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  1. Article: The economic impact of international travel measures used during the COVID-19 pandemic: a scoping review.

    Bazak, Ying Liu / Sander, Beate / Werker, Eric / Zhumatova, Salta / Worsnop, Catherine Z / Lee, Kelley

    BMJ global health

    2024  Volume 9, Issue 2

    Abstract: Introduction: Assessment of the use of travel measures during COVID-19 has focused on their effectiveness in achieving public health objectives. However, the prolonged use of highly varied and frequently changing measures by governments, and their ... ...

    Abstract Introduction: Assessment of the use of travel measures during COVID-19 has focused on their effectiveness in achieving public health objectives. However, the prolonged use of highly varied and frequently changing measures by governments, and their unintended consequences caused, has been controversial. This has led to a call for coordinated decision-making focused on risk-based approaches, which requires better understanding of the broader impacts of international travel measures (ITMs) on individuals and societies.
    Methods: Our scoping review investigates the literature on the economic impact of COVID-19 ITMs. We searched health, social science and COVID-19-specific databases for empirical studies preprinted or published between 1 January 2020 and 31 October 2023. Evidence was charted using a narrative approach and included jurisdiction of study, ITMs studied, study design, outcome categories, and main findings.
    Results: Twenty-six studies met the inclusion criteria and were included for data extraction. Twelve of them focused on the international travel restrictions implemented in early 2020. Limited attention was given to measures such as entry/exit screening and vaccination requirements. Eight studies focused on high-income countries, 6 on low-income and middle-income countries and 10 studies were comparative although did not select countries by income. Economic outcomes assessed included financial markets (n=13), economic growth (n=4), economic activities (n=1), performance of industries central to international travel (n=9), household-level economic status (n=3) and consumer behaviour (n=1). Empirical methods employed included linear regression (n=17), mathematical modelling (n=3) and mixed strategies (n=6).
    Conclusion: Existing studies have begun to provide evidence of the wide-ranging economic impacts resulting from ITMs. However, the small body of research combined with difficulties in isolating the effects of such measures and limitations in available data mean that it is challenging to draw general and robust conclusions. Future research using rigorous empirical methods and high-quality data is needed on this topic.
    MeSH term(s) Humans ; COVID-19 ; Pandemics/prevention & control ; Income ; Poverty ; Travel
    Language English
    Publishing date 2024-02-27
    Publishing country England
    Document type Review ; Journal Article ; Research Support, Non-U.S. Gov't
    ISSN 2059-7908
    ISSN 2059-7908
    DOI 10.1136/bmjgh-2023-013900
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Comorbid conditions as risk factors for West Nile neuroinvasive disease in Ontario, Canada: a population-based cohort study.

    Sutinen, Jessica / Fell, Deshayne B / Sander, Beate / Kulkarni, Manisha A

    Epidemiology and infection

    2022  Volume 150, Page(s) e103

    Abstract: West Nile neuroinvasive disease (WNND) is a severe neurological illness that can result from West Nile virus (WNV) infection, with long-term disability and death being common outcomes. Although WNV arrived in North America over two decades ago, risk ... ...

    Abstract West Nile neuroinvasive disease (WNND) is a severe neurological illness that can result from West Nile virus (WNV) infection, with long-term disability and death being common outcomes. Although WNV arrived in North America over two decades ago, risk factors for WNND are still being explored. The objective of this study was to identify WNND comorbid risk factors in the Ontario population using a retrospective, population-based cohort design. Incident WNV infections from laboratory records between 1 January 2002 - 31 December 2012 were individually-linked to health administrative databases to ascertain WNND outcomes and comorbid risk factors. WNND incidence was compared among individuals with and without comorbidities using risk ratios (RR) calculated with log binomial regression.Three hundred and forty-five individuals developed WNND (18.3%) out of 1884 WNV infections. West Nile encephalitis was driving most associations with comorbidities. Immunocompromised (aRR 2.61 [95% CI 1.23-4.53]) and male sex (aRR 1.32 [95% CI 1.00-1.76]) were risk factors for encephalitis, in addition to age, for which each 1-year increase was associated with a 2% (aRR 1.02 [95% CI 1.02-1.03]) relative increase in risk. Our results suggest that individuals living with comorbidities are at higher risk for WNND, in particular encephalitis, following WNV infection.
    MeSH term(s) Cohort Studies ; Humans ; Male ; Ontario/epidemiology ; Retrospective Studies ; Risk Factors ; West Nile Fever/complications ; West Nile Fever/epidemiology ; West Nile virus
    Language English
    Publishing date 2022-05-11
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 632982-2
    ISSN 1469-4409 ; 0950-2688
    ISSN (online) 1469-4409
    ISSN 0950-2688
    DOI 10.1017/S0950268822000887
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: [No title information]

    Thampi, Nisha / Sander, Beate / Science, Michelle

    CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne

    2021  Volume 193, Issue 5, Page(s) E198–E199

    Title translation Comment empêcher le SRAS-CoV-2 d’entrer dans les écoles.
    MeSH term(s) Alberta ; COVID-19 ; Child ; Humans ; SARS-CoV-2 ; Schools ; Specimen Handling
    Language French
    Publishing date 2021-02-01
    Publishing country Canada
    Document type Journal Article ; Comment
    ZDB-ID 215506-0
    ISSN 1488-2329 ; 0008-4409 ; 0820-3946
    ISSN (online) 1488-2329
    ISSN 0008-4409 ; 0820-3946
    DOI 10.1503/cmaj.202568-f
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Protocol for a longitudinal cohort study of Lyme disease with physical, mental and immunological assessment.

    Loeb, Mark / Brison, Robert / Bramson, Jonathan / Hatchette, Todd / Sander, Beate / Stringer, Elizabeth

    BMJ open

    2023  Volume 13, Issue 11, Page(s) e076833

    Abstract: Introduction: There are limited data on the longitudinal impact of Lyme disease. Predictors of recovery have not been fully established using validated data collection instruments. There are sparse data on the immunological response to infection over ... ...

    Abstract Introduction: There are limited data on the longitudinal impact of Lyme disease. Predictors of recovery have not been fully established using validated data collection instruments. There are sparse data on the immunological response to infection over time.
    Methods and analysis: This study is a longitudinal cohort study that will recruit 120 participants with Lyme disease in Ontario and Nova Scotia, Canada, with follow-up for up to 24 months. Data will be collected using the Short-Form 36 physical and mental component summaries, Depression and Anxiety Severity Scale Questionnaire, Fatigue Severity Scale and a battery of neuropsychological tests. Mononuclear cells, gene expression and cytokine profiling from blood samples will be used to assess immunological response. Analyses will include the use of non-linear mixed-effects modelling and proportional hazards models.
    Ethics and dissemination: Ethics approval has been obtained from ethics boards at McMaster University (Hamilton Integrated Research Ethics Board) (7564), Queens University (EMD 315-20) and Nova Scotia Health Research Ethics Board (1027173), and the study is enrolling participants. Written informed consent is obtained from all participants. The results will be disseminated by publication in a peer-reviewed journal and presented at a relevant conference. A brief report will be provided to decision-makers and patient groups.
    MeSH term(s) Humans ; Longitudinal Studies ; Anxiety ; Ontario/epidemiology ; Nova Scotia/epidemiology ; Lyme Disease/diagnosis
    Language English
    Publishing date 2023-11-02
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2599832-8
    ISSN 2044-6055 ; 2044-6055
    ISSN (online) 2044-6055
    ISSN 2044-6055
    DOI 10.1136/bmjopen-2023-076833
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Applying Quality Indicators to Examine Quality of Care During Active Surveillance in Low-Risk Prostate Cancer: A Population-Based Study.

    Timilshina, Narhari / Finelli, Antonio / Tomlinson, George / Sander, Beate / Alibhai, Shabbir M H

    Journal of the National Comprehensive Cancer Network : JNCCN

    2023  Volume 21, Issue 5, Page(s) 465–472.e9

    Abstract: Background: Although a few studies have reported wide variations in quality of care in active surveillance (AS), there is a lack of research using validated quality indicators (QIs). The aim of this study was to apply evidence-based QIs to examine the ... ...

    Abstract Background: Although a few studies have reported wide variations in quality of care in active surveillance (AS), there is a lack of research using validated quality indicators (QIs). The aim of this study was to apply evidence-based QIs to examine the quality of AS care at the population level.
    Methods: QIs were measured using a population-based retrospective cohort of patients with low-risk prostate cancer diagnosed between 2002 and 2014. We developed 20 QIs through a modified Delphi approach with clinicians targeting the quality of AS care at the population level. QIs included structure (n=1), process of care (n=13), and outcome indicators (n=6). Abstracted pathology data were linked to cancer registry and administrative databases in Ontario, Canada. A total of 17 of 20 QIs could be applied based on available information in administrative databases. Variations in QI performance were explored according to patient age, year of diagnosis, and physician volume.
    Results: The cohort included 33,454 men with low-risk prostate cancer, with a median age of 65 years (IQR, 59-71 years) and a median prostate-specific antigen level of 6.2 ng/mL. Compliance varied widely for 10 process QIs (range, 36.6%-100.0%, with 6 [60%] QIs >80%). Initial AS uptake was 36.6% and increased over time. Among outcome indicators, significant variations were observed by patient age group (10-year metastasis-free survival was 95.0% for age 65-74 years and 97.5% in age <55 years) and physician average annual AS volume (10-year metastasis-free survival was 94.5% for physicians with 1-2 patients with AS and 95.8% for those with ≥6 patients with AS annually).
    Conclusions: This study establishes a foundation for quality-of-care assessments and monitoring during AS implementation at a population level. Considerable variations appeared with QIs related to process of care by physician volume and Qis related to outcome by patient age group. These findings may represent areas for targeted quality improvement initiatives.
    MeSH term(s) Male ; Humans ; Middle Aged ; Aged ; Child ; Quality Indicators, Health Care ; Retrospective Studies ; Watchful Waiting ; Prostatic Neoplasms/diagnosis ; Prostatic Neoplasms/epidemiology ; Prostatic Neoplasms/therapy ; Ontario/epidemiology
    Language English
    Publishing date 2023-05-06
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2250759-0
    ISSN 1540-1413 ; 1540-1405
    ISSN (online) 1540-1413
    ISSN 1540-1405
    DOI 10.6004/jnccn.2022.7256
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Healthcare costs and outcomes associated with laboratory-confirmed Lyme disease in Ontario, Canada: A population-based cohort study.

    Mac, Stephen / Evans, Gerald / Pullenayegum, Eleanor / Patel, Samir N / Sander, Beate

    PloS one

    2023  Volume 18, Issue 6, Page(s) e0286552

    Abstract: Background: The objective of this study was to estimate the economic burden attributable to laboratory-confirmed Lyme disease (LD) in Ontario, Canada and assess health outcomes associated with LD.: Method: We conducted a cohort study using laboratory- ...

    Abstract Background: The objective of this study was to estimate the economic burden attributable to laboratory-confirmed Lyme disease (LD) in Ontario, Canada and assess health outcomes associated with LD.
    Method: We conducted a cohort study using laboratory-confirmed LD cases accrued between 2006 and 2018. The exposed cohort was matched 1:3 to the unexposed cohort using a combination of hard and propensity score matching. We used phase-of-care costing methods to calculate attributable costs for four phases of illness: pre-diagnosis, acute care, post-acute care, and continuing care in 2018 Canadian dollars. We used ICD-10-CA and OHIP billing codes to identify emergency department visits, physician billings and hospitalizations related to LD sequelae to assess health outcomes.
    Results: A total of 2,808 cases were identified with a mean age of 46.5 (20.7) years and 44% female. Within 30-days, 404 (14.3%) cases required an ED visit and 63 (2.4%) cases required hospitalization. The mean (95% CI) total costs for LD cases in pre-diagnosis, acute, and post-acute care phases were $209 ($181, 238), $1,084 ($956, $1,212), and $1,714 ($1,499, $1,927), respectively. The highest mean attributable 10-day cost was $275 ($231, $319) during acute care. At 1-year post-infection, LD increased the relative risk of nerve palsies by 62 (20, 197), and polyneuropathy by 24 (3.0, 190). LD resulted in 16 Lyme meningitis events vs. 0 events in the unexposed.
    Conclusion: Individuals with laboratory-confirmed LD have increased healthcare resource use pre-diagnosis and up to six months post-diagnosis, and were more likely to seek healthcare services related to LD sequelae.
    MeSH term(s) Humans ; Female ; Middle Aged ; Male ; Ontario/epidemiology ; Cohort Studies ; Health Care Costs ; Lyme Disease/diagnosis ; Lyme Disease/epidemiology ; Health Services ; Hospitalization ; Retrospective Studies
    Language English
    Publishing date 2023-06-22
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2267670-3
    ISSN 1932-6203 ; 1932-6203
    ISSN (online) 1932-6203
    ISSN 1932-6203
    DOI 10.1371/journal.pone.0286552
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Hepatitis C Attributable Healthcare Costs and Mortality among Immigrants: A Population-Based Matched Cohort Study.

    Erman, Aysegul / Sahakyan, Yeva / Everett, Karl / Greenaway, Christina / Janjua, Naveed / Kwong, Jeffrey C / Wong, William W L / Lu, Hong / Sander, Beate

    Canadian journal of gastroenterology & hepatology

    2024  Volume 2024, Page(s) 5573068

    Abstract: Background: Data on the economic burden of chronic hepatitis C (CHC) among immigrants are limited. Our objective was to estimate the CHC-attributable mortality and healthcare costs among immigrants in Ontario, Canada.: Methods: We conducted a ... ...

    Abstract Background: Data on the economic burden of chronic hepatitis C (CHC) among immigrants are limited. Our objective was to estimate the CHC-attributable mortality and healthcare costs among immigrants in Ontario, Canada.
    Methods: We conducted a population-based matched cohort study among immigrants diagnosed with CHC between May 31, 2003, and December 31, 2018, using linked health administrative data. Immigrants with CHC (exposed) were matched 1 : 1 to immigrants without CHC (unexposed) using a combination of hard (index date, sex, and age) and propensity-score matching. Net costs (2020 Canadian dollars) collected from the healthcare payer perspective were calculated using a phase-of-care approach and used to estimate long-term costs adjusted for survival.
    Results: We matched 5,575 exposed individuals with unexposed controls, achieving a balanced match. The mean age was 47 years, and 52% was male. On average, 10.5% of exposed and 3.5% of unexposed individuals died 15 years postindex (relative risk = 2.9; 95% confidence interval (CI): 2.6-3.5). The net 30-day costs per person were $88 (95% CI: 55 to 122) for the prediagnosis, $324 (95% CI: 291 to 356) for the initial phase, $1,016 (95% CI: 900 to 1,132) for the late phase, and $975 (95% CI: -25 to 1,974) for the terminal phase. The mean net healthcare cost adjusted for survival at 15 years was $90,448.
    Conclusions: Compared to unexposed immigrants, immigrants infected with CHC have higher mortality rates and greater healthcare costs. These findings will support the planning of HCV elimination efforts among key risk groups in the province.
    MeSH term(s) Male ; Humans ; Middle Aged ; Cohort Studies ; Hepatitis C ; Hepacivirus ; Health Care Costs ; Emigrants and Immigrants ; Ontario/epidemiology
    Language English
    Publishing date 2024-02-24
    Publishing country Egypt
    Document type Journal Article
    ZDB-ID 2762182-0
    ISSN 2291-2797 ; 1916-7237 ; 0835-7900
    ISSN (online) 2291-2797 ; 1916-7237
    ISSN 0835-7900
    DOI 10.1155/2024/5573068
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Moving from intervention management to disease management: a qualitative study exploring a systems approach to health technology assessment in Canada.

    Richardson, Marina / Sander, Beate / Daneman, Nick / Mighton, Chloe / Miller, Fiona A

    International journal of technology assessment in health care

    2023  Volume 39, Issue 1, Page(s) e67

    Abstract: Objectives: Health technology assessment (HTA) traditionally informs decision making for single health technologies, which could lead to ill-informed decisions, suboptimal care, and system inefficiencies. We explored opportunities for conceptualizing ... ...

    Abstract Objectives: Health technology assessment (HTA) traditionally informs decision making for single health technologies, which could lead to ill-informed decisions, suboptimal care, and system inefficiencies. We explored opportunities for conceptualizing the decision space in HTA as a disease management question versus an intervention management question.
    Methods: Semistructured interviews were conducted between April 2022 and October 2022 with purposefully selected individuals from national and provincial HTA agencies and related organizations in Canada. We conducted manual line by line coding of data informed by our interview guide and sensitizing concepts from the literature. One author coded the data, and findings were independently verified by a second author who coded a subset of transcripts.
    Results: Twenty-four invitations were distributed, and eighteen individuals agreed to participate. A disease management approach to HTA was differentiated from traditional approaches as being disease-based, multi-interventional, and dynamic. There was general support for an explicit care pathway approach to HTA by informing discussions around patient choice and suboptimal care, creating a space where decision makers can collaborate on shared objectives, and in setting up a platform for open dialogue about managing high-cost and high-severity diseases. There are opportunities for a care pathway approach to be implemented that build on the strengths of the existing HTA system in Canada.
    Conclusions: A disease management approach may enhance the impact of HTA by supporting dynamic decision making that could better inform a proactive, resilient, and sustainable healthcare system in Canada.
    MeSH term(s) Humans ; Technology Assessment, Biomedical ; Canada ; Systems Analysis
    Language English
    Publishing date 2023-11-06
    Publishing country England
    Document type Journal Article
    ZDB-ID 632573-7
    ISSN 1471-6348 ; 0266-4623
    ISSN (online) 1471-6348
    ISSN 0266-4623
    DOI 10.1017/S0266462323002696
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Characterising the effectiveness of social determinants of health-focused hepatitis B interventions: a systematic review.

    Anyiwe, Kikanwa / Erman, Aysegul / Hassan, Marian / Feld, Jordan J / Pullenayegum, Eleanor / Wong, William W L / Sander, Beate

    The Lancet. Infectious diseases

    2024  

    Abstract: Social determinants of health are important in designing effective interventions for hepatitis B virus (HBV) infection. This systematic review characterises equity-oriented, social determinants of health-focused HBV interventions, and describes their ... ...

    Abstract Social determinants of health are important in designing effective interventions for hepatitis B virus (HBV) infection. This systematic review characterises equity-oriented, social determinants of health-focused HBV interventions, and describes their effectiveness in terms of the prevention, care, or treatment of HBV in high-income countries. We searched electronic databases for central concepts of 'HBV', 'equity', 'social determinants of health', 'intervention', and 'Organization for Economic Co-operation and Development (OECD) countries'. Screening and data abstraction were conducted independently by two reviewers. Data were abstracted from 66 studies; articles with a comparative study design (n=36) were included in the narrative synthesis, highlighting social determinants of health domains of interventions, HBV-relevant health outcomes, and extra-health social determinants of health effects (ie, those effects that extend beyond health outcomes). Synthesis aligned with six emergent themes corresponding to HBV prevention and care: knowledge and education, diagnosis and screening, immunisation, care initiation, engagement with clinical care and treatment, and upstream prevention. Studies presented a heterogeneous array of HBV-relevant health outcomes. Most interventions were tailored for social determinants of health domains of race, ethnicity, culture, and language; drug use; and socioeconomic status. Across the themes, at least two-thirds of interventions showed comparative effectiveness for addressing HBV. Extra-health social determinants of health outcomes were observed for two studies. Considerable diversity in population-level approaches was observed regarding intervention goals and effectiveness; most interventions were effective at enhancing the prevention, care, or treatment of HBV.
    Language English
    Publishing date 2024-01-03
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2061641-7
    ISSN 1474-4457 ; 1473-3099
    ISSN (online) 1474-4457
    ISSN 1473-3099
    DOI 10.1016/S1473-3099(23)00590-X
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Feasibility of hepatitis C elimination by screening and treatment alone in high-income countries.

    Tian, Feng / Forouzannia, Farinaz / Feng, Zeny / Biondi, Mia J / Mendlowitz, Andrew B / Feld, Jordan J / Sander, Beate / Wong, William W L

    Hepatology (Baltimore, Md.)

    2024  

    Abstract: Background and aims: Despite the availability of highly effective direct-acting antiviral therapy, chronic hepatitis C (CHC) continues to cause a major public health burden. In many high-income countries, treatment rates have been declining, which was ... ...

    Abstract Background and aims: Despite the availability of highly effective direct-acting antiviral therapy, chronic hepatitis C (CHC) continues to cause a major public health burden. In many high-income countries, treatment rates have been declining, which was exacerbated by the impact of the COVID-19 pandemic, threatening the ability to meet the World Health Organization (WHO)'s targets for eliminating HCV as a public health threat by 2030. We sought to model the impact of CHC in Canada, a resource-rich country with ongoing immigration from HCV-endemic regions; which relies exclusively on risk-based screening for case identification.
    Approach and results: We developed an agent-based model to characterize the HCV epidemic in a high-income country with ongoing immigration. Combinations of prevention such as harm reduction, screening, and treatment strategies were considered. Model parameters were estimated from the literature and calibrated against historical HCV data. Sensitivity analyses were performed to assess uncertainty. Under the current status quo of risk-based screening, we predict the incidence of CHC-induced decompensated cirrhosis, HCC, and liver-related deaths would decrease by 79.4%, 76.1%, and 62.1%, respectively, between 2015 and 2030, but CHC incidence would only decrease by 11.1%. The results were sensitive to HCV transmission rate and an annual number of people initiating treatment.
    Conclusions: Current risk-based screening, and subsequent treatment, will be inadequate to achieve WHO goals. With extensive scale-up in screening, and treatment, the mortality target may be achievable, but the target for preventing new CHC cases is unlikely reachable, highlighting the importance of developing enhanced harm-reduction strategies for HCV elimination.
    Language English
    Publishing date 2024-03-13
    Publishing country United States
    Document type Journal Article
    ZDB-ID 604603-4
    ISSN 1527-3350 ; 0270-9139
    ISSN (online) 1527-3350
    ISSN 0270-9139
    DOI 10.1097/HEP.0000000000000779
    Database MEDical Literature Analysis and Retrieval System OnLINE

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