Non-pharmaceutical Interventions and the Infodemic on Twitter: Lessons Learned from Italy during the Covid-19 Pandemic

The growing burden of workplace violence against healthcare workers: trends in prevalence, risk factors, consequences, and prevention - a narrative review

Workplace violence (WPV) against healthcare workers (HCW) is a globally growing problem in healthcare systems. Despite decades of research and interventions violent incidents are rising in their severity and frequency. A structured review of PubMed and Scopus databases and supplementary internet searches, resulted in a synthesis of evidence covering multiple countries and healthcare worker populations. High rates of WPV are increasingly common due to unmet patient expectations, poor communication, long wait times and organizational factors such as resourcing and infrastructure. We highlight links between WPV and poor worker health outcomes, staff turnover, reduced patient safety and medical errors. Few prevention and mitigation activities have shown sustained effects, highlighting the challenges in understanding and addressing the complex interplay of factors that drive violence against HCWs. The rapidly rising incidence of WPV requires special consideration and action from multiple stakeholders including patients and visitors, healthcare providers, law enforcement, media and policy makers.

Strategies for Strengthening the Resilience of Public Health Systems for Pandemics, Disasters, and Other Emergencies

OBJECTIVE

The aim of this study was to identify and prioritize strategies for strengthening public health system resilience for pandemics, disasters, and other emergencies using a scorecard approach.

METHODS

The United Nations Public Health System Resilience Scorecard (Scorecard) was applied across 5 workshops in Slovenia, Turkey, and the United States of America. The workshops focused on participants reviewing and discussing 23 questions/indicators. A Likert type scale was used for scoring with zero being the lowest and 5 the highest. The workshop scores were analyzed and discussed by participants to prioritize areas of need and develop resilience strategies. Data from all workshops were aggregated, analyzed, and interpreted to develop priorities representative of participating locations.

RESULTS

Eight themes emerged representing the need for better integration of public health and disaster management systems. These include: assessing community disease burden; embedding long-term recovery groups in emergency systems; exploring mental health care needs; examining ecosystem risks; evaluating reserve funds; identifying what crisis communication strategies worked well; providing non-medical services; and reviewing resilience of existing facilities, alternate care sites, and institutions.

CONCLUSIONS

The Scorecard is an effective tool for establishing baseline resilience and prioritizing actions. The strategies identified reflect areas in most need for investment to improve public health system resilience.

Health misinformation and freedom of expression: considerations for policymakers

Health misinformation, most visibly following the COVID-19 infodemic, is an urgent threat that hinders the success of public health policies. It likely contributed, and will continue to contribute, to avoidable deaths. Policymakers around the world are being pushed to tackle this problem. Legislative acts have been rolled out or announced in many countries and at the European Union level. The goal of this paper is not to review particular legislative initiatives, or to assess the impact and efficacy of measures implemented by digital intermediaries, but to reflect on the high constitutional and ethical stakes involved in tackling health misinformation through speech regulation. Our findings suggest that solutions focused on regulating speech are likely to encounter significant constraints, as policymakers grasp with the limitations imposed by freedom of expression and ethical considerations. Solutions focused on empowering individuals - such as media literacy initiatives, fact-checking or credibility labels - are one way to avoid such hurdles.

Association of sociodemographic characteristics with self-perceived access to COVID-19 information and adherence to preventive measures among migrant origin and general populations in Finland: a cross-sectional study

OBJECTIVES

This study examines how access to COVID-19 information and adherence to preventive measures varies by sociodemographic characteristics, and whether the associations differ among the migrant origin and the general Finnish population. Additionally, the association of perceived access to information with adherence to preventive measures is examined.

DESIGN

Cross-sectional, population-based random sample.

BACKGROUND

Equity in access to information is crucial for securing individual well-being and successful management of a crisis at population level.

SETTING

Persons who have a residence permit in Finland.

PARTICIPANTS

Migrant origin population constituted of persons aged 21-66 years born abroad, who took part in the Impact of the Coronavirus on the Wellbeing of the Foreign Born Population (MigCOVID) Survey conducted from October 2020 to February 2021 (n=3611). Participants in the FinHealth 2017 Follow-up Survey conducted within the same time frame, representing the general Finnish population, constituted the reference group (n=3490).

OUTCOME MEASURES

Self-perceived access to COVID-19 information, adherence to preventive measures.

RESULTS

Self-perceived access to information and adherence to preventive measures was overall high both among the migrant origin and the general population. Perceived adequate access to information was associated with living in Finland for 12 years or longer (OR 1.94, 95% CI 1.05-3.57) and excellent Finnish/Swedish language skills (OR 2.71, 95% CI 1.62-4.53) among the migrant origin population and with higher education (OR 3.56, 95% CI 1.49-8.55 for tertiary and OR 2.87, 95% CI 1.25-6.59 for secondary) among the general population. The association between examined sociodemographic characteristics with adherence to preventive measures varied by study group.

CONCLUSIONS

Findings on the association of perceived access to information with language proficiency in official languages highlight the need for rapid multilingual and simple language crisis communications. Findings also suggest that crisis communications and measures designed to influence health behaviours at population level may not be directly transferable if the aim is to influence health behaviours also among ethnically and culturally diverse populations.

Economic and Performance Evaluation of E-Health before and after the Pandemic Era: A Literature Review and Future Perspectives

E-Health represents one of the pillars of the modern healthcare system and a strategy involving the use of digital and telemedicine tools to provide assistance to an increasing number of patients, reducing, at the same time, healthcare costs. Measuring and understanding the economic value and performance of e-Health tools is, therefore, essential to understanding the outcome and best uses of such technologies. The aim of this paper is to determine the most frequently used methods for measuring the economic value and the performance of services in the framework of e-Health, considering different pathologies. An in-depth analysis of 20 recent articles, rigorously selected from more than 5000 contributions, underlines a great interest from the clinical community in economic and performance-related topics. Several diseases are the object of detailed clinical trials and protocols, leading to various economic outcomes, especially in the COVID-19 post-pandemic era. Many e-Health tools are mentioned in the studies, especially those that appear more frequently in people's lives outside of the clinical setting, such as apps and web portals, which allow for clinicians to keep in contact with their patients. While such e-Health tools and programs are increasingly studied from practical perspectives, such as in the case of Virtual Hospital frameworks, there is a lack of consensus regarding the recommended models to map and report their economic outcomes and performance. More investigations and guidelines by scientific societies are advised to understand the potential and path of such an evolving and promising phenomenon.

An International Systematic Review Concerning the Effect of Social Media Exposure on Public Compliance with Infection Prevention and Control Measures During the COVID-19 Pandemic

Background

Effective health communication is crucial for achieving positive population health outcomes. This is important for infection prevention and control (IPC), which relies on widespread public compliance to be effective. Whilst social media (SM) platforms disseminate health information, there is conflicting evidence to suggest their influence on compliance with public health guidelines.

Objective

To appraise the available evidence and determine the extent to which social media exposure contributes to public compliance with IPC measures.

Methods

A systematic protocol based on the MOOSE and PRISMA guidelines was followed. Observational studies were identified through systematic searches of four electronic databases and a hand search. Following data extraction, eligible studies were quality assessed, and the findings were integrated using narrative synthesis.

Findings

15 studies were included. The studies located presented heterogeneous designs and findings. A weak positive association was identified, with 60% of the studies observing a positive association between social media and compliance with IPC measures. 26.7% identified a negative correlation, and 13.3% identified no correlation. Several factors were identified to mediate the relationship, including knowledge and conspiracy beliefs.

Discussion

This systematic review identified a weak positive correlation between exposure to social media and public compliance with recommended IPC measures, suggesting that social media should be utilised in future IPC related communication strategies. Social media provides a cost-effective, publicly accessible platform to disseminate accurate information, and neutralise misinformation. Recommendations are made for further research to reduce the uncertainty created by the identification of heterogenous studies.

Economic expectations and anxiety during the COVID-19 pandemic: a one-year longitudinal evaluation on Italian university students

The COVID-19 pandemic has produced an extensive aggravation of people's anxiety level. Different policies aimed at fighting the spread of the virus could affect anxiety in various ways. We built an ad hoc web-based survey, administered to the student population of three Italian universities at the beginning of the pandemic and at one year's distance, to collect information on retrospective and current anxiety levels and the underlining reasons. The survey also included questions concerning sociodemographic, economic, labor, lifestyle, academic career, and on-line teaching features, which prevents students from identifying the main survey topic to be anxiety. This research aims at assessing the change in anxiety levels between the analyzed periods and the main determinants of such change, focusing on students' economic expectancies. Results from a Poisson regression model show that anxiety has increased compared to both the pre-pandemic level and the one quantified during the first lockdown. This increase is revealed to be mostly driven by economic and career-related uncertainties, rather than by job loss and proximity to COVID-19. Thus, policymakers should take action to provide certainties both in terms of economic prospects and reopening strategies, especially to avoid that the resulting increase in anxiety translates into an amplified suicide risk.

Study on the communication effect of the social livestream of cabin hospitals' construction process during the COVID-19 outbreak

When the world is recovering from the chaos that COVID-19 creates, the epidemic is still posing challenges to the public health system and communication. However, a case of information communication during the COVID-19 outbreak can provide a reference for the current information promulgate strategy in China. In January 2020, CCTV broadcasted the construction of two cabin hospitals on a 24-h Livestream (24H-LS), creating a remarkable viewing effect. We conducted a quantitative analysis based on the number of views, social media communication, and internet search index. We collected posts and comment data of the 24H-LS audience and related topics on Weibo, using sentiment classification and word frequency analysis to study the communication effect of 24H-LS from three perspectives: perception effect, psychology, and subject issue. The results show that, first, 24H-LS has attracted extensive public attention on the Internet and social media after its launch. Second, the public's perception of the risks of the COVID-19 outbreak and its uncertainty has decreased after watching the 24H-LS. At the same time, the positive emotions of the public have been enhanced to a certain extent. Third, through subject analysis, we found that the public had high participation and strong interaction in 24H-LS, which produced collective symbols and emotions. The study shows that through 24H-LS, a new information form, the media can effectively convey important information and resolve the public's fear and anxiety.

Emerging lessons from the COVID-19 pandemic about the decisive competencies needed for the public health workforce: A qualitative study

The global COVID-19 crisis exposed the critical need for a highly qualified public health workforce. This qualitative research aimed to examine public health workforce competencies needed to face COVID-19 challenges and identify the gaps between training programs and the competency demands of real-world disasters and pandemics. Through a sample of thirty-one participant qualitative interviews, we examined the perspectives of diverse stakeholders from lead public health organizations in Israel. Grounded Theory was used to analyze the data. Six themes emerged from the content analysis: public health workforce's low professional status and the uncertain future of the public health workforce; links between the community and Higher Education institutions; the centrality of communication competencies; need to improve health promotion; the role of leadership, management, and partnership, and innovation in public health coherence. Increasing the attractiveness of the profession, professional and financial support, and improving the working conditions to ensure a sustainable and resilient PH system were deemed necessary. This paper describes and cultivates new knowledge and leadership skills among public health professionals, and lays the groundwork for future public health leadership preparedness programs.

Digital Marketing: A Unique Multidisciplinary Approach towards the Elimination of Viral Hepatitis

New technologies are supported by the global implementation of the internet. These improvements have deeply affected various disciplines of sciences and consequently changed services such as daily business, particularly health sectors. Innovative digital marketing strategies utilize the channels of social media and retrieved user data to analyze and improve relevant services. These multidisciplinary innovations can assist specialists, physicians and researchers in diagnostic, prophylaxis and treatment issues in the health sector. Accordingly, compared to recent decades, health decision makers are more accurate and trustful in defining new strategies. Interestingly, using social media and mobile health apps in current pandemics of SARS-CoV-2 could be an important instance of the key role of these platforms at the local and global level of health policies. These digital technologies provide platforms to connect public health sectors and health politicians for communicating and spreading relevant information. Adding influencers and campaigns to this toolbox strengthens the implementation of public health programs. In 2016, the WHO adopted a global program to eliminate viral hepatitis by 2030. Recent constructive measures that have been used in the battle against COVID-19 could be adopted for the elimination of viral hepatitis program. The presented evidence in our narrative review demonstrates that the application of digital marketing tools to create campaigns on social media, armed with professional influencers, can efficiently consolidate this program. The application of different strategies in using these popular tools will raise the public awareness about viral hepatitis. Subsequently, the availability of an effective vaccine for HBV and antiviral medication for HCV can motivate the audience to take steps towards prophylaxis and screening methods against these infectious illnesses. The encouragement of health policy makers to apply digital communication technologies and comprehensive roadmaps to implement this global program will certainly decrease the burden of viral hepatitis worldwide.

Making sense of COVID-19 over time in New Zealand: Assessing the public conversation using Twitter

COVID-19 has ruptured routines and caused breakdowns in what had been conventional practice and custom: everything from going to work and school and shopping in the supermarket to socializing with friends and taking holidays. Nonetheless, COVID-19 does provide an opportunity to study how people make sense of radically changing circumstances over time. In this paper we demonstrate how Twitter affords this opportunity by providing data in real time, and over time. In the present research, we collect a large pool of COVID-19 related tweets posted by New Zealanders-citizens of a country successful in containing the coronavirus-from the moment COVID-19 became evident to the world in the last days of 2019 until 19 August 2020. We undertake topic modeling on the tweets to foster understanding and sensemaking of the COVID-19 tweet landscape in New Zealand and its temporal development and evolution over time. This information can be valuable for those interested in how people react to emergent events, including researchers, governments, and policy makers.

Using data mining to track the information spreading on social media about the COVID-19 outbreak

Purpose

COVID-19, a causative agent of the potentially fatal disease, has raised great global public health concern. Information spreading on the COVID-19 outbreak can strongly influence people behaviour in social media. This paper aims to question of information spreading on COVID-19 outbreak are addressed with a massive data analysis on Twitter from a multidimensional perspective.

Design/methodology/approach

The evolutionary trend of user interaction and the network structure is analysed by social network analysis. A differential assessment on the topics evolving is provided by the method of text clustering. Visualization is further used to show different characteristics of user interaction networks and public opinion in different periods.

Findings

Information spreading in social media emerges from different characteristics during various periods. User interaction demonstrates multidimensional cross relations. The results interpret how people express their thoughts and detect topics people are most discussing in social media.

Research limitations/implications

This study is mainly limited by the size of the data sets and the unicity of the social media. It is challenging to expand the data sets and choose multiple social media to cross-validate the findings of this study.

Originality/value

This paper aims to find the evolutionary trend of information spreading on the COVID-19 outbreak in social media, including user interaction and topical issues. The findings are of great importance to help government and related regulatory units to manage the dissemination of information on emergencies, in terms of early detection and prevention.

Surveillance of Outbreaks of SARS-CoV-2 Infections at School in the Veneto Region: Methods and Results of the Public Health Response during the Second and Third Waves of the Pandemic between January and June 2021

During the COVID-19 pandemic, many countries adopted various non-pharmacological interventions to contain the number of infections. The most often used policy was school closures. We describe the strategy adopted by the Veneto Regional Authority to contain transmission in school settings. This included a detailed school surveillance system, strict contact tracing, and maintaining school attendance with self-monitoring for symptoms whenever possible. All analyzed COVID-19 cases among children, adolescents (0–19 years old), and school staff were registered using a web-based application between 4 January 2021 and 13 June 2021. During the study period, 6272 episodes of infection in schools were identified; 87% were linked to a student index case and 13% to school staff; 69% generated no secondary cases; 24% generated one or two; and only 7% caused more than two. Our data may help to clarify the role of school closures, providing useful input for decisions in the months to come. Good practice in public health management needs tools that provide a real-time interpretation of phenomena like COVID-19 outbreaks. The proposed measures should be easy to adopt and accessible to policymakers.

Team dynamics in emergency surgery teams: results from a first international survey

BACKGROUND

Emergency surgery represents a unique context. Trauma teams are often multidisciplinary and need to operate under extreme stress and time constraints, sometimes with no awareness of the trauma's causes or the patient's personal and clinical information. In this perspective, the dynamics of how trauma teams function is fundamental to ensuring the best performance and outcomes.

METHODS

An online survey was conducted among the World Society of Emergency Surgery members in early 2021. 402 fully filled questionnaires on the topics of knowledge translation dynamics and tools, non-technical skills, and difficulties in teamwork were collected. Data were analyzed using the software R, and reported following the Checklist for Reporting Results of Internet E-Surveys (CHERRIES).

RESULTS

Findings highlight how several surgeons are still unsure about the meaning and potential of knowledge translation and its mechanisms. Tools like training, clinical guidelines, and non-technical skills are recognized and used in clinical practice. Others, like patients' and stakeholders' engagement, are hardly implemented, despite their increasing importance in the modern healthcare scenario. Several difficulties in working as a team are described, including the lack of time, communication, training, trust, and ego.

DISCUSSION

Scientific societies should take the lead in offering training and support about the abovementioned topics. Dedicated educational initiatives, practical cases and experiences, workshops and symposia may allow mitigating the difficulties highlighted by the survey's participants, boosting the performance of emergency teams. Additional investigation of the survey results and its characteristics may lead to more further specific suggestions and potential solutions.

Translating Knowledge About Organ and Tissue Donation Using Webinars: An Exploratory Study In Italy

BACKGROUND

Organ transplant is considered a life-saving treatment for patients with end-stage diseases. The knowledge of the population and their opinions can influence the willingness of family members and patients to consent to organ and tissue donation. This work aims to evaluate the effectiveness of a webinar intervention as a knowledge translation tool on the Italian population's knowledge and attitudes related to organ and tissue donation.

METHODS

The study used an interventional methodology, analyzing the results of a webinar event lasting 120 minutes organized and managed by 4 experienced professionals in collaboration with the National Association of Donors. Evaluation of customer satisfaction at the end of the webinar was assessed, along with the impact of the event on the participants' perceived knowledge and attitudes.

RESULTS

The overall evaluation of the webinar can be considered satisfactory, and the webinar stood as a valid knowledge translation tool. The intervention significantly improved perceived knowledge, attitudes, and propensity to donate. The analysis showed that the difference between brain death and coma was still doubtful.

CONCLUSIONS

A short webinar course was effective and appreciated by the participants, representing a valid knowledge translation tool and an alternative to in-presence training on specific topics that require the creation of a real "culture of donation."