Papers by Enkeleint Aggelos Mechili
Nature Medicine, Feb 9, 2023
Population Medicine
Population Medicine considers the following types of articles: • Research Papers-reports of data ... more Population Medicine considers the following types of articles: • Research Papers-reports of data from original research or secondary dataset analyses. • Review Papers-comprehensive, authoritative, reviews within the journal's scope. These include both systematic reviews and narrative reviews. • Short Reports-brief reports of data from original research. • Policy Case Studies-brief articles on policy development at a regional or national level. • Study Protocols-articles describing a research protocol of a study. • Methodology Papers-papers that present different methodological approaches that can be used to investigate problems in a relevant scientific field and to encourage innovation. • Methodology Papers-papers that present different methodological approaches that can be used to investigate problems in a relevant scientific field and to encourage innovation. • Letters to the Editor-a response to authors of an original publication, or a very small article that may be relevant to readers. • Editorials-articles written by the Editorial Board or by invited experts on a specific topic. Research Papers Articles reporting research may be full length or brief reports. These should report original research findings within the journal's scope. Papers should generally be a maximum of 4000 words in length, excluding tables, references, and abstract and key points of the article, whilst it is recommended that the number of references should not exceed 36.
Population Medicine
Population Medicine considers the following types of articles: • Research Papers-reports of data ... more Population Medicine considers the following types of articles: • Research Papers-reports of data from original research or secondary dataset analyses. • Review Papers-comprehensive, authoritative, reviews within the journal's scope. These include both systematic reviews and narrative reviews. • Short Reports-brief reports of data from original research. • Policy Case Studies-brief articles on policy development at a regional or national level. • Study Protocols-articles describing a research protocol of a study. • Methodology Papers-papers that present different methodological approaches that can be used to investigate problems in a relevant scientific field and to encourage innovation. • Methodology Papers-papers that present different methodological approaches that can be used to investigate problems in a relevant scientific field and to encourage innovation. • Letters to the Editor-a response to authors of an original publication, or a very small article that may be relevant to readers. • Editorials-articles written by the Editorial Board or by invited experts on a specific topic. Research Papers Articles reporting research may be full length or brief reports. These should report original research findings within the journal's scope. Papers should generally be a maximum of 4000 words in length, excluding tables, references, and abstract and key points of the article, whilst it is recommended that the number of references should not exceed 36.
The Lancet Global Health
Background The COVID-19 pandemic highlighted gaps in health surveillance systems, disease prevent... more Background The COVID-19 pandemic highlighted gaps in health surveillance systems, disease prevention, and treatment globally. Among the many factors that might have led to these gaps is the issue of the financing of national health systems, especially in low-income and middle-income countries (LMICs), as well as a robust global system for pandemic preparedness. We aimed to provide a comparative assessment of global health spending at the onset of the pandemic; characterise the amount of development assistance for pandemic preparedness and response disbursed in the first 2 years of the COVID-19 pandemic; and examine expectations for future health spending and put into context the expected need for investment in pandemic preparedness. Methods In this analysis of global health spending between 1990 and 2021, and prediction from 2021 to 2026, we estimated four sources of health spending: development assistance for health (DAH), government spending, out-ofpocket spending, and prepaid private spending across 204 countries and territories. We used the Organisation for Economic Cooperation and Development (OECD)'s Creditor Reporting System (CRS) and the WHO Global Health Expenditure Database (GHED) to estimate spending. We estimated development assistance for general health, COVID-19 response, and pandemic preparedness and response using a keyword search. Health spending estimates were combined with estimates of resources needed for pandemic prevention and preparedness to analyse future health spending patterns, relative to need. Findings In 2019, at the onset of the COVID-19 pandemic, US$9•2 trillion (95% uncertainty interval [UI] 9•1-9•3) was spent on health worldwide. We found great disparities in the amount of resources devoted to health, with high-income countries spending $7•3 trillion (95% UI 7•2-7•4) in 2019; 293•7 times the $24•8 billion (95% UI 24•3-25•3) spent by low-income countries in 2019. That same year, $43•1 billion in development assistance was provided to maintain or improve health. The pandemic led to an unprecedented increase in development assistance targeted towards health; in 2020 and 2021, $1•8 billion in DAH contributions was provided towards pandemic preparedness in LMICs, and $37•8 billion was provided for the health-related COVID-19 response. Although the support for pandemic preparedness is 12•2% of the recommended target by the High-Level Independent Panel (HLIP), the support provided for the healthrelated COVID-19 response is 252•2% of the recommended target. Additionally, projected spending estimates suggest that between 2022 and 2026, governments in 17 (95% UI 11-21) of the 137 LMICs will observe an increase in national government health spending equivalent to an addition of 1% of GDP, as recommended by the HLIP. Interpretation There was an unprecedented scale-up in DAH in 2020 and 2021. We have a unique opportunity at this time to sustain funding for crucial global health functions, including pandemic preparedness. However, historical patterns of underfunding of pandemic preparedness suggest that deliberate effort must be made to ensure funding is maintained.
Epidemiology and Infection
This systematic literature review aimed to provide an overview of the characteristics and methods... more This systematic literature review aimed to provide an overview of the characteristics and methods used in studies applying the disability-adjusted life years (DALY) concept for infectious diseases within European Union (EU)/European Economic Area (EEA)/European Free Trade Association (EFTA) countries and the United Kingdom. Electronic databases and grey literature were searched for articles reporting the assessment of DALY and its components. We considered studies in which researchers performed DALY calculations using primary epidemiological data input sources. We screened 3053 studies of which 2948 were excluded and 105 studies met our inclusion criteria. Of these studies, 22 were multi-country and 83 were single-country studies, of which 46 were from the Netherlands. Food- and water-borne diseases were the most frequently studied infectious diseases. Between 2015 and 2022, the number of burden of infectious disease studies was 1.6 times higher compared to that published between 20...
BMC Public Health
Background Calculating the disease burden due to injury is complex, as it requires many methodolo... more Background Calculating the disease burden due to injury is complex, as it requires many methodological choices. Until now, an overview of the methodological design choices that have been made in burden of disease (BoD) studies in injury populations is not available. The aim of this systematic literature review was to identify existing injury BoD studies undertaken across Europe and to comprehensively review the methodological design choices and assumption parameters that have been made to calculate years of life lost (YLL) and years lived with disability (YLD) in these studies. Methods We searched EMBASE, MEDLINE, Cochrane Central, Google Scholar, and Web of Science, and the grey literature supplemented by handsearching, for BoD studies. We included injury BoD studies that quantified the BoD expressed in YLL, YLD, and disability-adjusted life years (DALY) in countries within the European Region between early-1990 and mid-2021. Results We retrieved 2,914 results of which 48 performed...
The Lancet Regional Health - Europe
Summary Background Mental health is a public health issue for European young people, with great h... more Summary Background Mental health is a public health issue for European young people, with great heterogeneity in resource allocation. Representative population-based studies are needed. The Global Burden of Disease (GBD) Study 2019 provides internationally comparable information on trends in the health status of populations and changes in the leading causes of disease burden over time. Methods Prevalence, incidence, Years Lived with Disability (YLDs) and Years of Life Lost (YLLs) from mental disorders (MDs), substance use disorders (SUDs) and self-harm were estimated for young people aged 10-24 years in 31 European countries. Rates per 100,000 population, percentage changes in 1990-2019, 95% Uncertainty Intervals (UIs), and correlations with Sociodemographic Index (SDI), were estimated. Findings In 2019, rates per 100,000 population were 16,983 (95% UI 12,823 – 21,630) for MDs, 3,891 (3,020 - 4,905) for SUDs, and 89·1 (63·8 - 123·1) for self-harm. In terms of disability, anxiety contributed to 647·3 (432–912·3) YLDs, while in terms of premature death, self-harm contributed to 319·6 (248·9–412·8) YLLs, per 100,000 population. Over the 30 years studied, YLDs increased in eating disorders (14·9%;9·4-20·1) and drug use disorders (16·9%;8·9-26·3), and decreased in idiopathic developmental intellectual disability (–29·1%;23·8-38·5). YLLs decreased in self-harm (–27·9%;38·3-18·7). Variations were found by sex, age-group and country. The burden of SUDs and self-harm was higher in countries with lower SDI, MDs were associated with SUDs. Interpretation Mental health conditions represent an important burden among young people living in Europe. National policies should strengthen mental health, with a specific focus on young people. Funding The Bill and Melinda Gates Foundation
Background: Injury remains a major concern to public health in the European region, particularly ... more Background: Injury remains a major concern to public health in the European region, particularly among adults younger than 49 years. Previous iterations of the Global Burden of Disease (GBD) study showed wide variation in injury death and disability adjusted life year (DALY) rates across Europe, indicating injury inequality gaps between sub-regions and countries. The objectives of this study were to: 1) compare GBD 2019 estimates on injury mortality and DALYs across European sub-regions and countries by cause-of-injury category and sex; 2) examine changes in injury DALY rates over a 20 year-period by cause-of-injury category, sub-region and country; and 3) assess inequalities in injury mortality and DALY rates across the countries. Methods: We performed a secondary database descriptive study using the GBD 2019 results on injuries in 44 European countries from 2000 to 2019. Inequality in DALY rates between these countries was assessed by calculating the DALY rate ratio between the hi...
European Journal of Public Health, 2021
Background Assessment of disability-adjusted life years (DALYs) resulting from non-communicable d... more Background Assessment of disability-adjusted life years (DALYs) resulting from non-communicable diseases (NCDs) requires specific calculation methods and input data. The aims of this study were to (i) identify existing NCD burden of disease (BoD) activities in Europe; (ii) collate information on data sources for mortality and morbidity; and (iii) provide an overview of NCD-specific methods for calculating NCD DALYs. Methods NCD BoD studies were systematically searched in international electronic literature databases and in grey literature. We included all BoD studies that used the DALY metric to quantify the health impact of one or more NCDs in countries belonging to the European Region. Results A total of 163 BoD studies were retained: 96 (59%) were single-country or sub-national studies and 67 (41%) considered more than one country. Of the single-country studies, 29 (30%) consisted of secondary analyses using existing Global Burden of Disease (GBD) results. Mortality data were mai...
Asian Journal of Medical Sciences, 2011
Objective: To estimate the prevalence of smoking among the college students and to identify the f... more Objective: To estimate the prevalence of smoking among the college students and to identify the factors associated with smoking. Material & Methods: This is a cross sectional study carried out on 304 college students in Kathmandu valley using purposive sampling during the months of December 2009 to January 2010. The self administrated questionnaire was adopted from Global Youth Tobacco Survey 2007 (GYTS) and data were collected after the verbal consent taken. The statistical analysis was done using descriptive statistics, univariate and binary logistic regression to measure prevalence of smoking and to identify the association between dependent and independent variables. Results: We found 7 in 10 students were currently smokers. Among currently smokers, 78% were established smokers. The mean age of smoking onset was 14.15 years (SD=2.62). The mean number of cigarettes smoked per day was 5.03(SD=3.72) and average daily expenditure was Rs. 15.18 (SD=7.87). About 90% students tried to ...
Nature
Despite notable scientific and medical advances, broader political, socioeconomic and behavioural... more Despite notable scientific and medical advances, broader political, socioeconomic and behavioural factors continue to undercut the response to the COVID-19 pandemic1,2. 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 approaches1, while maintaining proven preve...
Journal of Clinical Psychology in Medical Settings
The current financial crisis has affected the daily life of citizens. Due to the unemployment, jo... more The current financial crisis has affected the daily life of citizens. Due to the unemployment, job insecurity, stress and many other factors, population health-related quality of life (HRQoL) is affected. Persons in higher socioeconomic status tend to have higher HRQoL. A cross sectional study was conducted using convenience sampling of both employed and unemployed individuals in Attica, Greece. To evaluate HRQoL SF-36v2 questionnaire was used. The studied population consisted of 1049 people with an average age of 37.1 years. 91% were Greek, 36.8% had high school graduates and 62.4 were employed. In univariate analysis, work status, educational level, age, low income, parenthood, chronic illness and nationality were found to be related to the score of the participants at least one dimension. In linear regression analysis, there are statistically significant correlations between educational level, work status, chronic illness and age with HRQoL. Improvements of HRQoL should be direct...
Studies in health technology and informatics, 2019
Augmented Reality technology can provide useful tools and devices to support healthcare services.... more Augmented Reality technology can provide useful tools and devices to support healthcare services. The aim of this study is to investigate the intention of IT and health care scientists' to use Augmented Reality technology in Healthcare. A survey was conducted using a questionnaire based on a theoretical research model. According to the results, the participants seem to have positive perception about using the Augmented Reality technology in health domain, and they intend to use it.
Acta medica Lituanica
Objective: To investigate the hospital visits and mortality rate during the COVID-19 in emergency... more Objective: To investigate the hospital visits and mortality rate during the COVID-19 in emergency department of Vlora regional hospital in Albania and to compare with the three previous years (2017–2019). Methods: Secondary data of patients that visited emergency department of Vlora Regional hospital Albania (largest hospital in the south of the country), since January 1, 2017 till December 31, 2020. This is a retrospective study. We used the hard copy of the patients’ health register records. The data extraction was conducted during March 2021 till June 2021. Eligible were all patients admitted and recorded in the registry of the emergency department. The causes of admission were categorized in 14 different disease categories. All registered patients admitted to the Vlora regional hospital were included in the study. Results: Study population included 44,917 patients during 2017–2020. Mean age of patients was 51.5 years, while 53.6% were females. The highest number of patients was...
Vaccines, 2022
Background: Levels of fear have increased since the COVID-19 pandemic outbreak. The absence of a ... more Background: Levels of fear have increased since the COVID-19 pandemic outbreak. The absence of a safe and effective vaccine for mass-vaccination deteriorates this situation, which has a significant impact on mental health. This study aimed to assess the feelings of fear among nurses and nursing students in five European countries. Methods: A multicenter cross-sectional study was conducted in five European countries (Greece, Albania, Cyprus, Spain, and Kosovo) before the start of mass vaccination in Europe. Data collection was conducted in December 2020–January 2021 using an online questionnaire for nursing students and professional nurses. Fear of COVID-19 Scale (FCV-19S) was used for measuring levels of fear. IBM SPSS version 21.0 was used for statistical analysis. Results: The study population included 1135 nurses and 1920 nursing students from Kosovo (n = 1085), Spain (n = 663), Greece (n = 534), Albania (n = 529), and Cyprus (n = 244). According to multivariable analysis, female...
Background: Psoriasis is an autoimmune chronic inflammatory disorder of the skin with a 2 4% freq... more Background: Psoriasis is an autoimmune chronic inflammatory disorder of the skin with a 2 4% frequency of occurrence worldwide. The plaque psoriasis appears to be the most common form of the disease with an 85% frequency of occurrence. The biological drugs are considered as a revolutionary therapeutical treatment of the chronic inflammatory disease common as gastroenterology, rheumatology and dermatology in the last decade. Material and Methods: The objective of this study was, firstly the estimation of the Psoriasis Area and Severity Index (PASI) score of the Greek patients. Results: The sample consisted of 65 patients (32 men and 33 women) with mean age as 50.2 years. 36.9% of patients (n=24) received the Adalimumab drug for the treatment of psoriasis. Adalimumab received by 33.8% of patients (n = 22) who used the agent Ustekinumab, and finally 29.2% (n=19) of patients used Etanercept. PASI score for the first visit was 5.22, and for the second visit was 3.02. Conclusion: Conseque...
International Journal of Environmental Research and Public Health, 2020
Background: Evidence-based practice (EBP) is the appropriate approach to guide healthcare personn... more Background: Evidence-based practice (EBP) is the appropriate approach to guide healthcare personnel in their clinical practice. Despite the importance of EBP, undergraduate nursing students are not very much engaged and have a lack of knowledge and skills. Aim: The aim of this study was to gather, assess and synthesize evidence on educational interventions promoting evidence-based practice competencies in traditional undergraduate nursing students. Methods: This is a scoping review on sixteen English and non-English databases. A data extraction form was established including authors, year of publication, country, types of participant, specific objectives, study design, educational intervention, comparison if existed, and outcomes of significance. Results: The search strategy retrieved 8901 records in total. After screening for duplicates and eligibility, 20 articles were included in the qualitative synthesis. Improvement in EBP domains such as knowledge, skills, attitudes/behaviours...
Tobacco Prevention & Cessation, 2020
, authoritative, reviews within the journal's scope. • Short Reports-brief reports of data from o... more , authoritative, reviews within the journal's scope. • Short Reports-brief reports of data from original research. • Policy Case Studies-brief articles on policy development at a regional or national level. • Study Protocols-Articles describing a research protocol of a study. • Methodology Papers-Papers that present different methodological approaches that can be used to investigate problems in a relevant scientific field and to encourage innovation. • Tobacco Industry Monitoring Letters-brief articles on tobacco industry tactics. • Letters to the Editor-a response to authors of an original publication, or a very small article that may be relevant to readers. • Editorials-articles written by members of the Editorial Board. • Editorial notes from the field-articles written by relevant NGOs working on tobacco control that present regional or international work from the field. These usually are linked to full NGO reports. NEW FOR 2020 Research Papers Articles reporting research may be full length or brief reports. These should report original research findings within the journal's scope. Papers should generally be a maximum of 4000 words in length, excluding tables, references, and abstract and key points of the article, whilst it is recommended that the number of references should not exceed 30. The Title page should list the title of the article and suggestions for a short running title of no more than 60 characters (including spaces). Also include the authors names, affiliations and contact details including email address for the corresponding author. Affiliations should contain each author's department, institution (institute, university), city, country. The Title of the article should be clear, concise and highlighting the research topic. It should not include rhetorical questions, literary language, quotations and special symbols.
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Papers by Enkeleint Aggelos Mechili