bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exploring Burden of Disease Metrics in EU legislation: A Systematic Analysis
Authors: Chen-Xu J , Grad D A , Mahrouseh N , Cuschieri S , Gazzelloni F , Mechili E A , Riva S , Santos J V , Varga O , Viegas S 
Published: October 2024

Abstract

Background
The burden of disease (BoD) methodology is a valuable tool for evidence-based policymaking. However, there is currently no systematic analysis available regarding its use in the European Union (EU) legislation framework. This study aims to describe the implementation of BoD methodology in EU legislation.

Methods
A search was conducted on EUR-Lex, the official and most comprehensive platform to access EU legal documents. The main inclusion criteria in the analyses were date of publication (between 2004 and 2023, accounting for EU-25) and inclusion of BoD metrics (years of life lost - YLL, years lived with disability - YLD or disability-adjusted life years - DALY). Descriptive and network analysis were conducted to analyse the legislation content.

Results
Out of 2592 documents, 191 met the set criteria. Ten were legally binding, and 69% were published after 2018. The European Commission (n = 152) was the most regular issuing institution. BoD was mainly used as an argument (n = 93) and for impact assessment (n = 50). The metrics were commonly presented in the main text (n = 122) and in the annex (n = 48). EuroVoc domains like environment and social questions prevailed. The most frequent EuroVoc terms were climate change policy (n = 45), EU environmental policy (n = 32) and pollution control measures (n = 32).

Discussion
Despite the growing recognition of BoD metrics in supporting policymaking, only 191 documents published over the past 20 years within the EU legislation make reference to this methodology. Greater efforts in knowledge dissemination and directing research towards specific policy uptake may increase the application of BoD studies in EU policies. By advocating for increased awareness, promoting collaboration between researchers and policymakers, and targeting research efforts towards specific policy needs, a more comprehensive integration of BoD methodologies into EU legislation can be achieved, contributing for evidence-informed policies.

Key messages
• There were only 191 documents of the EU legislative documents published in the past 20 years mention burden of disease metrics, mainly addressing environmental and social issues.
• There is a need to increase EU policy uptake from BoD studies, by conducting policy-oriented research, and building capacity among researchers and policymakers on BoD methodology.
Outcomes of integrated knowledge translation: A comparative, multi-country case study
Authors: Sell K , Rehfuess E A , Osuret J , Pfadenhauer L M 
Published: October 2024

Abstract

Background
Integrated knowledge translation (IKT) seeks to establish continuous relationships between researchers and knowledge users, in particular decision-makers, to enhance evidence-informed decision-making in public health and healthcare. IKT is, however, difficult to evaluate and outcome evaluations remain scarce. The German-African Collaboration for Evidence-based Healthcare and Public Health in Africa (CEBHA+) undertook research on IKT and non-communicable diseases in Ethiopia, Malawi, Rwanda, South Africa, and Uganda. Over six years, we implemented an IKT approach and evaluated it according to a pre-defined programme theory.

Methods
We conducted qualitative interviews and surveys with CEBHA+ researchers and their decision-making partners at two stages (3/2020-2/2021; 9/2022-5/2023) and collected IKT-related documents (see protocol: https://rdcu.be/dyfBP). Transcripts and documents were analysed using qualitative content analysis and surveys were analysed descriptively, with subsequent integration, cross-case analysis, and revision of the programme theory.

Results
We collected 92 IKT-related documents; and 55 researchers and decision-makers participated in surveys, focus groups or interviews. Proximal outcomes were collaborative research; capacity-building related to research skills and evidence use; and relationship-building, establishing trust and partnerships. Intermediate outcomes were changes in attitudes and knowledge; decision-makers became attuned to research and researchers increased their understanding of the decision-making context, and developed a vision for research impact. Distal outcomes were the production of applicable research and the consideration of evidence by decision-makers. High opportunity costs associated with IKT implementation constituted unintended effects.

Conclusions
Our study presents rich, theory-informed insights into IKT outcomes, based in particular on the experience of researchers implementing the CEBHA+ IKT approach.

Key messages
• A multi-country research collaboration offered an opportunity to examine IKT implementation and investigate proximal, intermediate, and distal IKT outcomes based on a pre-defined programme theory.
• Beyond our initial conceptualisation, the IKT approach was linked to researchers developing a vision for ‘research impact’ and gaining a better understanding of the decision-making context.
Revisiting the Science-Policy Interface: Lessons from the Swiss Response to the COVID-19 Pandemic
Authors: Meyer S , Frahsa A 
Published: October 2024

Abstract

Background
In the wake of the COVID-19 pandemic, Switzerland found itself grappling with unforeseen challenges, particularly in the realm of the science-policy interface. Despite various post-crisis reflections on ‘lessons learned’, a cohesive and comprehensive assessment of these pivotal interactions has been notably absent. We aim to contribute to closing this gap by mapping interactions at the science-policy interface and critically analyze the interaction between researchers and policymakers during the COVID-19 pandemic in Switzerland.

Methods
Using Critical Discourse Analysis, we examine the sociopolitical influences on the discourse surrounding science-policy interaction. Our dataset includes tweets from Swiss National COVID-19 Science Task Force members, Federal Office of Public Health members, and government representatives, as well as print media articles and official press releases from public health departments. Drawing on Foucault’s notion of power-knowledge dynamics, we explore how researchers and decision-makers interact in the public sphere.

Results
Key aspects identified: (1) power struggles surrounding accountability and role clarity among stakeholders, (2) the dual role of print and social media as both vehicle for dissemination and communicator shaping public perception, and (3) the pervasive ambiguity in science-policy collaboration throughout the Swiss COVID-19 response.

Conclusions
Our study emphasizes the importance of reflective learning, drawing on insights from the COVID-19 pandemic. It reveals the complexities in navigating public health crises, emphasizing the challenges of transparency, accuracy, and delineation of responsibilities. These dynamics stress the need for continuous evaluation and refinement of strategies to foster collaboration between researchers and policymakers for effective pandemic preparedness and response.

Key messages
• Understanding and Addressing Power Dynamics in Science-Policy Interactions.
• Necessity for continuous evaluation to enhance collaboration between researchers and policymakers for future preparedness and response efforts.
Enhancing Labor Market Participation of Older Adults: Health and Workplace Adaptations
Authors: Reine I , Rajevska O 
Published: October 2024

Abstract

Background
The labor market dynamics for older adults have significantly shifted due to extended life expectancy and evolving socioeconomic conditions. This study examines the prerequisites for older adults to remain longer in the labor market across various European countries, emphasizing the interplay between health status, workplace adaptations, and economic factors.

Methods
This cross-sectional study analyzed data from several European surveys focusing on older workers. The methodology included logistic regression to evaluate the impact of health status and workplace adaptations on continued employment among older adults. Data were further stratified by country to assess regional differences in employment patterns for this demographic.

Results
Preliminary results indicate that older adults with access to workplace adaptations-such as flexible working hours and ergonomic interventions-show a significantly higher likelihood of remaining in the labor market (OR = 2.3, 95% CI 1.8-2.9). Additionally, those reporting good to excellent health were 1.5 times more likely to continue working compared to their peers with poor health outcomes. The results also highlight substantial regional variability, with Scandinavian countries showing higher employment rates among older adults compared to Southern European regions.

Conclusions
The data strongly support the need for policy interventions that promote health maintenance among older workers and encourage employers to implement adaptive measures. Such strategies are likely to enhance the labor market participation of older adults, contributing to economic stability and reducing the potential strain on social security systems. Innovative public health policies aimed at supporting aging workers are crucial for sustaining workforce productivity in the face of demographic shifts. NordForsk supports the study Sustainable working-life for aging populations in the Nordic-Baltic region, Project No.: 139986.

Key messages
• Workplace adaptations and good health significantly extend working life among older adults.
• Regional differences in employment for older workers highlight the need for tailored public health policies.
The Health-Employment-Longevity Nexus: Implications for Retirement Age Policies in European Countries
Authors: Tur-Sinai A , Gottlieb D 
Published: October 2024

Abstract

Background
Advances in medical knowledge and technology have led to increased general and healthy life expectancy in Europe. Combined with declining fertility rates, these trends have resulted in an aging population. Many European countries have been reluctant to adjust the retirement age, putting pension funds and Pay-As-You-Go social insurance systems at risk. Linking entitlement age to life expectancy could mitigate this risk and extend working life, but such policies are politically unpopular. This study investigates the empirical relationship among self-perceived health, employment, job quality, and life expectancy in the European context.

Methods
The study analyzes the determinants of self-rated health using the SHARE database, combined with general and healthy life-expectancy data from EUROSTAT and, where missing, the WHO, focusing on European countries.

Results
In Europe, both past and present employment improve self-rated health. Job quality has a detrimental effect on self-rated health for women and a positive effect on men. Life expectancy and healthy life expectancy raise self-rated health, while poverty rates negatively affect it. Job quality is widespread among European women, and its negative effect on health rises with age. For European men, job quality has a positive effect, peaking around age 56. The effects of employment and job quality on self-rated health are simultaneous. In European countries with an elasticity &gt;1, healthy life expectancy rises faster than general life expectancy at higher ages, suggesting an improved ability to work at older ages. This finding indicates that adjusting the retirement age could be a powerful tool for improving the sustainability of social insurance systems in Europe.

Conclusions
For younger European women, it may be rational to set higher retirement-age increments and put them on a declining course as they age, considering the gender-specific age dynamics and job quality effects on health.

Key messages
• In Europe, employment and job quality significantly influence self-rated health, with gender-specific effects that vary with age and impact retirement age policies.
• Adjusting retirement age in line with healthy life expectancy could improve the sustainability of European social insurance systems, considering health-employment dynamics.
Cross-national characteristics and differences in type 2 diabetes: Malta versus Luxembourg
Authors: Cuschieri S , Cuschieri A , Grech E , Samouda H , Ruiz-Castell M 
Published: October 2024

Abstract

Introduction
Type 2 diabetes mellitus (T2DM) is a significant global health concern, requiring a thorough understanding of its population-level features and impact. This study aims to compare the characteristics of T2DM in Malta and Luxembourg, two European nations with distinctive healthcare systems and societal attributes.

Methods
Data from national health surveys conducted in Malta and Luxembourg, encompassing various factors such as socio-demographics, medical history, biochemical metrics, and anthropometric measurements, were analysed to investigate the features of T2DM. Comparative analyses were conducted utilizing chi-square tests, independent t-tests, and multivariable binary regression.

Results
Malta (8.23%) and Luxembourg (7.82%) shared similar T2DM prevalence, with a predominance of men having T2DM. Malta exhibited a higher prevalence of obesity among the individuals having T2DM. Multivariable analysis showed no significant association between living in Malta or Luxembourg and diabetes. However, being male (OR: 1.49, CI 95%: 1.07–2.08, p = 0.02), an occasional smoker (OR: 2.49, CI 95%: 1.54–4.03, p &lt; 0.01), increasing age (OR: 1.05, CI 95%: 1.03–1.67), and larger waist circumference (OR: 1.02, CI 95%: 1.01–1.04, p = 0.01) were positively associated with diabetes.

Conclusions
Understanding similarities and differences in T2DM between Malta and Luxembourg is crucial for identifying common challenges to formulate effective prevention and management strategies. Despite similar T2DM prevalence rates, notable differences in obesity rates and socioeconomic factors may contribute to disparities in disease burden. The complex interplay of numerous population characteristics underscores the importance of tailored public health interventions. This study accentuates the need for interventions and evidence-based policies to address modifiable risk factors, and advocate for cross-national cooperation to reduce the T2DM epidemic, especially in the context of post-COVID public health planning and resource allocation.

Key messages
• Malta and Luxembourg share similar T2DM prevalence despite differences in other factors, hypothesised to be attributed to differences in risk factor profiles and health care infrastructure.
• This study underscores the necessity for tailored interventions and cross-national cooperation to address common challenges in T2DM management in the two small countries.
Impact of time and COVID-19 pandemic on GP mental health consultations in deprived neighborhoods
Authors: Sana S , Magnée T , van Pelt S , Kocken P L , Bindels P J , Denktas S , de Schepper EIT 
Published: October 2024

Abstract

Background
The stringent lockdown measures and limited physical access to GP care at the start of COVID-19 pandemic resulted into a decrease of mental health consultations. It raised concerns about the access of patients with mental health problems. The aim of this study is to investigate the mental health GP consultations amongst patients from deprived neighborhoods before and during COVID-19 pandemic, especially after the stringent lockdown in the Netherlands.

Methods
In an observational study (2018-2022), medical data of 360,645 patients were analyzed for the proportions of mental health consultations (segmented per month) by comparing the lockdown phase (March 2020-May 2020) and post-lockdown phase (June 2020-June 2022) with the pre-pandemic period the patients living in deprived and non-deprived neighborhoods.

Results
Analyzing a total of 759,863 mental health consultations showed that during the lockdown phase of COVID-19, less mental health problem consultations were observed than pre-pandemic. This decrease was not significant for patients from deprived neighborhoods, but the decrease was significant for patients from non-deprived neighborhoods, RR = 0.990; 95%CI=0.934-1.051 and RR = 0.918; 95%CI=0.885-0.953 respectively. Conversely, the number of post-lockdown phase consultations for patients in deprived neighborhoods was significantly increased compared to pre-pandemic levels (RR = 1.074;95%CI=1.002-1.152), but not for patients in non-deprived neighborhoods (RR = 1.000; 95%CI=0.959-1.043). This increase in post-lockdown phase consultations in deprived neighborhoods can be explained by the higher frequency of consultations per patient.

Conclusions
Consistently over time, demand for GP mental health care was and remains higher among patients from deprived neighborhoods, with an increase in post-lockdown consultations. Sufficient access to primary health care should be guaranteed to ensure treatment of mental health problems for social-economic disadvantaged groups.

Key messages
• Socioeconomic status has a negative sustainable impact on demand for mental health consultations in deprived neighbourhoods.
• To ensure the treatment of mental health problems for social-economic disadvantaged groups, sufficient access to the primary health care should be guaranteed at all times.
Strengthening Equity, Diversity, and Inclusion in medical education via an intersectional approach
Authors: Hunting G , Hankivsky O 
Published: October 2024

Abstract

Background
In the wake of COVID-19, equity, diversity, and inclusion (EDI) policies have been taken up in the health field, yet the actual impact of these initiatives, particularly for multiply marginalized individuals, is debated. Despite progress in areas such as diversity promotion, EDI has been critiqued as superficial and as failing to challenge the drivers of health inequity. This presentation discusses how an intersectionality-informed approach can help harness the transformative potential of EDI.

Methods
This research is informed by a literature review of EDI initiatives in the health field, and is an offshoot of a 4.5 year international project funded by the Canadian Institutes for Health Research focused on evaluating and strengthening intersectionality-informed policy guidance.

Results
There is a disconnect between EDI commitments and substantive action on health inequities and an intersectional approach can help bridge this divide. We demonstrate this with a case example which brings an intersectional approach to EDI initiatives in medical education - including bias trainings, courses on the social determinants of health, and the engagement of community groups. Drawing on promising equity promoting work across these areas, we show how intersectionality can harness the potential of EDI by bringing to the fore what has often been missing, including the promotion of health stakeholder reflexivity, attention to interacting systems and structures shaping health, and meaningful engagement with underrepresented communities.

Conclusions
An intersectionality-informed approach to EDI has the potential to enhance the health equity impacts of initiatives within medical education and the broader health field.

Key messages
• EDI initiatives in health often have limited impact on health inequities.
• An intersectionality-informed approach to EDI can help health stakeholders drive transformative action on health inequities.
Determining the trauma levels of individuals living in temporary housing after an earthquake
Authors: Baran A , Sülü M , Kekilli C , Boz G , Özer A 
Published: October 2024

Abstract

Background
Earthquakes cause many deaths and injuries in the region in which they occur. In addition, earthquakes can lead to significant mental health among survivors living in affected areas. The aim of this study is to determine the trauma levels of people living in temporary housing after an earthquake.

Methods
This descriptive cross-sectional study was conducted between September and December 2023. The target population consisted of people living in temporary housing, with a sample size of 260 people. Data were collected from a questionnairerelated to sociodemographic and earthquake experience status as well as the Post-Earthquake Trauma Level Determining Scale (PETS). The dependent variable in this study was the total PETS score, and the independent variables included age, being trapped under debris, and experiencing the loss of a loved one. The Student’s t-test and a one-way ANOVA were used in the statistical analyses.

Results
In the research group, 35.4% of the participants reported a job loss and 34.2% reported the loss of relatives. The mean total PETS score was 56.13±16.87. The total scores of individuals who were trapped under debris, lost first-degree relatives, and lost their jobs were significantly higher than others (p &lt; 0.05). In addition, individuals whose houses were destroyed due to the earthquake had significantly higher total PETS scores (p &lt; 0.05). Of the individuals who participated in the study, 88.8% stated that they did not receive psychosocial support after the earthquake.

Conclusions
In the study group, trauma levels were higher among individuals who experienced the loss of a home, job, family members, and relatives due to the earthquake. Alarmingly, more than three-quarters of the participants did not receive psychosocial support after the earthquake.

Key messages
• All individuals housed in temporary settlements after an earthquake should be evaluated in terms of trauma, and psychosocial support should be provided according to risk groups.
• The trauma experienced by individuals who lost their homes and jobs after the earthquake should be reduced by making plans such as providing shelter and job opportunities as soon as possible.