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    Scopus© Citations 11  7
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    COVID-19 Aftermath: Exploring the Mental Health Emergency among Students at a Northern Italian University
    (2022)
    Alessandra Patrono
    ;
    Stefano Renzetti
    ;
    Angela Manco
    ;
    Paola Brunelli
    ;
    Stefanny M. Moncada
    <jats:p>In this study, we investigated the symptoms of physical and mental health associated with lifestyle changes due to a lockdown among the students of a university in Northern Italy, one of the most affected areas in Europe during the first wave of COVID-19. We examined the psychopathological variations in relation to mental health problems in a young population. The goal was to develop interventions to resolve these new psychosocial problems. From June to July 2020, students participated in an anonymous survey asking about habits and symptoms that emerged during the lockdown and the COVID-19 pandemic. Five health outcomes were assessed: digestive disorders; headaches; fear of COVID-19; panic and anxiety crises; and depression/sadness. The conditions and duration of the social isolation, lifestyle, SARS-CoV-2 infection in the household, financial situation, and productivity were considered in the analysis. A total of 3533 students completed the survey. The participants experienced headaches, depression and sadness, digestive disorders, a fear of COVID-19, and anxiety/panic crises. The duration of isolation was associated with an increased risk of digestive disorders, headaches, and COVID-19 fear. The female gender, medium–intense telephone usage, sleep quality, memory difficulties, and performance reduction were associated with an increased risk of the health outcomes. Future interventions should focus on promoting and implementing different habits with the support of health and university organizations.</jats:p>
      8Scopus© Citations 9
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    A multinational Delphi consensus to end the COVID-19 public health threat
    (2022)
    Jeffrey V. Lazarus
    ;
    Diana Romero
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    Christopher J. Kopka
    ;
    Salim Abdool Karim
    ;
    Laith J. Abu-Raddad
    <jats:title>Abstract</jats:title><jats:p>Despite notable scientific and medical advances, broader political, socioeconomic and behavioural factors continue to undercut the response to the COVID-19 pandemic<jats:sup>1,2</jats:sup>. Here we convened, as part of this Delphi study, a diverse, multidisciplinary panel of 386 academic, health, non-governmental organization, government and other experts in COVID-19 response from 112 countries and territories to recommend specific actions to end this persistent global threat to public health. The panel developed a set of 41 consensus statements and 57 recommendations to governments, health systems, industry and other key stakeholders across six domains: communication; health systems; vaccination; prevention; treatment and care; and inequities. In the wake of nearly three years of fragmented global and national responses, it is instructive to note that three of the highest-ranked recommendations call for the adoption of whole-of-society and whole-of-government approaches<jats:sup>1</jats:sup>, while maintaining proven prevention measures using a vaccines-plus approach<jats:sup>2</jats:sup> that employs a range of public health and financial support measures to complement vaccination. Other recommendations with at least 99% combined agreement advise governments and other stakeholders to improve communication, rebuild public trust and engage communities<jats:sup>3</jats:sup> in the management of pandemic responses. The findings of the study, which have been further endorsed by 184 organizations globally, include points of unanimous agreement, as well as six recommendations with &gt;5% disagreement, that provide health and social policy actions to address inadequacies in the pandemic response and help to bring this public health threat to an end.</jats:p>
      10Scopus© Citations 179
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    Scaling behavior of public procurement activity
    (2021)
    António Curado
    ;
    Bruno Damásio
    ;
    Sara Encarnação
    ;
    ;
    Flávio L. Pinheiro
    Public procurement refers to the purchase by public sector entities—such as government departments or local authorities—of Services, Goods, or Works. It accounts for a significant share of OECD countries’ expenditures. However, while governments are expected to execute them as efficiently as possible, there is a lack of methodologies for an adequate comparison of procurement activity between institutions at different scales, which represents a challenge for policymakers and academics. Here, we propose using methods borrowed from urban scaling laws literature to study public procurement activity among 278 Portuguese municipalities between 2011 and 2018. We find that public procurement expenditure scales sublinearly with population size, indicating an economy of scale for public spending as cities increase their population size. Moreover, when looking at the municipal Scale-Adjusted Indicators (the deviations from the scaling law) by contract categories—Works, Goods, and Services—we are able to identify a richer local characterisation of municipalities based on the similarity of procurement activity. These results make up a framework for quantitatively studying local public expenditure by enabling policymakers a more appropriate foundation for comparative analysis.
      3Scopus© Citations 7
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      17Scopus© Citations 93
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    The effect of external inspections on safety in acute hospitals in the National Health Service in England: A controlled interrupted time-series analysis
    (2019)
    Karen Bloor
    ;
    Carl Thompson
    ;
    <jats:sec><jats:title>Objectives</jats:title><jats:p> To evaluate the effect of Care Quality Commission external inspections of acute trusts on adverse event rates in the English National Health Service. </jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p> Interrupted time-series analysis including all acute NHS trusts in England ( n = 155) using two control groups (new versus historical inspection regime and trusts not inspected). Multilevel random-coefficient modelling of (1) rates of falls with harm and (2) pressure ulcers, from April 2012 to June 2016, was undertaken using the new, resource-intensive regime of Care Quality Commission inspections as an intervention. Data used in the model included dates and type of inspection, patient safety indicators, demographic characteristics and financial risk of hospitals. </jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p> In one year, Care Quality Commission inspected 66 acute trusts (42% of all English trusts) using their new regime and 46 (30%) using their previous one. Prior to inspections being announced, rates of falls with harm and pressure ulcers were improving in both intervention and control hospitals. The announcement of an inspection did not affect either indicator. After inspections, rates of falls with harm improved more slowly, and pressure ulcer rates no longer improved for trusts inspected using both regimes. </jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p> Neither form of external inspection was associated with positive, clinically significant effects on adverse event rates. Any improvement happening before the announced Care Quality Commission inspections slowed after the inspection. </jats:p></jats:sec>
      11  1Scopus© Citations 18