Conducting national burden of disease studies and knowledge translation in eight small European states: challenges and opportunities

Background: Several countries across Europe are engaging in burden of disease (BoD) studies. This article aims to understand the experiences of eight small European states in relation to their research opportunities and challenges in conducting national BoD studies and in knowledge translation of research outputs to policy-making. Methods: Countries participating in the study were those outlined by the WHO/Europe Small Countries Initiative and members of the Cooperation in Science and Technology (COST) Action CA18218 European Burden of Disease Network. A set of key questions targeting the research landscape were distributed to these members. WHO’s framework approach for research development capacities was applied to gain a comprehensive understanding of shortages in relation to national BoD studies in order to help strengthen health research capacities in the small states of Europe. Results: Most small states lack the resources and expertise to conduct BoD studies, but nationally representative data are relatively accessible. Public health officials and researchers tend to have a close-knit relationship with the governing body and policy-makers. The major challenge faced by small states is in knowledge generation and transfer rather than knowledge translation. Nevertheless, some policy-makers fail to make adequate use of knowledge translation. Conclusions: Small states, if equipped with adequate resources, may have the capacity to conduct national BoD studies. This work can serve as a model for identifying current gaps and opportunities in each of the eight small European countries, as well as a guide for translating country BoD study results into health policy

Burden of infectious disease studies in Europe and the United Kingdom: a review of methodological design choices

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 2000 and 2014. Almost all studies (97%) estimated DALYs based on the incidence- and pathogen-based approach and without social weighting functions; however, there was less methodological consensus with regards to the disability weights and life tables that were applied. The number of burden of infectious disease studies undertaken across Europe has increased over time. Development and use of guidelines will promote performing burden of infectious disease studies and facilitate comparability of the results

Subnational inequalities in years of life lost and associations with socioeconomic factors in pre-pandemic Europe, 2009–19: an ecological study

Background: Health inequalities have been associated with shorter lifespans. We aimed to investigate subnational geographical inequalities in all-cause years of life lost (YLLs) and the association between YLLs and socioeconomic factors, such as household income, risk of poverty, and educational attainment, in countries within the European Economic Area (EEA) before the COVID-19 pandemic. Methods: In this ecological study, we extracted demographic and socioeconomic data from Eurostat for 1390 small regions and 285 basic regions for 32 countries in the EEA, which was complemented by a time-trend analysis of subnational regions within the EEA. Age-standardised YLL rates per 100 000 population were estimated from 2009 to 2019 based on methods from the Global Burden of Disease study. Geographical inequalities were assessed using the Gini coefficient and slope index of inequality. Socioeconomic inequalities were assessed by investigating the association between socioeconomic factors (educational attainment, household income, and risk of poverty) and YLLs in 2019 using negative binomial mixed models. Findings: Between Jan 1, 2009, and Dec 31, 2019, YLLs lowered in almost all subnational regions. The Gini coefficient of YLLs across all EEA regions was 14·2% (95% CI 13·6–14·8) for females and 17·0% (16·3 to 17·7) for males. Relative geographical inequalities in YLLs among women were highest in the UK (Gini coefficient 11·2% [95% CI 10·1–12·3]) and among men were highest in Belgium (10·8% [9·3–12·2]). The highest YLLs were observed in subnational regions with the lowest levels of educational attainment (incident rate ratio [IRR] 1·19 [1·13–1·26] for females; 1·22 [1·16–1·28] for males), household income (1·35 [95% CI 1·19–1·53]), and the highest poverty risk (1·25 [1·18–1·34]). Interpretation: Differences in YLLs remain within, and between, EEA countries and are associated with socioeconomic factors. This evidence can assist stakeholders in addressing health inequities to improve overall disease burden within the EEA. Funding: Research Council of Norway; Development, and Innovation Fund of Hungary; Norwegian Institute of Public Medicine; and COST Action 18218 European Burden of Disease Network

a review of methodological design choices

Publisher Copyright: © 2023 Cambridge University Press. All rights reserved.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 3,053 studies of which 2,948 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 2000 and 2014. Almost all studies (97%) estimated DALYs based on the incidence- and pathogen-based approach and without social weighting functions; however, there was less methodological consensus with regards to the disability weights and life tables that were applied. The number of burden of infectious disease studies undertaken across Europe has increased over time. Development and use of guidelines will promote performing burden of infectious disease studies and facilitate comparability of the results.publishersversionepub_ahead_of_prin

Burden of disease attributable to risk factors in European countries: a scoping literature review

Objectives: Within the framework of the burden of disease (BoD) approach, disease, and injury burden estimates attributable to risk factors are a useful guide for policy formulation and priority setting in disease prevention. Considering the important differences in methods, and their impact on burden estimates, we conducted a scoping literature review to: (1) map the BoD assessments including risk factors performed across Europe, and (2) identify the methodological choices in comparative risk assessment (CRA) and risk assessment methods. Methods: We searched multiple literature databases, including grey literature websites, and targeted public health agencies' websites. Results: A total of 113 studies were included in the synthesis and further divided into independent BoD assessments (54 studies) and studies linked to the Global Burden of Disease (59 papers). Our results showed that the methods used to perform CRA varied substantially across independent European BoD studies. While there were some methodological choices that were more common than others, we did not observe patterns in terms of country, year, or risk factor. Each methodological choice can affect the comparability of estimates between and within countries and/or risk factors since they might significantly influence the quantification of the attributable burden. From our analysis, we observed that the use of CRA was less common for some types of risk factors and outcomes. These included environmental and occupational risk factors, which are more likely to use bottom-up approaches for health outcomes where disease envelopes may not be available. Conclusions: Our review also highlighted misreporting, the lack of uncertainty analysis, and the under-investigation of causal relationships in BoD studies. Development and use of guidelines for performing and reporting BoD studies will help understand differences, and avoid misinterpretations thus improving comparability among estimates.info:eu-repo/semantics/publishedVersio

Burden of infectious disease studies in Europe and the United Kingdom: a review of methodological design choices.

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 2000 and 2014. Almost all studies (97%) estimated DALYs based on the incidence- and pathogen-based approach and without social weighting functions; however, there was less methodological consensus with regards to the disability weights and life tables that were applied. The number of burden of infectious disease studies undertaken across Europe has increased over time. Development and use of guidelines will promote performing burden of infectious disease studies and facilitate comparability of the results

Επιπολασμός του μητρικού θηλασμού μέχρι τον έκτο μήνα της ζωής του παιδιού και συσχέτιση με την αντιλαμβανόμενη αυτοπεποίθηση για μητρικό θηλασμό και την αυτοαναφερόμενη εφαρμογή των ’10 βημάτων για επιτυχή θηλασμό’ στα μαιευτήρια της Κύπρου

Breastmilk is the ideal source of infant nourishment. However, exclusive breastfeeding (EBF) for the first six months, as recommended by the WHO, remains relatively low even after three decades of international and national initiatives for the promotion of breastfeeding. While the effectiveness of the Baby-Friendly Hospital (BFH) Initiative’s “Ten Steps for Successful Breastfeeding” has been documented, there is often suboptimal implementation. No hospital in Cyprus has BFH certification and there is only anecdotal evidence with regards to the implementation of the 10 steps and the International Code for the Marketing of Breastmilk Substitutes (ICMBS). Furthermore, the only data for breastfeeding is restricted to the first 48 hours. Low maternal breastfeeding self-efficacy (BFSE), which is influenced by maternity care practices, contributes to the premature discontinuation of breastfeeding.Christiana Kouta, Ekaterini LambrinouComplete

THE ODYSSEY AND ITS ODYSSEY IN CONTEMPORARY TEXTS: RE-VISIONS IN STAR TREK, THE TIME TRAVELER’S WIFE, AND THE PENELOPIAD

Homer’s The Odyssey is the archetypal quest story. The dialogue began with Homer, and contemporary texts and popular culture media have continued the tradition of deconstructing and recreating stories, addressing issues related to the human psyche. As Hardwick and Stray note, the relationship between ancient and modern is “not merely inherited but constantly made and remade,” one that we see in the following varied genres and versions that retell the Odyssean myth, relating re-visions of characters, relationships, structures, and themes. The original Star Trek episode “Who Mourns for Adonais” is an allegory of the Odyssean quest for human knowledge, while Audrey Niffenegger’s The Time Traveler’s Wife presents a modern magical story of love, and Margaret Atwood’s The Penelopiad is a story of “slippery truth,” debunking the heroic and romantic. Beyond instilling aesthetic appreciation in our students, Odyssean stories indeed offer a plethora of rich pedagogical material. A comparative approach to the texts offers our students the ability to further their own analytical and critical insights. As the stories deal with issues of identity, self-knowledge, sense of place in the cosmos, and human relationships and communities, they provide perception of psychological and philosophical insights into both our human-ness and our present preoccupations in our world. Rather than view the Odyssean epic as “exclusive,” a constructive pedagogical approach is to explore the blurred spaces and/or gaps between the past and the present. Thus while texts are set in different and distinct times and spaces with varied purpose, story, and genre, what makes classroom discussions vital and vibrant are the similar issues raised, which explore our constant yearning to discover our human-ness, and following that, examination of the meaning of love, war, fate, meaning of life, and death, quintessential matters that are transcultural, universal, and timeless

Supporting and Promoting Breastfeeding: The 10 Steps to Successful Breastfeeding

Since the launch of the BFHI (Baby-Friendly Hospital Initiative), the “Ten Steps to Successful Breastfeeding” have been the cornerstone of national and international strategies that protect and promote breastfeeding. The aim of the BFHI has been the optimization of maternity care services by focusing on the adherence of maternity care facilities to good practices to support and protect breastfeeding. Numerous studies have evaluated the impact of the “10 Steps,” employing both observational or intervention study designs, and established higher breastfeeding initiation and longer breastfeeding duration. Nevertheless, suboptimal implementation of the “10 Steps” has been reported in many countries worldwide

Burnout, coping and resilience of the cancer care workforce during the SARS-CoV-2: A multinational cross-sectional study

Over the past year, the SARS-CoV-2 pandemic has significantly increased the demand placed on health care professionals around the world. The already complex cancer care has been complicated further by the restructuring of services (e.g., working processes, treatment allocation). This study was designed to explore the level of burnout, coping and resilience of the cancer care workforce during SARS-CoV-2