Showing papers by "Toomas Timpka published in 2022"

Cyberchondria, Fear of COVID-19, and Risk Perception Mediate the Association between Problematic Social Media Use and Intention to Get a COVID-19 Vaccine

Abstract: Vaccination is the most effective way to control the COVID-19 pandemic, but vaccination hesitancy threatens this effort worldwide. Consequently, there is a need to understand what influences individuals’ intention to get a COVID-19 vaccine. Restriction of information gathering on societal developments to social media may influence attitudes towards COVID-19 vaccination through exposure to disinformation and imbalanced arguments. The present study examined the association between problematic social media use and intention to get the COVID-19 vaccine, taking into account the mediating roles of cyberchondria, fear of COVID-19, and COVID-19 risk perception. In a cross-sectional survey study, a total of 10,843 residents of Qazvin City, Iran completed measures on problematic social media use, fear of COVID-19, cyberchondria, COVID-19 risk perception, and intention to get a COVID-19 vaccine. The data were analyzed using structural equation modeling (SEM). The results showed that there was no direct association between problematic social media use and intention to get a COVID-19 vaccine. Nonetheless, cyberchondria, fear of COVID-19, and COVID-19 risk perception (each or serially) mediated associations between problematic social media use and intention to get a COVID-19 vaccine. These results add to the understanding of the role of problematic social media use in COVID-19 vaccine hesitancy, i.e., it is not the quantity of social media use per se that matters. This knowledge of the mediating roles of cyberchondria, fear of COVID-19, and COVID-19 risk perception can be used by public health experts and policymakers when planning educational interventions and other initiatives in COVID-19 vaccination programs.

App-based COVID-19 syndromic surveillance and prediction of hospital admissions in COVID Symptom Study Sweden

Abstract: The app-based COVID Symptom Study was launched in Sweden in April 2020 to contribute to real-time COVID-19 surveillance. We enrolled 143,531 study participants (≥18 years) who contributed 10.6 million daily symptom reports between April 29, 2020 and February 10, 2021. Here, we include data from 19,161 self-reported PCR tests to create a symptom-based model to estimate the individual probability of symptomatic COVID-19, with an AUC of 0.78 (95% CI 0.74-0.83) in an external dataset. These individual probabilities are employed to estimate daily regional COVID-19 prevalence, which are in turn used together with current hospital data to predict next week COVID-19 hospital admissions. We show that this hospital prediction model demonstrates a lower median absolute percentage error (MdAPE: 25.9%) across the five most populated regions in Sweden during the first pandemic wave than a model based on case notifications (MdAPE: 30.3%). During the second wave, the error rates are similar. When we apply the same model to an English dataset, not including local COVID-19 test data, we observe MdAPEs of 22.3% and 19.0% during the first and second pandemic waves, respectively, highlighting the transferability of the prediction model.

Nuances in key constructs need attention in research on mental health and psychiatric disorders in sports medicine

Abstract: Department of Behavioral Sciences and Learning, Linköping University, Linkoping, Sweden Athletics Research Center, Department of Health, Medicine and Caring Sciences, Linköping University, Linkoping, Sweden Department of Child and Adolescent Psychiatry and Department of Biomedical and Clinical Sciences, Center for Social and Affective Neuroscience, Linköping University, Linkoping, Sweden Department of Health, Medicine and Caring Sciences, Division of Society and Health, Linköping University, Linkoping, Sweden

Nowcasting (Short-Term Forecasting) of COVID-19 Hospitalizations Using Syndromic Healthcare Data, Sweden, 2020

Abstract: We report on local nowcasting (short-term forecasting) of coronavirus disease (COVID-19) hospitalizations based on syndromic (symptom) data recorded in regular healthcare routines in Östergötland County (population ≈465,000), Sweden, early in the pandemic, when broad laboratory testing was unavailable. Daily nowcasts were supplied to the local healthcare management based on analyses of the time lag between telenursing calls with the chief complaints (cough by adult or fever by adult) and COVID-19 hospitalization. The complaint cough by adult showed satisfactory performance (Pearson correlation coefficient r>0.80; mean absolute percentage error <20%) in nowcasting the incidence of daily COVID-19 hospitalizations 14 days in advance until the incidence decreased to <1.5/100,000 population, whereas the corresponding performance for fever by adult was unsatisfactory. Our results support local nowcasting of hospitalizations on the basis of symptom data recorded in routine healthcare during the initial stage of a pandemic.

Corruption should be taken into account when considering COVID-19 vaccine allocation

Abstract: Twelve months after vaccines against COVID-19 were made available, the number of vaccinated was still at an unsatisfactory level, even in world regions with highly developed biotechnical industries (1). Duch et al. (2) argue that how to allocate scarce COVID-19 vaccines is one of the most important decisions governments around the world have recently faced. From a study involving 13 countries, they reported a consistent population preference for a government-only mode of allocation. However, they also observed that large groups in lowand middle-income countries were willing to purchase vaccine on the private market in order to receive it faster. The authors infer that any private access would complement public provision to maximize the vaccination benefits and minimize the potential for corruption (3). However, they did not include corruption in their analysis model. Systemic corruption is the use of power for private gain and the deliberate betrayal of public trust (4). To quantify the influence from illicit use of power on COVID-19 vaccination coverage, we investigated countrylevel associations between vaccination coverage and level of corruption. The vaccinated population fraction (VPF) (1) Fig. 1. Country-level associations between the population proportion having received at least one dose of COVID-19 vaccine and corruption measured by the CPI displayed by HDI categories. Regression lines for countries in the low, middle, high, and very high HDI categories are shown. Country-level data on the VPF were collected on 14 December 2021 and on CPI and HDI on 21 October 2021. From a total of 223 listed countries, 169 countries were included in a linear regression analysis, where each country was regarded as an independent observation. The excluded countries comprised those with missing data on any of three variables (n = 51) or having introduced compulsory vaccination for all adults (n = 3).

Computational models predicting the early development of the COVID-19 pandemic in Sweden: systematic review, data synthesis, and secondary validation of accuracy

Abstract: Computational models for predicting the early course of the COVID-19 pandemic played a central role in policy-making at regional and national levels. We performed a systematic review, data synthesis, and secondary validation of studies that reported on prediction models addressing the early stages of the COVID-19 pandemic in Sweden. A literature search in January 2021 based on the search triangle model identified 1672 peer-reviewed articles, preprints and reports. After applying inclusion criteria 52 studies remained out of which 12 passed a Risk of Bias Opinion Tool. When comparing model predictions with actual outcomes only 4 studies exhibited an acceptable forecast (mean absolute percentage error, MAPE < 20%). Models that predicted disease incidence could not be assessed due to the lack of reliable data during 2020. Drawing conclusions about the accuracy of the models with acceptable methodological quality was challenging because some models were published before the time period for the prediction, while other models were published during the prediction period or even afterwards. We conclude that the forecasting models involving Sweden developed during the early stages of the COVID-19 pandemic in 2020 had limited accuracy. The knowledge attained in this study can be used to improve the preparedness for coming pandemics.

Hospital bed occupancy for COVID‐19 or with SARS‐CoV‐2 infection in a Swedish county during the omicron wave

Abstract: In the first months of 2022, European nations experienced a resurge of patients admitted to hospital with SARS-CoV-2 infection. Driven by the omicron subvariant BA2, the community dissemination was also notably high; the Real Time Assessment of Community Transmission study in England reported SARS-CoV-2 infections to reach 6.4% prevalence in March 2022, which exceeded the previous peak prevalence of 4.4% recorded in January 2022. The European Centre for Disease Prevention and Control (ECDC) recommended during the spread of the ancestral variant in 2020 that all patients admitted to hospital should be tested for SARS-CoV-2. At the early stage of the pandemic, COVID-19 was the outstanding reason for hospital admission in patients with a positive test. Due to the high prevalence of mild or asymptomatic disease during the omicron wave, it can be questioned whether SARS-CoV-2 testing alone provides sufficient information for adequate hospital resource management. We therefore monitored the occupancy of hospital beds by patients admitted for COVID-19, multiple morbidity including COVID-19, and conditions not associated with SARS-CoV-2 infection in a Swedish county during the omicron wave. The study was approved by the Swedish Ethical Review Authority (Dnr 2021-05203). Data collection was performed between January 18 and April 19, 2022 in Östergötland (population 465,000), where all patients were provided a reverse-transcription PCR (PCR) test for SARSCoV-2 on hospital admission. The medical records of patients with a positive test were accessed through the county-wide health information system to classify them by whether COVID-19, multiple morbidity including COVID-19, or a condition unrelated to SARSCoV-2 infection was the reason for admission. The medical record review was performed on a weekly basis by two senior consultant physicians (CA, RS) with extensive experience from hospital management and patient safety monitoring. Assessments were first made individually and then compared; at disagreements (<10% of assessments) the classification was discussed until consensus was reached. The review data were structured to establish a temporal record of the bed occupancy of hospital patients in each of the three admission categories. In total 15,904 patients were admitted to hospital in Östergötland county during the monitoring period; 878 (5.5%) of these patients were admitted with a positive SARS-CoV-2 test. The median cross-sectional hospital bed occupancy during the period was 135 (Interquartile range [IQR] 122–139) per 100,000 population. The bed occupancy by patients with positive SARS-CoV-2 test on admission reached its peak on February 7, 2022 with 23 patients per 100,000 population (16% of all hospital patients at that point in time), declining to 8 patients per 100,000 population (6% of hospital patients at that point) on April 19 (Figure 1). On average, patients admitted for conditions unrelated to SARS-CoV-2 infection accounted for 52% of the hospital bed occupancy among patients with positive SARS-CoV-2 test on admission. The median length of bed occupancy was for these patients 4 days (IQR 2–8 days). Patients admitted for COVID-19 accounted for on average 31% of the bed occupancy among patients with positive SARS-CoV-2 test on admission and patients with COVID-19 as a contributing reason for admission on average 18%. At any point in time during the study, patients treated for COVID-19 thus accounted for on average less than 50% of the hospital bed occupancy by patients with positive SARS-CoV-2 test on admission, corresponding to between 8% (on February 7, 2022) and 2% (on April 19, 2022) of all patients occupying a hospital bed. The median length of hospital bed occupancy in patients treated for COVID-19 was 6 days (IQR 3–11 days). The risk of severe outcomes following SARS-CoV-2 infection has been established to be lower for omicron than for the initial SARSCoV-2 variants of concern but the reduction in intrinsic severity is counterbalanced by a reduction in vaccine effectiveness compared to the initial variants. Our repeated cross-sectional monitoring during the omicron wave showed that more than every second patient occupying a hospital bed with positive SARS-CoV-2 test on admission was not treated for COVID-19. This observation should be considered when planning infectious disease control measures at hospitals. Our results echo a recent study reporting that 63% of patients testing positive for SARS-CoV-2 at the peak of the omicron wave in South Africa were admitted to hospital for an alternative primary diagnosis. We conclude that appropriate routines for infectious disease control should be developed for management of hospital patients testing Received: 26 May 2022 Accepted: 29 May 2022

Universal prevention through a digital health platform reduces injury incidence in youth athletics (track and field): a cluster randomised controlled trial

Abstract: Objectives To examine whether universal prevention via a digital health platform can reduce the injury incidence in athletics athletes aged 12–15 years and if club size had an influence on the effect of the intervention. Methods This was a cluster randomised trial where young athletics athletes were randomised through their club following stratification by club size into intervention (11 clubs; 56 athletes) and control (10 clubs; 79 athletes) groups. The primary endpoint was time from baseline to the first self-reported injury. Intervention group parents and coaches were given access to a website with health information adapted to adolescent athletes and were encouraged to log in and explore its content during 16 weeks. The control group continued training as normal. Training exposure and injury data were self-reported by youths/parents every second week, that is, eight times. The primary endpoint data were analysed using the log-rank test. Cox proportional hazards regression was used to analyse the second study aim with intervention status and club size included in the explanatory models. Results The proportion of completed training reports was 85% (n=382) in the intervention group and 86% (n=545) in the control group. The injury incidence was significantly lower (HR=0.62; χ2=3.865; p=0.049) in the intervention group. The median time to first injury was 16 weeks in the intervention group and 8 weeks in the control group. An interaction effect between the intervention and stratification factor was observed with a difference in injury risk between athletes in the large clubs in the intervention group versus their peers in the control group (HR 0.491 (95% CI 0.242 to 0.998); p=0.049). Conclusions A protective effect against injury through universal access to health information adapted for adolescent athletes was observed in youth athletics athletes. The efficacy of the intervention was stronger in large clubs. Trial registration number NCT03459313.

Effectiveness of the BNT162b2 mRNA Vaccine Compared with Hybrid Immunity in Populations Prioritized and Non-Prioritized for COVID-19 Vaccination in 2021–2022: A Naturalistic Case-Control Study in Sweden

Abstract: The term hybrid immunity is used to denote the immunological status of vaccinated individuals with a history of natural infection. Reports of new SARS-CoV-2 variants of concern motivate continuous rethought and renewal of COVID-19 vaccination programs. We used a naturalistic case-control study design to compare the effectiveness of the BNT162b2 mRNA vaccine to hybrid immunity 180 days post-vaccination in prioritized and non-prioritized populations vaccinated before 31 July 2021 in three Swedish counties (total population 1,760,000). Subjects with a positive SARS-CoV-2 test recorded within 6 months before vaccination (n = 36,247; 6%) were matched to vaccinated-only controls. In the prioritized population exposed to the SARS-CoV-2 Alpha and Delta variants post-vaccination, the odds ratio (OR) for breakthrough infection was 2.2 (95% CI, 1.6–2.8; p < 0.001) in the vaccinated-only group compared with the hybrid immunity group, while in the later vaccinated non-prioritized population, the OR decreased from 4.3 (95% CI, 2.2–8.6; p < 0.001) during circulation of the Delta variant to 1.9 (95% CI, 1.7–2.1; p < 0.001) with the introduction of the Omicron variant (B.1.617.2). We conclude that hybrid immunity provides gains in protection, but that the benefits are smaller for risk groups and with circulation of the Omicron variant and its sublineages.

Vulnerability and stressors on the pathway to depression in a global cohort of young athletics (track and field) athletes

Abstract: Abstract This research set out to identify pathways from vulnerability and stressors to depression in a global population of young athletes. Retrospective data were collected at age 18–19 years from Athletics athletes (n = 1322) originating from Africa, Asia, Europe, Oceania, and the Americas. We hypothesised that sports-related and non-sports-related stressors in interaction with structural vulnerability instigate depression. Path modelling using Maximum likelihood estimation was employed for the data analysis. Depression caseness and predisposition were determined using the WHO-5 instrument. Thirty-six percent of the athletes (n = 480) returned complete data. Eighteen percent of the athletes reported lifetime physical abuse, while 11% reported sexual abuse. Forty-five percent of the athletes had recently sustained an injury. The prevalence of depression caseness was 5.6%. Pathways to depression caseness were observed from female sex ( p = 0.037) and injury history ( p = 0.035) and to predisposition for depression also through exposure to a patriarchal society ( p = 0.046) and physical abuse ( p < 0.001). We conclude that depression in a global population of young athletes was as prevalent as previously reported from general populations, and that universal mental health promotion in youth sports should include provision of equal opportunities for female and male participants, injury prevention, and interventions for abuse prevention and victim support.

Vulnerability and stressors on the pathway to depression in a global cohort of young athletics (track and field) athletes

Abstract: Abstract This research set out to identify pathways from vulnerability and stressors to depression in a global population of young athletes. Retrospective data were collected at age 18–19 years from Athletics athletes (n = 1322) originating from Africa, Asia, Europe, Oceania, and the Americas. We hypothesised that sports-related and non-sports-related stressors in interaction with structural vulnerability instigate depression. Path modelling using Maximum likelihood estimation was employed for the data analysis. Depression caseness and predisposition were determined using the WHO-5 instrument. Thirty-six percent of the athletes (n = 480) returned complete data. Eighteen percent of the athletes reported lifetime physical abuse, while 11% reported sexual abuse. Forty-five percent of the athletes had recently sustained an injury. The prevalence of depression caseness was 5.6%. Pathways to depression caseness were observed from female sex ( p = 0.037) and injury history ( p = 0.035) and to predisposition for depression also through exposure to a patriarchal society ( p = 0.046) and physical abuse ( p < 0.001). We conclude that depression in a global population of young athletes was as prevalent as previously reported from general populations, and that universal mental health promotion in youth sports should include provision of equal opportunities for female and male participants, injury prevention, and interventions for abuse prevention and victim support.

Design of the performance outcome scoring template (POS-T) with example application on CO2 emissions reduction amongst 36 OECD member countries

Abstract: In applied program settings, such as in natural environment control and education, performance evaluation is usually conducted by evaluators considering both self-comparison and comparison with peers. We have developed the performance outcome scoring template (POS-T) for assessments with high face-validity in these settings. POS-T puts achievements of individuals or groups in context, i.e. the resulting performance outcome score (POS) reflects a meaningful measure of performance magnitude with regards to internal and external comparisons. Development of a POS is performed in four steps supported by a statistical framework. Software is supplied for creation of scoring applications in different performance evaluation settings. We demonstrate the POS-T by evaluation of CO2 emissions reduction amongst 36 OECD member countries.