bluuebunny/crossref_metadata_2025_split huggingface dataset:
Infographics and the knowledge translation framework
Authors: Hilderink HBM , Deuning C , van der Wilk E 
Published: October 2021

Abstract
The concept of Knowledge Translation (KT) can be used to narrow the gap between knowledge producers, such as researchers, and knowledge users, such as policy makers. KT is the process in which complex research and data are translated into more easily to understand understood content to support evidence-informed policy making. KT covers a wide variety of activities including knowledge dissemination, two-way exchange process between researchers and knowledge users, and communication. The nature of these activities can be classified in four models of interaction, Push, Pull, Exchange and Integration. Especially, the push model is applied when potential users are still unaware that they should be considering information on a certain topic, which is often the case for Burden of Disease (BoD) results. Next to push method as such policy briefings and health status reports, a product focusing on visualization might be more effective. A visualized product that has gained popularity is the infographic as a collection of imagery, charts, and minimal text that gives an easy-to-understand overview of a topic. Also regarding BOD, with its complex methodology and large amounts of data and information, infographics can be an efficient tool for KT. However, the use of infographics for BoD is still rather limited and could benefit from effective data visualization techniques applied in other fields within public health. Though communication through an infographic can be rather powerful, one has to be aware that the interpretation of the infographic by the receptor can also result in less-balanced messages. In this presentation, the concept of KT will be linked to visualization techniques as infographics using good and bad examples from BoD and beyond.
Health system description and assessment: a review of systematic tools for analyses
Authors: Waitzberg R , Rechel B , Maresso A , van Ginneken E , Quentin W 
Published: October 2021

Abstract

Introduction
Comparing health systems allows policymakers to benchmark against other countries, and improve processes and performance. A template to guide authors on how to present systems' features and performance in a meaningful manner is the basis for understanding and assessing a country's health system. This study presents an overview of approaches for standardized descriptions and analyses of health systems.

Methods
We conceptualized four criteria to define a “template” for our analysis. It must have (1) a framework, (2) a list of indicators, (3) instructions for authors on how to write an informative document, and (4) should cover health systems design and performance.
Based on these criteria we searched the academic and grey literature, and the web for templates.

Results
We found 29 tools that can be used as templates to describe and assess health systems. While ten tools are comprehensive, 19 tools focus on specific topics such as primary care, universal coverage, and quality of care. Another 21 tools focused on health system performance assessment but cannot serve as templates, as we define it. Most tools were developed by big organizations such as WHO, OECD and USAID.

Discussion
New models of governance and accountability are leading to increased interest in health system performance. A good template is key to write documents with an organized, coherent and meaningful description and assessment of a health system while allowing for cross-country comparison. We found ten tools that may serve as models of comprehensive templates, while most tools focus on specific topics or on performance assessment only.

Conclusions
This study provides a first-ever overview of templates that analyze health systems features and performance. Future studies could explore successful examples to consolidate a template that may potentially improve analysis and comparison of health systems in order to support policymaking.

Key messages
We found ten comprehensive tools for describing and assessing health systems. Our overview may help to improve existing templates by learning from experiences of different organizations.
Image of psychiatry and psychic illness during the COVID-19 pandemic: social media monitoring
Authors: Bogdan I , Chistyakova D , Pravednikov A 
Published: October 2021

Abstract

Background
Experts indicate that despite the demand there was no increase in referrals to Moscow psychiatric services in 2020. Among contributing factors are image/public perception of psychiatry and psychiatric diseases that are heavily influenced by social media.

Methods
More than 700 thousand social media messages of Muscovites matching relevant keywords (January-August, 2020) were downloaded using specialized software. Alongside with quantitative analysis, qualitative analysis was performed on a random subsample of 401 messages and respective images.

Results
Our analysis allowed combining messages into 6 groups and the biggest one was “Frivolous attitude to psychiatry”. In these messages, psychiatric terms are mainly used as means of stigmatization, to insult the opponent, even in cases when person is “guilty” of liking the “wrong” ideology, politicians or fashion. This heavily stigmatizes seeking help in official psychiatric facilities. People discuss numerous psychiatric diagnoses but at the same time they do not distinguish between types of psychiatric services (even in- and outpatient facilities). In the overall majority of messages people rely not on their personal experience, but on their thoughts based on e.g. stigmatizing pieces of art. This often leads to highly incompetent statements. COVID-19 references were very few in the subsample (&lt;4%) but it should be highlighted that sometimes information gaps are filled with esoteric and conspiracy theories which do not promote seeking help in official psychiatric facilities either.

Conclusions
Analysis showed high level of stigmatization of the service in social media, which can distract people from seeking help when needed. It can be recommended to create appropriate social media monitoring system to find main topics for informational interventions and monitor the effectiveness of such interventions.

Key messages
Psychiatry and psychic illness are highly stigmatized in social media. Social media monitoring can help in destigmatization of psychiatric care.
How the Euripid collaboration contributes to price transparency of pharmaceuticals
Authors: Habl CAH , Fischer SF 
Published: October 2021

Abstract

Background
Spending on pharmaceuticals is growing continuously with a forecast of reaching over one trillion Euro in the next five years. Also, the average price of newly launched medicines is steeply raising, thus putting pressure on public payers. With several new advanced therapies in the pipeline, there are concerns in terms of both affordability and access for all patients who may need these treatments. To manage high launch prices, public payers in Europe more and more rely on private law contractual arrangements with pharmaceutical companies, requiring significant price discounts and other types of managed-entry agreements (MEAs).

Methods
In spring 2021 we analysed the EURIPID database (www.euripid.eu) for occurrence and frequency of MEA in the 28 countries (AT, BE, BG, CH, CY, CZ, DK, EE, EL, ES, FI, FR, HR, HU, IE, IL, IS, IT, LV, LT, NL, NO, PT, RO, SE, SI, SK, and UK) that are covered. Euripid is a voluntary, non-profit collaboration between mainly European countries on building up and maintaining a database with information on national prices of medicinal products.

Results
24 out 28 countries acknowledge the existence of MEA in their country. The highest number was identified in Italy with 1,317 agreements, followed by Latvia with 555 and Austria with 235. Seven countries use MEA as more or less standard instrument to manage their public pharmaceutical budget, whereas other countries just use it on case-by-case basis. Analysis shows that products above 100.0 Euro per unit (i.e. per shot or tablet) are much more likely to have a MEA than products with lower prices. Still, we found MEA in place also for products with a sales price per unit with &lt;1.0 Euro. When looking into therapeutic areas, Antineoplastic and immunomodulating agents (ATC group L) including cancer medicines and immunosuppressants and medicines for the nervous system (ATC group N) dominated. Also, for some companies the likelihood of a MEA is higher than for others.

Key messages
Managed Entry Agreements (MEA) have become a standard tool for many public payers to manage high launch prices of pharmaceuticals. The scope of use varies widely: in some countries almost all newly launched pharmaceuticals are subject to such an agreement.
Geographic and socioeconomic equity in PHC performance among the elderly in three Nordic countries
Authors: Satokangas M , Arffman M , Agerholm J , Hougaard C&Oslash; , Andersen I , Burström B , Keskimäki I 
Published: October 2021

Abstract

Denmark, Finland, and Sweden pursue equity in health for their citizens through universal health care. It is however unclear if these services reach the elderly population equally between different socioeconomic positions (SEP) or living-areas. Our aim was to assess both socioeconomic and geographic equity in primary health care (PHC) performance among the elderly 2000-2015 in the City of Copenhagen, Metropolitan Area of Helsinki, and Stockholm County. Hospitalisations for ambulatory care sensitive conditions (ACSC) was applied as a proxy for PHC performance. Hospitalization data for population aged ≥45 was acquired from the Danish National Patient Register, Finnish Care Register HILMO and patient administrative register from Stockholm County Council. Over time development of geographical variation in ACSC within each metropolis was analysed with Poisson multilevel models. These models were adjusted with individual SEP to distinguish between geographic and socioeconomic disparities. When compared to Stockholm, incidence rate ratios of ACSCs were higher both in Copenhagen (IRR 1.25; CI 95% 1.17-1.35) and in Helsinki (1.39; 1.30-1.49). While the average effect of time slightly decreased in each of the three capital regions (0.97; 0.96-0.98), this decrease was slightly more pronounced in Helsinki than in Stockholm (0.98; 0.97-0.99). Geographic variation in ACSCs seemed the highest both in Copenhagen and in Helsinki. Over time these variations seemed to reduce in Helsinki and in Stockholm, but not in Copenhagen. Adjusting for individual SEP seemed to explain a half of this variance in Helsinki and a third in both Stockholm and Copenhagen - after which over time geographic variation seemed to reduce also in Copenhagen. Geographic disparities in PHC performance among the elderly seem to have narrowed in Finland and in Sweden but remained stable in Denmark. However, in Denmark this seems to rather reflect socioeconomic disparities than stagnant development of PHC.

Key messages
Despite the universal health care in Denmark, Finland and Sweden, there seems to persist both socioeconomic and geographic disparities in PHC performance among their elderly populations. Among the elderly, over time geographic disparities in PHC performance seem to have improved in both Finland and Sweden – but stagnated in Denmark due to the socioeconomic disparities.
The impact of COVID-19 on migrants in Greece: a retrospective analysis of national data
Authors: Hargreaves S , Kondilis E , Papamichail D , McCann S , Orcutt M , Carruthers E , Veizis A 
Published: October 2021

Abstract

Background
For 56,000 refugees and asylum seekers in Reception and Identification Centres (RICs) and Reception Sites (RS) in Greece, living in severely substandard living conditions, prevention measures have been severely limited. We assessed the impact of COVID-19 on migrants in these settings.

Methods
We did a retrospective analysis of policy documents and national surveillance data to identify COVID-19 outbreaks and estimate incidence among migrants residing in these camps (26th Feb - 15th Nov 2020). Incidence proportion (IP) of COVID-19 confirmed cases was calculated for three population groups (migrant populations in RICs, migrant populations in RSs, and the general population in Greece) during three time periods (first wave, second wave, and overall across the 9-month period).

Results
25 outbreaks were identified in migrant reception facilities, with 6 (85.7%) of 7 RICs and 18 (56.3%) of 32 RSs reporting at least one outbreak during the study period. The overall 9-month COVID-19 IP among refugee and asylum seeker populations residing in RSs on the Greek mainland was 1,758 cases per 100,000 population; in RICs the incidence was 2,052 cases per 100,000 population. Compared to the general population the risk of COVID-19 infection among migrants in reception facilities was 2.5 to 3 times higher; the risk of acquiring COVID-19 infection was higher among migrant populations in RSs on the Greek mainland (IP ratio: 2.45; 95% CI: 2.25-2.68) but higher still among migrant populations in RICs in the Greek islands and the land border with Turkey (IP ratio: 2.86; 95% CI: 2.64-3.10), where living conditions are particularly poor.

Conclusions
We identified high levels of COVID-19 transmission among migrants in reception facilities in Greece, with immediate implications for policy and practice to ensure refugee and asylum seeker populations are included in national response plans to reduce transmission, alongside ensuring their inclusion in plans for COVID-19 vaccine roll out.

Key messages
Thousands of migrants in Greece live in severely substandard conditions and largely excluded from the COVID-19 response. We identified high levels of COVID-19 transmission among migrants in reception facilities in Greece, with immediate implications for policy and practice.
“Time does not heal all wounds”: mental health impact of sexual victimisation in old age
Authors: Nobels A , Lemmens G , Thibau L , Beaulieu M , Vandeviver C , Keygnaert I 
Published: October 2021

Abstract

Background
Sexual violence (SV) has an important impact on mental health. Childhood sexual abuse is linked to internalizing disorders in later life. In older adults, SV occurs more often than previously believed. Moreover, health care workers lack the skills to adequately address SV in later life. Studies researching the mental health impact of lifetime SV, i.e. SV that happened during childhood, adulthood and old age, are currently lacking. In this study we research the association between lifetime sexual victimization and adverse mental health outcomes in older adults, and its moderators.

Methods
Between July 2019 and March 2020, 513 older adults living in Belgium participated in a structured face-to-face-interview. Selection occurred via a cluster random probability sampling with a random walk finding approach. Depression, anxiety and post-traumatic stress syndrome (PTSD) were measured using validated scales. Suicide attempts and self-harm were questioned during lifetime and in the past 12-months. SV was measured using behaviorally specific questions based on a broad definition of SV.

Results
Over 44% experienced lifetime SV, 8% in the past 12-months. Rates for depression, anxiety and PTSD were 27%, 26% and 6%. Almost 2% committed suicide, 1% reported self-harm in the past 12-months. Lifetime SV was linked to depression (p =.001), anxiety (p =.001), and PTSD in participants with a chronic illness/disability (p = .002) or no/lower education (p &lt;.001). We found no link between lifetime SV and suicide attempts or self-harm in the past 12-months.

Conclusions
Lifetime SV is linked to mental health problems in late life. Tailored mental health care for older SV victims is necessary. Therefore, capacity building of professionals and development of clinical guidelines and care procedures are urgently needed.

Key messages
The mental health impact of sexual victimisation continues into old age. Tailored mental health care for older SV victims and capacity building of professionals are of the utmost importance.
Burden of disease methods: integrating COVID-19 to the cause list
Authors: Wyper G 
Published: October 2021

Abstract
Until recently, most efforts to understand the comparative population health impact of COVID-19 have been made using mortality-based metrics. This has intensified discussion over methodological choices; in particular, how we value the life-years prematurely lost due to COVID-19. The direct impact of COVID-19 on population health has varied across countries, with wide variation in incidence and infection fatality rates. Understanding and quantifying the combined impact of morbidity and mortality is a key step to standardizing comparisons across countries, and to quantify the within-country impact of COVID-19 relative to other causes of disease and injury, sub-national areas or demographics. Burden of disease metrics, such as disability-adjusted life years (DALYs) offer a means of monitoring the direct population health impact of COVID-19 infection. They also offer opportunities to assess the indirect impact of the pandemic that has occurred due to national lockdowns and restrictions to vital services. We present recommendations on methodology for estimating DALYs for COVID-19 at national level. These include a protocol for calculations, the data requirements and approaches to overcome data gaps, a consensus health outcome, and the disability weights to describe the severity of each health outcome. These standardized approaches to estimating DALYs due to COVID-19 can allow for more accurate and comparable estimates of the burden of disease across populations.
Burden of Disease of COVID-19 in European countries: examples from Germany and Scotland
Authors: Wengler A 
Published: October 2021

Abstract
Since the start of the pandemic, scientists have been challenged to estimate the impact of COVID-19 on the worldwide population. Research in many countries has concentrated on finding a feasible way of quantifying the effects in terms of severity and ill-health of the infection and its short- and long-term impact, as well as in terms of mortality. All of these factors can be combined when estimating disability-adjusted life years (DALYs). COVID-19 DALY estimates from Germany and Scotland will be presented as examples for burden of disease calculations. The methods used are aligned with the guidelines developed by the European Burden of Disease Network for estimating DALYs due to COVID-19. Nevertheless, both studies made adaptations, which depended largely on data availability and quality, and country-specific context upon which burden of disease assessments were undertaken. The German study showed that a total of 305,641 DALYs (368 per 100,000 persons) were lost in the population in 2020 due to COVID-19. There were 9.6 years of life lost (YLL) per death; women lost fewer YLL than men (8.1 vs. 11.0 YLL). In Scotland, DALYs due to COVID-19 ranged from 96,500 to 108,200 in 2020. This estimate meant that COVID-19 was framed as the second leading cause of disease and injury, with only ischaemic heart disease having a larger impact on population health in Scotland. Both studies indicated that over 98% of DALYs were due to YLL, i.e., a high proportion of DALYs is due to COVID-19 mortality. Notwithstanding methodological differences, the inputs from both studies could be used with common methodology to facilitate comparisons across countries. These findings illustrate how burden of disease indicators can be useful for monitoring public health in an ongoing pandemic.
Injury inequalities in the European Region: trends cross-country and within-country and potential COVID-19 impacts
Authors: Sengoelge M , Laflamme L 
Published: October 2021

Abstract
We will provide a review of the knowledge base from studies on injuries in the WHO European Region from 2010 to 2019, both cross-country and within-country, for all causes and cause-specific. The focus is whether inequalities between countries and within countries persist such that people from low socioeconomic status and from less affluent areas tend to die by injury to a greater extent than others. This has previously been observed for most causes of injury (e.g., traffic, self-directed violence, interpersonal violence, poisoning, burns) but also for several settings (e.g., home, work, transport) based on a review of socioeconomic disparities in injury risks from 1990-2006. In addition, the pandemic touches upon factors with a known impact, directly or indirectly, on the risk and social distribution of injuries (e.g. social isolation, change in transportation mode and volume, alcohohol consumption, etc.). Until the 2020-2021GBD data are available at the regional level for Europe, we hypothesise on how the pandemic may have affected the social distribution of injuries in the Region. For example, we hypothesise a significant decrease in road traffic related injuries due to lockdown measures (reduced commuting to work, 24-hour curfews). There may also be an increase in unintentional injuries related to children spending increased hours in the home environment and an increase in do-it-yourself injuries in adults. We also see a possible increase in self-harm injuries due to the mental ill health burden related to confinement and social isolation, but data thus far from single EU countries do not report an increase in suicides. We will then present a research agenda for investigating how the pandemic has affected the injury burden in the Europe Region.
The impact of the second victim phenomenon in an Italian Academic Hospital: a cross-sectional study
Authors: Moretti V , Scarpis E , Ruscio E , Bianchet B , Doimo A , Farneti F , Castriotta L , Quattrin R , Cocconi R 
Published: October 2021

Abstract

Background
Adverse patient safety events (AEs) can negatively impact on healthcare workers (HCWs) by causing emotional distress and affecting professional ability. The challenge of healthcare organizations is to support HCWs involved in AEs. This study aims to investigate the second victim phenomenon in a large Italian Academic Hospital (AH).

Methods
A cross sectional survey was conducted from June to November 2019 involving all HCWs working at the AH of Udine. HCWs' demographic characteristics and answers to the Second Victim Experience and Support Tool, Italian version (IT-SVEST; 29 items representing 7 dimensions and 2 outcome variables; Likert-scale: 1-5) were collected. Higher scores indicated a greater negative impact of the AEs and a perceived inadequacy of support resources. Median (M) and interquartile range (IQR) were assessed for each item. The agreement (AGR) (respondents with a mean score ≥4) was assessed for each dimension. Relationship between items score and demographic aspects was analyzed with non-parametric tests.

Results
A total of 349 HCWs joined the survey. Women were 79.4% and mean age was 39.4±10.7 years. 58.7% of respondents referred to be involved in a AEs. Lots of HCWs expressed feelings of psychological distress (AGR=26.9%) and less experienced HCWs were more affected by feelings of shame than senior ones (M = 4, IQR=1.5 vs M = 3, IQR=2; p &lt; 0.01). Physical distress (AGR=10.9%) and professional self-efficacy (AGR=11.8%) did not had a great impact on HCWs, but younger (M = 3, IQR=2 vs M = 2, IQR=2; p &lt; 0.01) and female (M = 3, IQR=2 vs M = 2, IQR=2; p &lt; 0.01) HCWs were more inclined to question their skills. Support services offered by Hospital organization may be improved (AGR 8,9%).

Conclusions
Psychological impact of the AEs is relevant in our cohort and less experienced and female HCWs resulted more inclined to doubt their professional abilities when involved. Improvements in support resources should be desirable to create a safer working environment.

Key messages
HCWs’ psychological dimension and perceived professional self-esteem can be negatively affected by adverse events, especially for less experienced and female professionals. Healthcare organizations need to develop and to implement a second victim support program designed to provide emotional, psychological and professional support for HCWs.