fusco M, Usala M, Vitale F, Michiara M, Tumino R, Mangone L, Falcini F, Ferretti S, Filiberti RA, Marani E, Iannelli A, Sensi F, Piffer S, Gentilini M, Madeddu A, Ziino A, Maspero S, Candela P, Stracci F, Tagliabue G, Rugge M, Trama A, Gatta G, Botta L, Capocaccia R, Pildava S, Smailyte G, Calleja N, Johannesen TB, Rachtan J, Góźdź S, Błaszczyk J, Kępska K, de Lacerda GF, Bento MJ, Miranda A, Diba CS, Almar E, Larrañaga N, de Munain AL, Torrella-Ramos A, Díaz García JM, Marcos-Gragera R, Sanchez MJ, Navarro C, Salmeron D, Moreno-Iribas C, Galceran J, Carulla M, Mousavi M, Bouchardy C, M. Ess S, Bordoni A, Konzelmann I, Rashbass J, Gavin A, Brewster DH, Huws DW, Visser O, Bielska-Lasota M, Primic-Zakelj M, Kunkler I, Benhamou E. Testicular germ-cell tumours and penile squamous cell carcinoma: Appropriate management makes the difference. Eur J Surg Oncol 2019. [DOI: 10.1016/j.ejso.2018.02.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
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Cuschieri S, Vassallo J, Calleja N, Mamo J. Relationship of past, present, and passive smoking with sociodemographic, anthropometric, biochemical, and dysglycemic profiles. J Diabetes 2019; 11:87-89. [PMID: 30144285 DOI: 10.1111/1753-0407.12844] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2018] [Revised: 07/20/2018] [Accepted: 08/19/2018] [Indexed: 01/20/2023] Open
Affiliation(s)
- Sarah Cuschieri
- Department of Anatomy, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
| | - Josanne Vassallo
- Department of Medicine, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
| | - Neville Calleja
- Department of Public Health, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
- Department of Health Information and Research, Ministry of Health, Gwardamangia, Malta
| | - Julian Mamo
- Department of Public Health, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
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Imbimbo M, Maury JM, Garassino M, Girard N, Hackl M, Eycken EV, Henau K, Dimitrova N, Sekerija M, Dušek L, Mägi M, Malila N, Leinonen M, Velten M, Troussard X, Bouvier V, Guizard AV, Bouvier AM, Arveux P, Maynadié M, Woronoff AS, Robaszkiewicz M, Baldi I, Monnereau A, Tretarre B, Colonna M, Molinié F, Bara S, Schvartz C, Lapôtre-Ledoux B, Grosclaude P, Stabenow R, Luttmann S, Nennecke A, Engel J, Schubert-Fritschle G, Heidrich J, Holleczek B, Jónasson JG, Clough-Gorr K, Comber H, Mazzoleni G, Giacomin A, Sardo AS, Barchielli A, Serraino D, De Angelis R, Mallone S, Tavilla A, Pierannunzio D, Rossi S, Santaquilani M, Knijn A, Pannozzo F, Gennaro V, Benfatto L, Ricci P, Autelitano M, Spagnoli G, Fusco M, Usala M, Vitale F, Michiara M, Tumino R, Mangone L, Falcini F, Ferretti S, Angela Filiberti R, Marani E, Iannelli A, Sensi F, Piffer S, Gentilini M, Madeddu A, Ziino A, Maspero S, Candela P, Stracci F, Tagliabue G, Rugge M, Trama A, Gatta G, Botta L, Capocaccia R, Pildava S, Smailyte G, Calleja N, Johannesen TB, Rachtan J, Góźdź S, Błaszczyk J, Kępska K, de Lacerda GF, Bento MJ, Miranda A, Diba CS, Almar E, Larrañaga N, de Munain AL, Torrella-Ramos A, Díaz García JM, Marcos-Gragera R, Sanchez MJ, Navarro C, Salmeron D, Moreno-Iribas C, Galceran J, Carulla M, Mousavi M, Bouchardy C, Ess SM, Bordoni A, Konzelmann I, Rashbass J, Gavin A, Brewster DH, Huws DW, Visser O, Bielska-Lasota M, Primic-Zakelj M, Kunkler I, Benhamou E. Mesothelioma and thymic tumors: Treatment challenges in (outside) a network setting. Eur J Surg Oncol 2019; 45:75-80. [DOI: 10.1016/j.ejso.2018.01.078] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 01/02/2018] [Accepted: 01/07/2018] [Indexed: 10/18/2022] Open
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Caruana M, Calleja N, Cordina M. Asthma Management and Support in Primary Schools. Res Social Adm Pharm 2019. [DOI: 10.1016/j.sapharm.2018.10.014] [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: 11/17/2022]
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Cuschieri S, Vassallo J, Calleja N, Barbara C, Mamo J. The interaction of dyslipidaemia with glycaemia in an adult population study. J Diabetes Metab Disord 2018; 17:315-323. [PMID: 30918867 DOI: 10.1007/s40200-018-0377-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 11/16/2018] [Indexed: 01/13/2023]
Abstract
Purpose Individuals with dysglycaemic are prone to dyslipidaemia. Understanding the dyslipidaemic status of dysglycaemic individuals is essential for monitoring and early prevention. The aim was to assess the control of lipidaemia by glycaemic status in a representative adult population. Methods A retrospective health examination survey was performed on a sample of adults (n = 3947) in Malta in 2014-6. Sociodemographic data, biochemistry blood tests and anthropometric measurements were gathered. Statistical analysis was performed to evaluate the lipidaemic status and its control across the glycaemic spectrum (normoglycemic, impaired fasting glucose individuals, new diabetics and known diabetics). Results The prevalence of uncontrolled dyslipidaemia was 7.75% (CI 95%: 6.69-8.63), among whom 6.97% (CI 95%: 6.21-7.81) were naïve dyslipidaemic. A progressive elevation in both LDL-C and total cholesterol but not triglycerides was present among uncontrolled dyslipidaemia individuals across the glycaemic spectrum. Global dyslipidaemia was present in 19.26% (CI 95%: 18.05-20.52) of the total general population and in 46.59% (CI 95%: 40.49-52.69%) of known diabetics. Most individuals irrespective of lipid status were normoglycaemic. Conclusions Dyslipidaemia occurs in the presence of insulin resistance. Dyslipidaemia predominated in the normoglycaemic state irrespective of statins use, indicating the need to manage dyslipidaemia prior to dysglycaemia.
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Affiliation(s)
- Sarah Cuschieri
- 1Department of Anatomy, Faculty of Medicine and Surgery, Biomedical Building, University of Malta, Msida, MSD 2080 Malta
| | - Josanne Vassallo
- 2Faculty of Medicine and Surgery, University of Malta, Msida, Malta
| | - Neville Calleja
- 3Department of Public Health, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
- 4Department of Health Information and Research, Ministry of Health, Gwardamangia, Malta
| | | | - Julian Mamo
- 2Faculty of Medicine and Surgery, University of Malta, Msida, Malta
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Abstract
Linear regression is the equation which provides of straight line that best describes the association between two continuous variables, x and y. However, it is often the case that the dependent variable y is influenced by more than one variable and not just a single x variable. Multivariate analysis is a statistical modeling technique wherein multiple x variables are analysed simultaneously for their effect on y, resulting in an additive model (via an equation) that explains the observation/s and corrects for confounding association/s using one dependent and several independent variables, assigning a gradient to each of these independent variables, and with all product terms of gradient and magnitude of the independent variables adding up to estimate 'y'. This paper outlines these various techniques and applications.
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Affiliation(s)
- Victor Grech
- Academic Department of Paediatrics, Mater Dei Hospital, Malta.
| | - Neville Calleja
- Department for Policy in Health - Health Information and Research, Malta.
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Grech V, Calleja N. WASP (Write a Scientific Paper): Probability - Poisson and binomial distributions. Early Hum Dev 2018; 123:46-47. [PMID: 29678515 DOI: 10.1016/j.earlhumdev.2018.04.013] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
This paper outlines Binomial and Poisson distributions which are both used to measure the occurrence of a number of random events within a certain period.
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Affiliation(s)
- Victor Grech
- Academic Department of Paediatrics, Mater Dei Hospital, Malta.
| | - Neville Calleja
- Department for Policy in Health - Health Information and Research, Malta.
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Abstract
Data may be normally distributed in which case standard and relatively familiar tests may be used for inferential testing. Or data may be non-normally distributed, such as ordinal data, in which case, non-parametric tests are usually advocated. This paper will review current thinking with regard to these tests, and the appropriateness of their application/s.
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Affiliation(s)
- Victor Grech
- Academic Department of Paediatrics, Mater Dei Hospital, Malta.
| | - Neville Calleja
- Department for Policy in Health - Health Information and Research, Malta.
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Agius A, Calleja N, Camenzuli C, Sultana R, Pullicino R, Zammit C, Calleja Agius J, Pomara C. Perceptions of first-year medical students towards learning anatomy using cadaveric specimens through peer teaching. Anat Sci Educ 2018; 11:346-357. [PMID: 29112798 DOI: 10.1002/ase.1751] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Revised: 08/22/2017] [Accepted: 10/17/2017] [Indexed: 06/07/2023]
Abstract
During the last decade, global interest in the multiple benefits of formal peer teaching has increased. This study aimed to explore the perceptions of first-year medical students towards the use of peer teaching to learn anatomy using cadaveric specimens. A descriptive, cross-sectional, retrospective survey was carried out. Data were collected using an online questionnaire which was administered to all medical students who were in their second year of their medical school curriculum and who had participated in sessions taught by their peers during their first year. Peer teaching was perceived as an effective method of learning anatomy by more than half of the participants. Analysis of mean responses revealed that the peer teachers created a positive, non-intimidating learning environment. Overall, participants gave positive feedback on their peer teachers. Six categories emerged from the responses given by participants as to why they would or would not recommend peer teaching. Ways of improvement as suggested by the respondents were also reported. Variables found to be significantly associated with the perceived benefits of the peer teaching program included sex differences, educational level and recommendations for peer teaching. This study brings to light the merits and demerits of peer teaching as viewed through the eyes of the peer learners. Peer teaching provides a sound platform for teaching and learning anatomy. Further discussions at higher levels are encouraged in order to explore the feasibility of introducing formal peer teaching in the medical curriculum. Anat Sci Educ 11: 346-357. © 2017 American Association of Anatomists.
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Affiliation(s)
- Andee Agius
- Faculty of Medicine and Surgery, University of Malta, Msida, Malta
| | - Neville Calleja
- Directorate for Health Information and Research, Ministry of Health, Valletta, Malta
- Department of Public Health, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
| | - Christian Camenzuli
- Department of Surgery, Faculty of Medicine and Surgery, University of Malta, Tal-Qroqq, Malta
- Department of Anatomy, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
| | - Roberta Sultana
- Department of Occupational Therapy, Saint Vincent de Paul Long-Term Care Facility, Luqa, Malta
| | - Richard Pullicino
- The Walton Centre, National Health Service Foundation Trust, Liverpool, United Kingdom
| | - Christian Zammit
- Department of Anatomy, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
| | - Jean Calleja Agius
- Department of Anatomy, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
| | - Cristoforo Pomara
- Department of Anatomy, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
- Section of Forensic Pathology, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
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Matz M, Coleman MP, Sant M, Chirlaque MD, Visser O, Gore M, Allemani C, Bouzbid S, Hamdi-Chérif M, Zaidi Z, Bah E, Swaminathan R, Nortje S, El Mistiri M, Bayo S, Malle B, Manraj S, Sewpaul-Sungkur R, Fabowale A, Ogunbiyi O, Bradshaw D, Somdyala N, Stefan D, Abdel-Rahman M, Jaidane L, Mokni M, Kumcher I, Moreno F, González M, Laura E, Espinola S, Calabrano G, Carballo Quintero B, Fita R, Garcilazo D, Giacciani P, Diumenjo M, Laspada W, Green M, Lanza M, Ibañez S, Lima C, Lobo de Oliveira E, Daniel C, Scandiuzzi C, De Souza P, Melo C, Del Pino K, Laporte C, Curado M, de Oliveira J, Veneziano C, Veneziano D, Latorre M, Tanaka L, Azevedo e Silva G, Galaz J, Moya J, Herrmann D, Vargas S, Herrera V, Uribe C, Bravo L, Arias-Ortiz N, Jurado D, Yépez M, Galán Y, Torres P, Martínez-Reyes F, Pérez-Meza M, Jaramillo L, Quinto R, Cueva P, Yépez J, Torres-Cintrón C, Tortolero-Luna G, Alonso R, Barrios E, Nikiforuk C, Shack L, Coldman A, Woods R, Noonan G, Turner D, Kumar E, Zhang B, McCrate F, Ryan S, Hannah H, Dewar R, MacIntyre M, Lalany A, Ruta M, Marrett L, Nishri D, McClure C, Vriends K, Bertrand C, Louchini R, Robb K, Stuart-Panko H, Demers S, Wright S, George J, Shen X, Brockhouse J, O'Brien D, Ward K, Almon L, Bates J, Rycroft R, Mueller L, Phillips C, Brown H, Cromartie B, Schwartz A, Vigneau F, MacKinnon J, Wohler B, Bayakly A, Clarke C, Glaser S, West D, Green M, Hernandez B, Johnson C, Jozwik D, Charlton M, Lynch C, Huang B, Tucker T, Deapen D, Liu L, Hsieh M, Wu X, Stern K, Gershman S, Knowlton R, Alverson J, Copeland G, Rogers D, Lemons D, Williamson L, Hood M, Hosain G, Rees J, Pawlish K, Stroup A, Key C, Wiggins C, Kahn A, Schymura M, Leung G, Rao C, Giljahn L, Warther B, Pate A, Patil M, Schubert S, Rubertone J, Slack S, Fulton J, Rousseau D, Janes T, Schwartz S, Bolick S, Hurley D, Richards J, Whiteside M, Nogueira L, Herget K, Sweeney C, Martin J, Wang S, Harrelson D, Keitheri Cheteri M, Farley S, Hudson A, Borchers R, Stephenson L, Espinoza J, Weir H, Edwards B, Wang N, Yang L, Chen J, Song G, Gu X, Zhang P, Ge H, Zhao D, Zhang J, Zhu F, Tang J, Shen Y, Wang J, Li Q, Yang X, Dong J, Li W, Cheng L, Chen J, Huang Q, Huang S, Guo G, Wei K, Chen W, Zeng H, Demetriou A, Pavlou P, Mang W, Ngan K, Swaminathan R, Kataki A, Krishnatreya M, Jayalekshmi P, Sebastian P, Sapkota S, Verma Y, Nandakumar A, Suzanna E, Keinan-Boker L, Silverman B, Ito H, Nakagawa H, Hattori M, Kaizaki Y, Sugiyama H, Utada M, Katayama K, Narimatsu H, Kanemura S, Koike T, Miyashiro I, Yoshii M, Oki I, Shibata A, Matsuda T, Nimri O, Ab Manan A, Bhoo-Pathy N, Tuvshingerel S, Chimedsuren O, Al Khater A, El Mistiri M, Al-Eid H, Jung K, Won Y, Chiang C, Lai M, Suwanrungruang K, Wiangnon S, Daoprasert K, Pongnikorn D, Geater S, Sriplung H, Eser S, Yakut C, Hackl M, Mühlböck H, Oberaigner W, Zborovskaya A, Aleinikova O, Henau K, Van Eycken L, Dimitrova N, Valerianova Z, Šekerija M, Zvolský M, Engholm G, Storm H, Innos K, Mägi M, Malila N, Seppä K, Jégu J, Velten M, Cornet E, Troussard X, Bouvier A, Faivre J, Guizard A, Bouvier V, Launoy G, Arveux P, Maynadié M, Mounier M, Fournier E, Woronoff A, Daoulas M, Clavel J, Le Guyader-Peyrou S, Monnereau A, Trétarre B, Colonna M, Cowppli-Bony A, Molinié F, Bara S, Degré D, Ganry O, Lapôtre-Ledoux B, Grosclaude P, Estève J, Bray F, Piñeros M, Sassi F, Stabenow R, Eberle A, Erb C, Nennecke A, Kieschke J, Sirri E, Kajueter H, Emrich K, Zeissig S, Holleczek B, Eisemann N, Katalinic A, Brenner H, Asquez R, Kumar V, Ólafsdóttir E, Tryggvadóttir L, Comber H, Walsh P, Sundseth H, Devigili E, Mazzoleni G, Giacomin A, Bella F, Castaing M, Sutera A, Gola G, Ferretti S, Serraino D, Zucchetto A, Lillini R, Vercelli M, Busco S, Pannozzo F, Vitarelli S, Ricci P, Pascucci C, Autelitano M, Cirilli C, Federico M, Fusco M, Vitale M, Usala M, Cusimano R, Mazzucco W, Michiara M, Sgargi P, Maule M, Sacerdote C, Tumino R, Di Felice E, Vicentini M, Falcini F, Cremone L, Budroni M, Cesaraccio R, Contrino M, Tisano F, Fanetti A, Maspero S, Candela G, Scuderi T, Gentilini M, Piffer S, Rosso S, Sacchetto L, Caldarella A, La Rosa F, Stracci F, Contiero P, Tagliabue G, Dei Tos A, Zorzi M, Zanetti R, Baili P, Berrino F, Gatta G, Sant M, Capocaccia R, De Angelis R, Liepina E, Maurina A, Smailyte G, Agius D, Calleja N, Siesling S, Visser O, Larønningen S, Møller B, Dyzmann-Sroka A, Trojanowski M, Góźdż S, Mężyk R, Grądalska-Lampart M, Radziszewska A, Didkowska J, Wojciechowska U, Błaszczyk J, Kępska K, Bielska-Lasota M, Kwiatkowska K, Forjaz G, Rego R, Bastos J, Silva M, Antunes L, Bento M, Mayer-da-Silva A, Miranda A, Coza D, Todescu A, Valkov M, Adamcik J, Safaei Diba C, Primic-Žakelj M, Žagar T, Stare J, Almar E, Mateos A, Quirós J, Bidaurrazaga J, Larrañaga N, Díaz García J, Marcos A, Marcos-Gragera R, Vilardell Gil M, Molina E, Sánchez M, Franch Sureda P, Ramos Montserrat M, Chirlaque M, Navarro C, Ardanaz E, Moreno-Iribas C, Fernández-Delgado R, Peris-Bonet R, Galceran J, Khan S, Lambe M, Camey B, Bouchardy C, Usel M, Ess S, Herrmann C, Bulliard J, Maspoli-Conconi M, Frick H, Kuehni C, Schindler M, Bordoni A, Spitale A, Chiolero A, Konzelmann I, Dehler S, Matthes K, Rashbass J, Stiller C, Fitzpatrick D, Gavin A, Bannon F, Black R, Brewster D, Huws D, White C, Finan P, Allemani C, Bonaventure A, Carreira H, Coleman M, Di Carlo V, Harewood R, Liu K, Matz M, Montel L, Nikšić M, Rachet B, Sanz N, Spika D, Stephens R, Peake M, Chalker E, Newman L, Baker D, Soeberg M, Aitken J, Scott C, Stokes B, Venn A, Farrugia H, Giles G, Threlfall T, Currow D, You H, Hendrix J, Lewis C. Erratum to “The histology of ovarian cancer: Worldwide distribution and implications for international survival comparisons (CONCORD-2)” [Gynecol. Oncol. 144 (2017) 405–413]. Gynecol Oncol 2017; 147:726. [DOI: 10.1016/j.ygyno.2017.06.032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Cuschieri S, Vassallo J, Calleja N, Pace N, Mamo J. The effect of age, gender, TG/HDL-C ratio and behavioral lifestyles on the metabolic syndrome in the high risk Mediterranean Island population of Malta. Diabetes Metab Syndr 2017; 11 Suppl 1:S321-S327. [PMID: 28283398 DOI: 10.1016/j.dsx.2017.03.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Accepted: 03/03/2017] [Indexed: 12/22/2022]
Abstract
AIMS Metabolic syndrome (MetS) is a public health epidemic, typically with female predominance. The aim was to analyse the effect of gender and age on MetS and its components; analyse effects of lifestyle, diabetes mellitus and identify predictors for MetS including TG/HDL ratio, on a national level in a Mediterranean island. Findings will provide evidence-based data for neighboring countries to aid in combat of this epidemic. METHOD A cross-sectional survey was conducted in Malta (2014-2016) on a randomized adults population sample. Various components of MetS were measured along with lifestyle habits (smoking, alcohol and physical activity) and family history (cardiovascular and diabetes). Both descriptive and statistical analyses were performed. RESULTS A total of 80,788 Maltese adults estimated to suffer from MetS. Males were predominantly affected with significant difference from females. All MetS components were found to be significant predictors along with alcohol habits but not smoking. Neither physical inactivity nor family history of cardiovascular disease, showed any predictive ability for MetS even after adjustment. Elevated triglyceride levels exhibited highest predictive effect on MetS. TG/HDL ratio showed predictive ability in the Maltese population. CONCLUSIONS Males were at higher risk for MetS in Malta. A number of predictors were established but not sedentary lifestyle. TG/HDL ratio may provide to be a good indicator for development of MetS.
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Affiliation(s)
- Sarah Cuschieri
- Department of Anatomy, Faculty of Medicine and Surgery, University of Malta, Msida, Malta.
| | - Josanne Vassallo
- Professor of Medicine, Faculty of Medicine and Surgery, University of Malta, Msida, Malta.
| | - Neville Calleja
- Department of Public Health, Faculty of Medicine and Surgery, University of Malta, Msida, Malta; Director of the Department of Health Information and Research, Ministry of Health, Gwardamangia, Malta.
| | - Nikolai Pace
- Department of Anatomy, Faculty of Medicine and Surgery, University of Malta, Msida, Malta.
| | - Julian Mamo
- Head of Department of Public Health, Faculty of Medicine and Surgery, University of Malta, Msida, Malta.
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Vestergaard LS, Nielsen J, Krause TG, Espenhain L, Tersago K, Bustos Sierra N, Denissov G, Innos K, Virtanen MJ, Fouillet A, Lytras T, Paldy A, Bobvos J, Domegan L, O'Donnell J, Scortichini M, de Martino A, England K, Calleja N, van Asten L, Teirlinck AC, Tønnessen R, White RA, P Silva S, Rodrigues AP, Larrauri A, Leon I, Farah A, Junker C, Sinnathamby M, Pebody RG, Reynolds A, Bishop J, Gross D, Adlhoch C, Penttinen P, Mølbak K. Excess all-cause and influenza-attributable mortality in Europe, December 2016 to February 2017. ACTA ACUST UNITED AC 2017; 22:30506. [PMID: 28424146 PMCID: PMC5388126 DOI: 10.2807/1560-7917.es.2017.22.14.30506] [Citation(s) in RCA: 87] [Impact Index Per Article: 12.4] [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: 03/10/2017] [Accepted: 04/06/2017] [Indexed: 11/25/2022]
Abstract
Since December 2016, excess all-cause mortality was observed in many European countries, especially among people aged ≥ 65 years. We estimated all-cause and influenza-attributable mortality in 19 European countries/regions. Excess mortality was primarily explained by circulation of influenza virus A(H3N2). Cold weather snaps contributed in some countries. The pattern was similar to the last major influenza A(H3N2) season in 2014/15 in Europe, although starting earlier in line with the early influenza season start.
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Affiliation(s)
| | | | | | | | | | | | - Gleb Denissov
- National Institute for Health Development, Tallinn, Estonia
| | - Kaire Innos
- National Institute for Health Development, Tallinn, Estonia
| | | | - Anne Fouillet
- French Public Health Agency (Santé Publique France), Saint-Maurice, France
| | - Theodore Lytras
- Hellenic Centre for Disease Control and Prevention, Athens, Greece
| | - Anna Paldy
- National Public Health Center, Budapest, Hungary
| | - Janos Bobvos
- National Public Health Center, Budapest, Hungary
| | - Lisa Domegan
- Health Service Executive - Health Protection Surveillance Centre, Dublin, Ireland
| | - Joan O'Donnell
- Health Service Executive - Health Protection Surveillance Centre, Dublin, Ireland
| | | | | | | | | | - Liselotte van Asten
- National Institute of Public Health and the Environment (RIVM), The Netherlands
| | - Anne C Teirlinck
- National Institute of Public Health and the Environment (RIVM), The Netherlands
| | | | | | - Susana P Silva
- Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisbon, Portugal
| | - Ana P Rodrigues
- Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisbon, Portugal
| | - Amparo Larrauri
- CIBER Epidemiología y Salud Pública (CIBERESP) Instituto de Salud Carlos III, Madrid, Spain
| | - Inmaculada Leon
- CIBER Epidemiología y Salud Pública (CIBERESP) Instituto de Salud Carlos III, Madrid, Spain
| | - Ahmed Farah
- The Public Health Agency of Sweden, Stockholm, Sweden
| | | | | | | | | | | | - Diane Gross
- WHO Regional Office for Europe, Copenhagen, Denmark
| | - Cornelia Adlhoch
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Pasi Penttinen
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
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Gatta G, Peris-Bonet R, Visser O, Stiller C, Marcos-Gragera R, Sánchez MJ, Lacour B, Kaatsch P, Berrino F, Rutkowski S, Botta L, Hackl M, Zielonke N, Oberaigner W, Van Eycken E, Henau K, Valerianova Z, Dimitrova N, Sekerija M, Storm H, Engholm G, Mägi M, Aareleid T, Malila N, Seppä K, Faivre J, Bossard N, Uhry Z, Colonna M, Clavel J, Lacour B, Desandes E, Brenner H, Kaatsch P, Katalinic A, Garami M, Jakab Z, Comber H, Mazzoleni G, Bulatko A, Buzzoni C, Giacomin A, Sutera Sardo A, Mancuso P, Ferretti S, Barchielli A, Caldarella A, Gatta G, Sant M, Amash H, Amati C, Baili P, Berrino F, Bonfarnuzzo S, Botta L, Capocaccia R, Di Salvo F, Foschi R, Margutti C, Meneghini E, Minicozzi P, Trama A, Serraino D, Zucchetto A, De Angelis R, Caldora M, Carrani E, Francisci S, Mallone S, Pierannunzio D, Roazzi P, Rossi S, Santaquilani M, Tavilla A, Pannozzo F, Busco S, Filiberti R, Marani E, Ricci P, Pascucci C, Autelitano M, Spagnoli G, Cirilli C, Fusco M, Vitale M, Usala M, Vitale F, Ravazzolo B, Michiara M, Merletti F, Maule M, Tumino R, Mangone L, Di Felice E, Falcini F, Iannelli A, Sechi O, Cesaraccio R, Piffer S, Madeddu A, Tisano F, Maspero S, Fanetti A, Candela P, Scuderi T, Stracci F, Bianconi F, Tagliabue G, Contiero P, Rugge M, Guzzinati S, Pildava S, Smailyte G, Calleja N, Agius D, Johannesen T, Rachtan J, Góźdź S, Mężyk R, Błaszczyk J, Bębenek M, Bielska-Lasota M, Forjaz de Lacerda G, Bento M, Castro C, Miranda A, Mayer-da-Silva A, Safaei Diba C, Primic-Zakelj M, Errezola M, Bidaurrazaga J, Vicente Raneda M, Díaz García J, Marcos-Navarro A, Marcos-Gragera R, Izquierdo Font A, Sanchez M, Chang D, Navarro C, Chirlaque M, Moreno-Iribas C, Ardanaz E, Peris-Bonet R, Pardo Romaguera E, Galceran J, Carulla M, Lambe M, Mousavi M, Bouchardy C, Usel M, Ess S, Frick H, Lorez M, Herrmann C, Bordoni A, Spitale A, Konzelmann I, Visser O, Aarts M, Otter R, Coleman M, Allemani C, Rachet B, Verne J, Stiller C, Gavin A, Donnelly C, Brewster D. Geographical variability in survival of European children with central nervous system tumours. Eur J Cancer 2017; 82:137-148. [DOI: 10.1016/j.ejca.2017.05.028] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Revised: 05/11/2017] [Accepted: 05/16/2017] [Indexed: 11/28/2022]
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Gatt I, Calleja N, Cordina M. An investigation into the beliefs about medicines of university students across disciplines. Res Social Adm Pharm 2017. [DOI: 10.1016/j.sapharm.2017.02.066] [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: 10/19/2022]
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Gatt I, West LM, Calleja N, Briffa C, Cordina M. Psychometric properties of the Belief about Medicines Questionnaire (BMQ) in the Maltese language. Pharm Pract (Granada) 2017; 15:886. [PMID: 28503224 PMCID: PMC5386625 DOI: 10.18549/pharmpract.2017.01.886] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Accepted: 02/27/2017] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Investigating beliefs about medicines has been of interest over the past years, with studies aiming to better understand theoretical reasons behind development of such beliefs. OBJECTIVE This study aimed to produce a culturally and contextually appropriate version of the Beliefs about Medicines Questionnaire (BMQ) in the Maltese language and to assess its psychometric properties. METHODS Medication beliefs were evaluated using the BMQ which is divided into two sections: BMQ-General (sub-scales: Overuse and Harm, 4 items per sub-scale) and BMQ-Specific (sub-scales: Necessity and Concerns, 5 items per sub-scale). Following translation/back translation, the Maltese version of the BMQ was applied to patients having asthma, diabetes, cardiovascular disease or depression who attended out-patients' clinics at the main state general hospital in Malta between June and September 2013. Cronbach's alpha coefficient, alpha, was used to determine internal consistency of the BMQ and Principal Component Analysis using Varimax rotation with Kaiser normalisation was carried out to analyse component loading of the items on the respective sub-scales. RESULTS The Maltese version of the BMQ showed acceptable internal consistency for the harm scale (alpha=0.56), the necessity scale (alpha=0.73) and the concerns scale (alpha=0.66), however the overuse scale gave poor internal consistency (alpha=0.48) due to the item on natural remedies which posed some difficulty in the Maltese sample. The final solution for Principal Component Analysis yielded a four-factor structure representing the 4 sub-scales of the BMQ, with results being comparable to previous studies out in different languages. CONCLUSION The Maltese version of the BMQ was found to have acceptable psychometric properties for the beliefs about medicines in the Maltese population.
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Affiliation(s)
- Ingrid Gatt
- BSc (Hons) Biology & Chemistry, MSc (Clin Pharmacol). Department of Clinical Pharmacology and Therapeutics, Faculty of Medicine and Surgery, University of Malta. Msida (Malta).
| | - Lorna M West
- BPharm (Hons), MSc (Clin Pharm), PhD. Post-Doctoral Researcher. Department of Clinical Pharmacology and Therapeutics, Faculty of Medicine and Surgery, University of Malta. Msida (Malta).
| | - Neville Calleja
- MD, MSc(Melit) MSc, PhD (Open), FFPH. Senior Lecturer. Department of Public Health, Faculty of Medicine and Surgery, University of Malta. Msida (Malta).
| | - Charles Briffa
- BA (Hons), MA, PhD. Professor. Department of Translation, Terminology and Interpreting Studies, Faculty of Arts, University of Malta. Msida, (Malta).
| | - Maria Cordina
- BPharm (Hons) (Melit), PhD. Associate Professor. Department of Clinical Pharmacology and Therapeutics, Faculty of Medicine and Surgery, University of Malta, Msida (Malta).
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50
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Azzopardi-Muscat N, Buttigieg S, Calleja N, Merkur S. Malta: Health System Review. Health Syst Transit 2017; 19:1-137. [PMID: 28485715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Maltese life expectancy is high, and Maltese people spend on average close to 90% of their lifespan in good health, longer than in any other EU country. Malta has recently increased the proportion of GDP spent on health to above the EU average, though the private part of that remains higher than in many EU countries. The total number of doctors and GPs per capita is at the EU average, but the number of specialists remains relatively low; education and training are being further strengthened in order to retain more specialist skills in Malta. The health care system offers universal coverage to a comprehensive set of services that are free at the point of use for people entitled to statutory provision. The historical pattern of integrated financing and provision is shifting towards a more pluralist approach; people already often choose to visit private primary care providers, and in 2016 a new public-private partnership contract for three existing hospitals was agreed. Important priorities for the coming years include further strengthening of the primary and mental health sectors, as well as strengthening the health information system in order to support improved monitoring and evaluation. The priorities of Malta during its Presidency of the Council of the EU in 2017 include childhood obesity, and Structured Cooperation to enhance access to highly specialized and innovative services, medicines and technologies. Overall, the Maltese health system has made remarkable progress, with improvements in avoidable mortality and low levels of unmet need. The main outstanding challenges include: adapting the health system to an increasingly diverse population; increasing capacity to cope with a growing population; redistributing resources and activity from hospitals to primary care; ensuring access to expensive new medicines whilst still making efficiency improvements; and addressing medium-term financial sustainability challenges from demographic ageing.
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Affiliation(s)
- Natasha Azzopardi-Muscat
- Department of Health Services Management, Faculty of Health Science, University of Malta; Directorate for Health Information and Research, Ministry for Health, Malta
| | - Stefan Buttigieg
- Directorate for Health Information and Research, Ministry for Health, Malta
| | - Neville Calleja
- Directorate for Health Information and Research, Ministry for Health, Malta
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