COVID-19 Pandemic Period Research Articles

The dynamics of digitalisation of ultra-micro, micro, small, and medium enterprises during COVID-19 pandemic and recovery periods: evidence from Indonesia

The dynamics of digitalisation of ultra-micro, micro, small, and medium enterprises during COVID-19 pandemic and recovery periods: evidence from Indonesia

CHALLENGES IN BRAIN METASTASES DIAGNOSIS AND TREATMENT

Although brain metastases are the most frequent type of intracranial tumors, their diagnosis and treatment is still challenging. They have poor prognosis and life expectancy is short, as brain metastases appear in advanced stage cancers. In U.S., the rate of recently discovered cancer that will evolve with brain metastases is considered to be 6-14%. Left untreated, brain metastases become lethal in less than 2 months. The most common primary cancers that develop brain metastases are lung, breast, melanoma and colorectal. In our department, approximately 60 patients with brain tumors were diagnosed after surgery with brain metastases in the last 10 years. The most common cancer to metastasize by far was lung cancer, with a mean age at diagnosis 60 years old, affecting mostly smoking men. The majority of patients presented with multiple metastases, unaware of the primary disease and without conducting any oncological treatment prior to admission in our departement. We observed that COVID-19 pandemic period highly affected patients with cancer. The number of patients with brain metastases operated on in our department has drastically decreased in that period. There were a lot of reasons why cancer patients among which being the imposibility to reach emergency rooms without having COVID-19 symptoms and difficulty of reaching radiology centers for early imaging. Most of the patients presented in the Emergency Department with multiple brain metastases, comatose or with focal neurological deficits installed long before presentation, regardless of their primary cancer, thus making neurosurgery an impractical option for most of these cases. Although there have been significant advances in systemic oncological treatment and radiotherapy, surgery remains an essential method of managing brain metastases, even in cases presenting with multiple lesions. Careful patient selection is essential in obtaining the best outcome.

What is the state of play? A nursing and midwifery workplace satisfaction survey across five local health districts

Background The COVID-19 pandemic and recovery period have exacerbated workforce challenges for nurses and midwives. The increasingly complex nature of healthcare, combined with rising workloads and staff attrition highlights the need for initiatives that improve workplace satisfaction and retention. In response, mentoring programs aimed at enhancing job satisfaction and retention are being increasingly implemented. Aims This study sought to measure the workplace satisfaction of nurses and midwives across five New South Wales local health districts, utilising data captured from a wider study investigating the implementation of the Deadly Aboriginal and Torres Strait Islander Nursing and Midwifery Mentoring program. Design An exploratory, mixed methods study using purposive sampling was employed. Methods A secondary analysis of a modified version of the Nursing Workplace Satisfaction Questionnaire, was used to quantify intrinsic, extrinsic, and relational workplace satisfaction constructs among nursing and midwifery staff. Open ended questions included in the survey were thematically analysed using methods developed by Braun and Clarke (2022). Results Between June–October 2023, n = 106 participants returned the survey. Differences between intrinsic (items 2 & 5), extrinsic (item 9) relational (items 13-15) constructs were observed for health districts, Aboriginality, age, and professional role characteristics (P < 0.05). Five qualitative themes emerged from the data: Helping people is the priority; Teams make a difference to my workplace satisfaction; Managers impact my satisfaction; Scope and recognition; and Organisational factors. Conclusions Overall, our findings indicate noticeable differences in workforce satisfaction and retention across various factors, including workforce areas, Aboriginality, age, and professional roles. For these groups, initiatives aimed at improving satisfaction and retention should prioritise fostering teamwork and a sense of belonging, as these elements have significant impact on job satisfaction for nurses and midwives and provide valuable guidance for nursing leaders. Impact statement This study identifies that teamwork and belongingness impact workplace satisfaction for nurses and midwives.

COVID-19 and pregnancy: a comprehensive study of comorbidities and outcomes.

This study aimed to investigate the impact of pregnancy and pre-existing comorbidities on COVID-19 infections and associated complications of hospitalisation and mortality in women of reproductive age (WRA). The study also compared the risk of severe COVID-19 complications between pregnant women (PW) and non-pregnant women (NPW) with and without pre-existing comorbidities. Special focus was placed on some understudied comorbidities of immunosuppression, chronic renal disease and chronic obstructive pulmonary disease (COPD). The study utilized anonymized patient-related information for a population of 7,342,869 WRA from the Mexican Ministry of Health data repository on COVID-19. Descriptive variables were characterized using frequencies, percentages, means, and standard deviations. Adjusted odds ratios (aORs) were used to assess the associations between risk factors and outcomes of hospitalisation and mortality. The study covered the entire COVID-19 pandemic period from January 30, 2020, to May 5, 2023. The findings revealed that PW were not more likely to get COVID-19 infections than NPW. PW with COVID-19 infections were more likely to require hospital admission, intubation treatments, and ICU admission compared to NPW with COVID-19. PW with immunosuppression had an increased odds ratio (aOR) of getting COVID-19 infections compared to NPW (PW: aOR = 1.0396; NPW: aOR = 0.8373). NPW with immunosuppression had higher risk of mortality (all-cause death: aOR = 1.7084; COVID-19-associated death: aOR = 1.4079) and hospitalisation (all-cause hospitalisation: aOR = 4.1328; COVID-19-associated hospitalisation: aOR = 3.0451) than NPW without immunosuppression. Renal disease was identified as a concerning pre-existing condition that increased the risks of COVID-19 associated mortality/hospitalizations and all-cause mortality/hospitalizations for both PW and NPW. NPW with renal disease had much higher odds ratio (aOR) of either COVID-19-associated-hospitalisations (NPW: aOR = 8.639; PW: aOR = 1.7603) or all-cause hospitalisations (NPW: aOR = 8.8594; PW: aOR = 1.786) than PW with renal disease. This study provides valuable insights into the impact of pregnancy and pre-existing comorbidities on COVID-19 outcomes in WRA. The findings underscore the importance of considering demographic factors and pre-existing comorbidities in the management of PW with COVID-19. The study also highlights the need for further research to understand the unique impacts of different comorbidities, particularly immunosuppression and renal disease, on COVID-19 outcomes in WRA.

HPB SO66 - Has the Complexity of Laparoscopic Cholecystectomies Increased Following the COVID-19 Pandemic?

Abstract Background Laparoscopic cholecystectomy (LC) is recognized for its diverse complexity between cases, which profoundly influences perioperative progression and patient outcomes. It is notoriously difficult to accurately predict surgical complexity pre-operatively. The COVID-19 pandemic notably contributed to substantial delays in the definitive management of gallstone disease. The present study aimed to compare the intraoperative complexity grading of LCs performed post-pandemic with data previously reported in the literature. Method A prospectively collected database of all LCs and laparoscopic common bile duct exploration (LCBDE) performed between August 2022 and June 2024 was analysed. The database was populated from a single benign biliary center by two specialized biliary surgeons. The study focused on clinical and intraoperative parameters, with particular emphasis on assessing the cholecystectomy operative difficulty using the Nassar scale. Parameters from the database were compared with previously published data from a single surgeon over a 29-year period (n=5,391 cases). P value was calculated using Pearson uncorrected chi-square test. Results 201 patients were eligible for inclusion. Median age was 54 years (IQR 40-66) and 124 (61.7%) were female. 86 (42.8%) were emergency cases. 118 (58.7%) patients were classed as socially and economically deprived. 80 (39.8%) cases were carried out for acute cholecystitis and 48 (23.9%) were for gallstone pancreatitis. 52 (25.8%) underwent LC alone, 89 (44.3%) also had intra-operative cholangiogram and 60 (29.9%) underwent LCBDE. Grade-1 LC (33.2% vs 8%, p&amp;lt;0.001) were significantly less prevalent than grade-4 LC (14.2% vs 33.8%, p&amp;lt;0.001) in the post pandemic period when compared to the previous published data. Conclusion The present study suggests there has been an increase in the complexity and operative difficulty of LC in the immediate post COVID-19 pandemic period. The reasons are likely multifactorial, however delays in the timely management of gallstone disease, resulting in repeated episodes of acute inflammation is hypothesised to be the key driving factor. Minimising a delay to definitive treatment through the establishment of efficient dedicated biliary care pathways could reduce the incidence of complex LC. Further work is required to determine if reducing the incidence of complex LC has a beneficial impact on complications and length of hospital stay.

Banking Financial Performance as Influenced by Credit Risk, Liquidity and Bank Size In Conventional Banks Listed On The Indonesian Stock Exchange For The Period 2014 - 2023

This study aims to empirically examine the impact of credit risk, liquidity, and bank size on the financial performance of conventional banks listed on the Indonesia Stock Exchange (IDX) during the period 2014-2023, with a particular focus on the COVID-19 pandemic period. The research variables used include the Non-Performing Loan (NPL) ratio, Loan to Deposit Ratio (LDR), and bank size, while Return on Assets (ROA) is used as a financial performance indicator. This study uses the purposive sampling method to select a sample from 138 banks listed on the IDX, resulting in 9 banks that meet the established criteria. Data analysis was conducted using panel data regression with the Fixed Effect Generalized Least Square (GLS) model to address the issues of autocorrelation and heteroskedasticity found in classical assumptions. The research results show that credit risk (NPL) has a significant negative impact on ROA, while bank size and liquidity (LDR) have a significant positive impact on ROA during the pandemic. These findings highlight the importance of managing credit and liquidity risks as well as optimizing bank size to improve financial performance amid the challenging economic conditions caused by the pandemic. This study also suggests that the financial performance of banks can be more stable if supported by appropriate risk management strategies and good operational efficiency. The limitations of this study include a sample restricted to conventional banks in Indonesia and the specific conditions during the COVID-19 pandemic, which may affect the generalization of the results.

A RESPONSABILIZAÇÃO DOS AGENTES PÚBLICOS POR FRAUDES NAS AQUISIÇÕES PÚBLICAS DURANTE A PANDEMIA DE COVID-19

This is a scientific production whose theme is the accountability of public agents for fraud in public procurement during the COVID-19 pandemic. The Law of Administrative Improbity has been standing out in several aspects of the legal system and evolving in terms of legal and current protection, giving concreteness to the constitutional demand of art. 37, § 4.º, in order to effectively protect administrative morality, valuing honesty in dealing with public matters. For this, penalties have been sanctioned when there is disrespect for probity. This work was dedicated to analyzing the cases of accountability of public agents for fraud in acquisitions during the pandemic period of COVID-19, making an analysis of the concepts brought by the doctrinators and characterizing the improbable conduct, based on the principles of the Federal Constitution of 1988 and especially in compliance with Law No. 14230/21, which provides for administrative impropriety. The methodology used was a descriptive and exploratory literature review, with a qualitative approach. Regarding the results obtained, it is correct to state that during the pandemic period, mainly between the years 2020 and 2021, several public agents were involved in embezzlement, as shown in cases I, II, III and IV. As a result, there is passive corruption, which is practiced by the public agent who requests or receives, for himself or for another person of his interest, either directly or indirectly, any undue advantage due to the position he occupies.

The Prevalence, Serogroup Distribution and Risk Factors of Meningococcal Carriage in Children, Adolescents and Young Adults in Turkey Meningo-Carr-TR Study PART 3: COVID-19 Pandemic Situation

Background: The prevalence of meningococcal carriage and serogroup distribution is crucial for assessing the epidemiology of invasive meningococcal disease, forecasting outbreaks and formulating potential immunization strategies. Following the meningococcal carriage studies conducted in Turkey in 2016 and 2018, we planned to re-evaluate meningococcal carriage in children, adolescents and young adults during the COVID-19 pandemic period. Methods: In the MENINGO-CARR-3 study, we collected nasopharyngeal samples from 1585 participants 0–24 years of age, across 9 different centers in Turkey. We used polymerase chain reaction and serogroup distribution to determine how common it is for people to carry Neisseria meningitidis. Results: The overall meningococcal carriage rate was 8.5% (n = 134). The serogroup distribution was as follows: serogroup A, 6%; serogroup B, 30.6%; serogroup W, 12.7%; serogroup Y, 3.7%; serogroup X, 1.5% and nongroupable as 45.5%. The highest carriage rate was found in 15–17-year-old adolescents (24.1%, 17.9%, and 20.2%, respectively). The carriage rate was higher among participants who had a previous COVID-19 infection (P = 0.05; odds ratio: 1.95; 95% confidence interval: 1.11–3.44). The nasopharyngeal carriage rate was also higher than in the 2016 and 2018 studies (8.45% vs. 6.3% and 7.5%, respectively), and the most prevalent groupable serogroup was B during this study period, followed by serogroup W in 2016 and serogroup X in 2018. Conclusions: The present study found that meningococcal carriage was higher during the post-COVID-19 pandemic period, especially in adolescents and young adults. Severe acute respiratory syndrome coronavirus-2 virus itself and/or pandemic mitigation strategies may affect both meningococcal carriage and serogroup distribution. Serogroup distribution varies between years, and further immunization strategies, including adolescent immunization, may play a role in controlling invasive meningococcal disease.

Prospective clinical surveillance for severe acute respiratory illness and COVID-19 vaccine effectiveness in Kenyan hospitals during the COVID-19 pandemic.

There are limited data from sub-Saharan Africa describing the demographic characteristics, clinical features and outcome of patients admitted to public hospitals with severe acute respiratory infections during the COVID-19 pandemic. We conducted a prospective longitudinal hospital-based sentinel surveillance between May 2020 and December 2022 at 16 public hospitals in Kenya. All patients aged above 18 years admitted to adult medical wards in the participating hospitals were included. We collected data on demographic and clinical characteristics, SARS-CoV-2 infection and COVID-19 vaccination status and, admission episode outcomes. We determined COVID-19 vaccine effectiveness (VE) against admission with SARS-CoV-2 positive severe acute respiratory illness (SARI) (i.e., COVID-19) andprogression to inpatient mortality among patients admitted with SARI, using a test-negative case control design. Of the 52,636 patients included in the study, 17,950 (34.1%) were admitted with SARI. The median age was 50 years. Patients were equally distributed across sexes. Pneumonia was the most common diagnosis at discharge. Hypertension, Human Immunodeficiency Virus (HIV) infection and Diabetes Mellitus were the most common chronic comorbidities. SARS-CoV-2 test results were positive in 2,364 (27.9%) of the 8,471 patients that underwent testing. After adjusting for age, sex and presence of a chronic comorbidity, SARI patients were more likely to progress to inpatient mortality compared to non-SARI patients regardless of their SARS-CoV-2 infection status (adjusted odds ratio (aOR) for SARI and SARS-CoV-2 negative patients 1.22, 95% CI 1.10-1.37; and aOR for SARI and SARS-CoV-2 positive patients 1.32, 95% CI 1.24-1.40). After adjusting for age, sex and presence of a chronic comorbidity, COVID-19 VE against progression to inpatient mortality following admission with SARI for those with a confirmed vaccination status was 0.59 (95% CI 0.27-0.77). We have provided a comprehensive description of the demographic and clinical pattern of admissions with SARI in Kenyan hospitals during the COVID-19 pandemic period as well as the COVID-19 VE for these patients. These data were useful in providing situational awareness during the first three years of the pandemic in Kenya and informing national response measures.

The early COVID-19 pandemic period and associated gestational weight gain.

The aim of this study was to investigate if gestational weight gain was altered during the early COVID-19 pandemic period. This a retrospective cohort study evaluating gestational weight gain among individuals delivering during the early COVID-19 pandemic epoch (March 10-December 31,2020) compared to temporally matched pre-pandemic (matched months in 2018 and 2019) controls using electronic medical record data from a large tertiary care hospital. The primary outcome was gestational weight gain defined as a categorical measure representing below, meeting, or above Institute of Medicine (IOM) criteria with further adjustment for gestational age at delivery. The early-pandemic exposure group was also categorized by gestational age at the start period (<14weeks' and 14-20weeks') to assess if duration of exposure affected gestational weight gain risks with the use of multinominal logistic regression. Among 5,377 individuals 3,619 (67.3 %) and 1,758 (32.7 %) were in the pre and early pandemic epochs respectively. Overall, 934 (17.4 %) individuals gained below recommended, 1,280 (23.8 %) met recommendations, and 3,163 (58.8 %) gained above IOM recommended gestational weight gain. Compared to the pre-pandemic epoch, the early pandemic period was not associated with weight gain below (OR 1.06, 95 % Cl 0.89-1.27) or above (OR 1.03, 95 % Cl 0.89-1.19) IOM recommendations. This was also true when the early pandemic group was stratified based on gestational age at the start of the early pandemic period (<14weeks' and 14-20weeks'). This study demonstrated no significant difference in maternal weight gain between pre and early COVID-19 pandemic periods.

Association Between Short-Term Exposure to Air Pollutants and Emergency Attendance for Upper Gastrointestinal Bleeding in Hong Kong: A Time-Series Study.

The relationship between exposure to ambient air pollutants and emergency attendance for upper gastrointestinal bleeding (UGIB) remains inconclusive. This study examines the association between short-term exposure to various ambient pollutants and the risk of UGIB emergency attendance. Data on daily UGIB emergency attendance, ambient pollutants, and meteorological conditions in Hong Kong were collected from 2017 to 2022. A time-series study using a distributed lag non-linear model to analyze the data, considering lag days. Stratified analysis was performed based on sex, seasons, and the COVID-19 pandemic period. The burden was quantified using attributable fraction (AF) and number (AN). The study included 31,577 UGIB emergency records. Exposure to high levels of PM2.5 significantly increased the risk of UGIB emergency attendance from lag day 3 (RR: 1.012) to day 6 (RR: 1.008). High NO2 exposure also posed a significant risk from lag day 0 (RR: 1.026) to day 2 (RR: 1.014), and from lag day 5 (RR: 1.013) to day 7 (RR: 1.024). However, there was no association between UGIB and high O3 levels. The attributable burden of high-concentration NO2 exposure was higher compared to those of PM2.5. Males and elderly individuals (≥65years) faced a higher risk of UGIB emergencies, particularly during cold seasons. Our study suggests that both PM2.5 and NO2 exposure are associated with an increased risk of emergency attendance for UGIB. Ambient pollutant exposure has a stronger effect on UGIB in males and the elderly, particularly during cold seasons.

Unraveling Influenza Sentinel Surveillance in Pakistan 2008-2024: Epidemiological Insights during the Pre and post Pandemic period of COVID-19

Unraveling Influenza Sentinel Surveillance in Pakistan 2008-2024: Epidemiological Insights during the Pre and post Pandemic period of COVID-19

Negative and Positive Experiences During the COVID-19 Pandemic in Canadians With Developmental Disabilities: AOne-Year Ontario-Based Survey.

Understanding the experiences of people with developmental disabilities during the initial period of COVID-19 pandemic. Individuals with developmental disabilities and their caregivers completed baseline and up to five follow-up online surveys using the CRISIS-AFAR measures, between July 2020 and September 2021. We used qualitative (thematic analysis) and quantitative (MANOVA) analytic methods. One hundred and eighteen participants (64 caregivers on individuals 6-62 years, 54 self-reporting individuals aged 17-55 years) completed baseline survey; 46 participants (23 caregivers, 23 self-reporting adults) completed ≥1 follow-up. Qualitative themes included uncertainty, and negative and positive influences on behaviours and routines, daily life and mental wellness. Those experiencing positive impacts did not stably perceive so longitudinally. Despite both negative and positive influences on individuals with developmental disabilities and their families, the prolonged pandemic had wide-ranging repercussions. Emergency preparedness planning should consider the disruptive effects of public health measures on routine and support for this vulnerable population.

Factors influencing healthcare access for persons with disabilities in Kakamega County, Kenya during COVID-19: A qualitative study

INTRODUCTION Access to healthcare for persons with disabilities is an indicator of the overall effectiveness of the healthcare system in terms of equity, accessibility and the right to health. This study explores factors affecting access to healthcare among persons with disabilities in Kakamega County in the context of COVID-19. MATERIALS AND METHODS Materials used in this study are part of a larger study that looked at access to healthcare and its effect on the quality of life of persons with disabilities in Kakamega County. In this paper, we present data generated from the qualitative component of the study that comprised 7 focus group discussions, 15 in-depth interviews, and 8 key informants who provided contextual information on health services for persons with disabilities. Data was coded and analysed thematically. RESULTS The study established key barriers to healthcare access for persons with disabilities during the COVID-19 pandemic period ranging from availability, affordability, discrimination, accommodation, assistive devices, and appropriateness of healthcare. In addition, the results show that these obstacles are not limited to the pandemic, but represent everyday challenges that persons with disability experience; but were exacerbated during the pandemic. CONCLUSION AND RECOMMENDATIONS This study highlights the need for disability-friendly infrastructure in healthcare facilities, subsidized medical costs, and the provision of assistive technologies to improve healthcare access for persons with disabilities. We also recommend increasing community and provider awareness of disability rights, enforcing existing laws and policies, and ensuring equal employment opportunities to support full social participation for individuals with disabilities.

Sectoral Performance of ESG Enabled Stocks during COVID-19 Pandemic in the Indian Stock Market

Over past one decade, there is significant rise in Environment, Social and Governance (ESG) enabled investment practices across the globe and Indian economy is no exception to that. The ESG-enabled investment options provide better investment avenues for investment for retail and institutional investors by ensuring the long-term sustainability of the business. The present study tries to assess whether there is any impact of ESG scores on performance of stocks at the time of COVID-19 pandemic period. The study compares the performance of stocks with high ESG score vis-à-vis stocks with low ESG scores during COVID-19 period for different sectors of Indian stock market. The study considers the data of 312 sample firms listed on BSE 500 index. The event study methodology is used to assess the impact of COVID-19 on Indian stocks. The stocks were further divided into three categories high score (top 30% of firms), medium (middle 40% of firms) and low (bottom 30% of the firms). The results of the study suggest that the investors were more confident about the performance and revival of firms that carry high ESG scores than firms with low ESG scores. The investors are confident about the long-term prospects and sustainability of the firms, and they tend to hold their investment in the firms with high ESG scores.

Internet-Based Social Connections of Black American College Students in Pre-COVID-19 and Peri-COVID-19 Pandemic Periods: Network Analysis.

A global-scale pandemic, such as the COVID-19 pandemic, greatly impacted communities of color. Moreover, physical distancing recommendations during the height of the COVID-19 pandemic negatively affected people's sense of social connection, especially among young individuals. More research is needed on the use of social media and communication about depression, with a specific focus on young Black Americans. This paper aims to examine whether there are any differences in social-networking characteristics before and during the pandemic periods (ie, pre-COVID-19 pandemic vs peri-COVID-19 pandemic) among the students of historically black colleges and universities (HBCUs). For the study, the researchers focus on the students who have posted a depression-related tweet or have retweeted such posts on their timeline and also those who have not made such tweets. This is done to understand the collective patterns of both groups. This paper analyzed the social networks on Twitter (currently known as X; X Corp) of HBCU students through comparing pre-COVID-19 and peri-COVID-19 pandemic data. The researchers quantified the structural properties, such as reciprocity, homophily, and communities, to test the differences in internet-based socializing patterns between the depression-related and non-depression related groups for the 2 periods. During the COVID-19 pandemic period, the group with depression-related tweets saw an increase in internet-based friendships, with the average number of friends rising from 1194 (SD 528.14) to 1371 (SD 824.61; P<.001). Their mutual relationships strengthened (reciprocity: 0.78-0.8; P=.01), and they showed higher assortativity with other depression-related group members (0.6-0.7; P<.001). In a network with only HBCU students, internet-based and physical affiliation memberships aligned closely during the peri-COVID-19 pandemic period, with membership entropy decreasing from 1.0 to 0.5. While users without depression-related tweets engaged more on the internet with other users who shared physical affiliations, those who posted depression-related tweets maintained consistent entropy levels (modularity: 0.75-0.76). Compared with randomized networks before and during the COVID-19 pandemic (P<.001), the users also exhibited high homophily with other members who posted depression-related tweets. The findings of this study provided insight into the social media activities of HBCU students' social networks and communication about depression on social media. Future social media interventions focused on the mental health of Black college students may focus on providing resources to students who communicate about depression. Efforts aimed at providing relevant resources and information to internet-based communities that share institutional affiliation may enhance access to social support, particularly for those who may not proactively seek assistance. This approach may contribute to increased social support for individuals within these communities, especially those with a limited social capacity.

Estimating the Incremental Cost Per QALY Produced by the Spanish NHS: A Fixed-Effect Econometric Approach.

Knowing the health opportunity costs of funding decisions is crucial to assess whether the health gains associated with new interventions are larger than the health losses imposed by the displacement of resources. Empirical estimates based on the effect of health spending on health outcomes have been proposed in several countries, including Spain, as a proxy to capture these opportunity costs. However, there is a need to regularly update existing health opportunity cost estimates and to explore the role of omitted variable bias in these estimations. The aim of this paper is to provide an updated and refined estimate of the causal impact of health spending on health in Spain that can be translated into an estimate of the incremental cost per quality-adjusted life-year produced by the Spanish national health system. We applied fixed-effect models using data for 17 Spanish regions from 2002 until 2022 to estimate the impact of public health spending on health outcomes and explored the extent of omitted variable bias. Changes in these estimates over time were assessed and alternative specifications were tested. Based on fixed-effect models with control variables, the estimated spending elasticity was 0.061, which translated into an incremental cost per quality-adjusted life-year of approximately €34,000. The bias-corrected elasticity was 0.075, with a corresponding incremental cost per quality-adjusted life-year of €27,000. We found that the estimated impact of spending on health decreases when recent years of data are added, and that the extent of omitted variable bias appears to increase, particularly when adding the COVID-19 pandemic period. This study provides an updated estimation of the incremental cost per quality-adjusted life-year produced by the Spanish national health system. The estimates provided can be easily updatable as new data become accessible, and the methods applied might be transferable to other settings with similar available data.

The review of advanced methods and techniques for estimating research output in bibliometrics (Part 1)

The authors explore the significant changes in traditional bibliometrics, including distinctive innovations in this area. Within the five-year period (2019– 2024), two processes have had a significant impact on the methods and technologies: these are the COVID-19 pandemic period (recognition of the importance of open research outcomes) and the period of sanctions (an attempt to exclude Russia from the global scientific process).The authors review in brief the improvements of existing methods, e. g. the introduction of the system of beamplot diagrams and research-based citation analysis. The role of scientometrics in global rankings is evaluated. The focus is also made on new vectors of analysis development, such as altmetrics and artificial intelligence. The application of artificial intelligence tools not only ensures high speed but also lays the basis for the entirely new system for comparing scientific publications with the existing array of accumulated knowledge.

Evaluation of the Relationship Between Health Literacy and the Perspectives of Pregnancy on Covid-19 Vaccines During the Covid-19 Pandemic Period

SOYUT Amaç:1 Bu çalışmanın amacı, COVID-19 pandemisi sırasında COVID-19'a maruz kalan gebe kadınların aşılara ilişkin bakış açılarını, aşılanma durumlarını, aşılara yönelik tutumlarını araştırmak ve yaklaşımları ile sağlık okuryazarlığı arasındaki ilişkiyi değerlendirmektir. Gereç ve Yöntem: Çalışmanın evreni, Kastamonu Eğitim ve Araştırma Hastanesi ve İnebolu Devlet Hastanesi'ne başvuran ve en az dört haftalık gebeliği olan ve diğer tüm trimester dönemlerini kapsayan gebeler (N=375)'dir. Mayıs 2022- Aralık 2023 tarihleri ​​arasında gebelerin sosyo-demografik özellikleri, obstetrik özellikleri, aşılanma durumları, aşılara karşı tutum ve davranışları sağlık okuryazarlık düzeylerini belirlemek ve saptamak amacıyla Anket Soru Formu Türkiye Sağlık Okuryazarlığı Ölçeği-32 (TSOY-32) kullanılmıştır. Analizler SPSS 22 programı kullanılarak yapılmıştır. Verilerin Ortalama±Standart Sapması ve yüzde dağılımı ile analizinde Ki-kare testi kullanılmıştır. p&lt;0,05 anlamlılık düzeyi istatistiksel olarak anlamlı kabul edilmiştir. Bulgular: Gebelerin yaş ortalaması 28,40±5,61, gebelik haftası ortalaması 28,40±5,61 ± 22,69±11,47 olarak bulundu. Çalışmada gebelerin %69,1’inin COVID-19 hastalığına yakalandığı, %76’sının COVID-19 aşısı olduğu ve %9,3’ünün gebelik sırasında COVID-19 aşısı olduğu görüldü. Gebelerin %68’inin hastalığı ailesine bulaştırması nedeniyle COVID-19 aşısını kendi isteği dışında yaptırdığı, %90,7’sinin ise gebe kalmadan COVID-19 aşısını yaptırmaktan vazgeçtiği görüldü. Gebelerin TSOY-32 ölçeğinin genel indeks puanı ortalaması 23,37±8,35 olarak bulundu. Gebelerin %55,7’sinin yetersiz sağlık okuryazarlığı düzeyinde olduğu belirlendi. Sonuç: Çalışma sonucunda COVID-19 pandemisi sırasında COVID-19 aşılarına yönelik yaklaşım, tutum ve davranış gösterdiği belirlenen gebelerin sağlık okuryazarlık düzeylerinin yetersiz olduğu belirlenmiştir. Bu sonuçlar doğrultusunda sağlık profesyonelleri arasında yer alan hekim ve ebelerin multidisipliner ekip yaklaşımı desteklenerek, Sağlık okuryazarlığı düşük olan gebelerin COVID-19 aşıları konusunda bilgi düzeyleri artırılmalıdır. Anahtar Kelimeler: Gebelik, COVID-19, COVID-19 aşıları, Sağlık okuryazarlığı.

Long term mortality trends in people with severe mental illnesses and how COVID-19, ethnicity and other chronic mental health comorbidities contributed: a retrospective cohort study.

People with schizophrenia-spectrum and bipolar disorders (severe mental illnesses; 'SMI') experience excess mortality. Our aim was to explore longer-term trends in mortality, including the COVID-19 pandemic period, with a focus on additional vulnerabilities (psychiatric comorbidities and race/ ethnicity) in SMI. Retrospective cohort study using electronic health records from secondary mental healthcare, covering a UK region of 1.3 million people. Mortality trends spanning fourteen years, including the COVID-19 pandemic, were assessed in adults with clinician-ascribed ICD-10 diagnoses for schizophrenia-spectrum and bipolar disorders. The sample comprised 22 361 people with SMI with median follow-up of 10.6 years. Standardized mortality ratios were more than double the population average pre-pandemic, increasing further during the pandemic, particularly in those with SMI and psychiatric comorbidities. Mortality risk increased steadily among people with SMI and comorbid depression, dementia, substance use disorders and anxiety over 13-years, increasing further during the pandemic. COVID-19 mortality was elevated in people with SMI and comorbid depression (sub-Hazard Ratio: 1.48 [95% CI 1.03-2.13]), dementia (sHR:1.96, 1.26-3.04) and learning disabilities (sHR:2.30, 1.30-4.06), compared to people with only SMI. COVID-19 mortality risk was similar for minority ethnic groups and White British people with SMI. Elevated all-cause mortality was evident in Black Caribbean (adjusted Rate Ratio: 1.40, 1.11-1.77) and Black African people with SMI (aRR: 1.59, 1.07-2.37) during the pandemic relative to earlier years. Mortality has increased over time in people with SMI. The pandemic exacerbated pre-existing trends. Actionable solutions are needed which address wider social determinants and address disease silos.