• COVID-19
• Publicationsclose
• Research softwareclose
• Other research productsclose
• 2019-2023close
• GB close
• English close
• Alexandria Research Platform close

Background: The current COVID-19 coronavirus pandemic is an emergency on a global scale, with huge swathes of the population required to remain indoors for prolonged periods to tackle the virus. In this new context, individuals' health-promoting routines are under greater strain, contributing to poorer mental and physical health. Additionally, individuals are required to keep up to date with latest health guidelines about the virus, which may be confusing in an age of social-media disinformation and shifting guidelines. To tackle these factors, we developed Elena+, a smartphone-based and conversational agent (CA) delivered pandemic lifestyle care intervention. Methods: Elena+ utilizes varied intervention components to deliver a psychoeducation-focused coaching program on the topics of: COVID-19 information, physical activity, mental health (anxiety, loneliness, mental resources), sleep and diet and nutrition. Over 43 subtopics, a CA guides individuals through content and tracks progress over time, such as changes in health outcome assessments per topic, alongside user-set behavioral intentions and user-reported actual behaviors. Ratings of the usage experience, social demographics and the user profile are also captured. Elena+ is available for public download on iOS and Android devices in English, European Spanish and Latin American Spanish with future languages and launch countries planned, and no limits on planned recruitment. Panel data methods will be used to track user progress over time in subsequent analyses. The Elena+ intervention is open-source under the Apache 2 license (MobileCoach software) and the Creative Commons 4.0 license CC BY-NC-SA (intervention logic and content), allowing future collaborations; such as cultural adaptions, integration of new sensor-related features or the development of new topics. Discussion: Digital health applications offer a low-cost and scalable route to meet challenges to public health. As Elena+ was developed by an international and interdisciplinary team in a short time frame to meet the COVID-19 pandemic, empirical data are required to discern how effective such solutions can be in meeting real world, emergent health crises. Additionally, clustering Elena+ users based on characteristics and usage behaviors could help public health practitioners understand how population-level digital health interventions can reach at-risk and sub-populations. Frontiers in Public Health, 9 (1543) ISSN:2296-2565

Revised August 2020. Global value chains are highly fragmented across countries and dominated by a few large multinational firms. But the challenges of an increasingly difficult international business environment are raising the question of how these patterns will change. I study the role of international Just-in-Time (JIT) supply chains in how global production is organized and what the future may hold. Using survey and administrative data for a large panel of French manufacturers, I first document that JIT is widespread across all industries and accounts for roughly two thirds of aggregate employment and trade. Next, I establish two novel stylized facts about the structure of international JIT supply chains: (1) They are more concentrated in space and (2) more vertically integrated than their ‘traditional’ counterparts. I rationalize these patterns in a framework of sequential production where failure to coordinate adaptation decisions in an uncertain environment leads to inventory holding. In JIT supply chains, information about downstream demand conditions is relayed upstream, which facilitates coordination. The associated inventory saving effect is stronger when firms are close to each other, so that the supply chain reacts quickly to changes in demand. This also applies when they are part of the same company and incentives for adaptation are aligned. I validate this model by supporting empirical evidence for further predictions and discuss potential long term implications of Brexit and COVID-19 for the structure of international supply chains.

Less economic integration would make it difficult for the ECB to stabilise the euro area economies. Symmetric monetary policy cannot do anything about this and individual countries would need to use fiscal policy tools.