Environmental innovation, knowledge spillovers and policy implications: A systematic review of the economic effects literature

The Physical Activity Guidelines for Americans (Guidelines) advises older adults to be as active as possible. Yet, despite the well documented benefits of physical activity just 12.8% of those ages 65 and older meet the Guidelines. To address this, the U.S. Department of Health and Human Services (HHS) developed a Midcourse Report focused on effective strategies to improve older adult physical activity behaviors. The first step in this process was a systematic literature review. A literature review team was contracted to examine the evidence on key settings and effective behavioral intervention strategies, as well as effective policy, systems, and environmental (PSE) approaches, to improve physical activity among older adults. The PSE search employed an equity-centered framework adapted to researching PSE approaches for improving physical activity outcomes in older adults. Sixteen thousand eight hundred and eighty-three titles and abstracts were screened, and 734 full articles were reviewed for inclusion. Of those, 64 original research articles were included for the final review to answer two questions, one (plus 5 sub-questions) focused on Settings/Strategies literature (45 studies) and one (plus 2 sub-questions) focused on PSE literature (19 studies). The literature review process identified key settings and evidence-based strategies to support older adults in becoming more physically active, and provides a foundation for the Physical Activity Guidelines for Americans Midcourse Report: Implementation Strategies for Older Adults. More research is needed to address how factors related to equity and psychosocial constructs influence physical activity behaviors among older adults.

Methods and Results Report - Evidence and consensus-based (S3) Guidelines for the Treatment of Actinic Keratosis -International League of Dermatological Societies in cooperation with the European Dermatology Forum.

Environmental spillover effects on firm productivity and efficiency: An analysis of agri-food business in Southeast Spain

Review question/objective Public health interventions are often implemented directly by government and so have an observational, rather than experimental, evidence base that may not be captured in traditional academic published sources. There is, therefore, a need to determine whether this grey literature is being actively sought when evaluating the effectiveness of public health interventions through systematic literature review; and also whether the inclusion of this grey literature has an impact on the conclusions of systematic literature reviews (SRs) evaluating public health interventions. This is particularly important as the findings of systematic literature reviews are increasingly used to inform public health policy decisions. Where possible, the sources used to obtain the grey literature in the included SRs will be categorised. As the prevention of childhood obesity is a major emerging public health issue in developed countries, this has been chosen as the topic for this methodological systematic review. The review question is: What is the impact of findings from grey literature on the outcomes of systematic reviews on interventions to prevent obesity among children? Primary Review Objective is to evaluate the impact of findings from grey literature on the results of systematic reviews on prevention of childhood obesity. Secondary Review Objective is to determine the ratio of black to grey literature (definitions are provided in Background) included in the eligible systematic reviews; to determine the study design of the grey literature included in SRs. Background By 2025 obesity rates are predicted to rise in Australia by 65% despite the myriad substantial efforts of a multiplicity of interventions and strategies from the public health sector, particularly those at the community or small unit level.1 Childhood obesity often persists into adulthood, and these strongly established links to adult obesity along with all the attendant risks and consequences make childhood a natural starting point for a closer examination of prevention literature.2,5-6 It also provides a logical focus for early intervention and therefore an abundance of literature exists in the field. Recent literature increasingly supports the argument that high level policy, regulation and legislation is required to prevent childhood obesity, and that whole-of-population, whole-of -environment approaches need to be developed and implemented.7-8 However while policy: “a set of plans to establish and achieve the desired performance goals of a group or organisation”9 abounds, and often confounds10 successes remain generally elusive. To be genuinely evidence-informed, policy needs to access systematic reviews which provide summary conclusions derived from their critical assessments and syntheses of the relevant evidence base. To be comprehensive and representative this base should include, or at least consider, “grey literature and unpublished studies”.11There are two types of literature which could be included in systematic reviews and are known colloquially as black and grey. Black literature is that which is published in academic, scholarly journals. Grey literature, which is usually defined as “Information produced on all levels of government, academia, business and industry in electronic and print formats not controlled by commercial publishing i.e. where publishing is not the primary activity of the producing body”12, takes many different forms13 but is essentially documents that have not been formally published, and have commonly not been peer-reviewed.14 Research institutes for example, produce working papers, technical and consensus reports, issues papers and policy briefs which have valuable content to impart and constitute grey literature. In addition the Joanna Briggs Institute, the Cochrane Collaboration and the Campbell Collaboration stipulate that, in addition to black literature, searches for grey and unpublished literature must be conducted by their systematic reviewers in order to avoid publication bias.15 While systematic reviews sum up the best available research on a specific question by “synthesizing the results of several studies”16 decision makers are now often faced with numerous systematic reviews on the same health issue. The next logical and appropriate step is an overview of systematic reviews, to synthesise and summarise the findings17 and if the overview is itself a systematic review, then the end result should provide stronger and even more comprehensive evidence. A recent dialogue of Australian public health professionals and dietitians emphasised the advocacy approach to obesity prevention, settling on the tripartite strategy of “political commitment, multi-sectoral support and community engagement.”18 It is this complexity of approach that may benefit from an examination of the grey literature (GL) supporting these policies. Simkhada's view19 that GL is needed to fill the information gap as “an essential part of the evidence base for practice in complex interventions, which may have multi-stakeholders, have multi-variables, have a lack of predictability and robust data and require a broad literature approach”, is held by many others20-23. Currently the Australian government is investing in research into the access and preservation of GL in light of its relevance to the development of health policy24. Similarly in 2006 the U.S. National Library of Medicine, aware that policymakers, more than any other research group, found GL especially relevant for context, and for its ability to reflect and map “how debate changes over time on a particular topic”25 commissioned AcademyHealth26 to conduct a research project into the scope and status of this literature. Often the strength of GL lies in the way it can reflect the lay voice, the voice from the field, public opinion: what people think. How can policy succeed when individuals' beliefs and behaviours are at odds with the underlying principles and truths of achieving healthy weight?27-28 Baum and others suggest that we need to look below the surface, focusing on the underlying social determinants of heath rather than “immediate and visible causes” and that the role of public policy should be to shape the social environment so that it is more conducive to good health.29-30 As Australian obesity prevalence continues to rise (in fact no country has managed to reverse obesity trends)31-32, it is reasonable to suggest that policy associated with obesity prevention is at best flawed or limited and possibly under- or ill-informed. As Badger et al argue “it is irresponsible to interfere in the lives of other people on the basis of theories unsupported by reliable empirical evidence”11. Community engagement is a challenging but well-supported aspect of behavioural change in public health. Community receptiveness needs to be gauged and substantiated in creative ways so that it can feed into the information that underpins our policies and supports implementations.33-34. To achieve a greater degree of success in regard to childhood obesity prevention, there is a need to tap into evidence from the widest variety of sources, so as to reflect the complexities of the issue and perceptions of end-users.35 Grey literature is where community attitudes, beliefs, values and opinions might be reasonably expected to be found, and also where pilot programs and case studies assessing the feasibility of public health interventions will have been reported. The degree to which this literature has been accessed and incorporated into the evidence that informs policy may have an impact on the ultimate success or sustained “take-up” of an intervention. To determine the extent to which systematic reviews in the field of child obesity prevention identify and include grey literature in their collated evidence-bases, a comprehensive search of the literature will be undertaken. The resultant systematic reviews will be retrieved and examined for inclusion. Those that do not match the selection criteria will be excluded. The ratio of black to grey literature in the included systematic reviews will be calculated and the proportion of systematic reviews that are grey will be briefly discussed. A comparison of results from grey versus black systematic reviews, and of those systematic reviews with high versus low ratios of included grey literature, will be undertaken to determine whether grey literature changes the findings or interpretation of the outcomes that are assessed. Inclusion criteria Types of studies Systematic reviews of interventions to prevent obesity among children, where there is either meta-analysis or narrative summary or tabular presentation of results. Types of reviews will include those where the primary literature consists of experimental or observational literature. Traditional literature reviews, or narrative reviews not based upon an a-priori protocol and rigorous methodology will be excluded. Qualitative synthesis or mixed methods reviews will also be included. Types of participants The reviews of interest will only include studies on children aged two to 18 years without (at baseline) a diagnosis of obesity, or eating disorders, or co-morbid conditions that pre-dispose to obesity. Types of intervention(s) Public health interventions aimed at obesity prevention that may be applied at the population, community (including schools) or primary care level. Types of outcomes Primary - Obesity prevention will be measured according to body mass index (weight/height2) as calculated against a suitable growth reference e.g. relevant age and .sex growth classification standards, with classification into underweight, healthy weight, overweight, and obese categories.36-37 Outcomes will be grouped according to the type of prevention program implemented. Secondary - Ratio of black to grey eligible systematic reviews; ratio of black to grey studies included in eligible systematic reviews; study designs of grey literature included in eligible systematic reviews; sources used in eligible systematic reviews to obtain grey literature Search strategy The search strategy aims to find both published and unpublished systematic reviews. A three-step search strategy will be utilised in this review. An initial limited search of MEDLINE, EMBASE, CINAHL and the Cochrane Library will be undertaken to “scope” the literature followed by an analysis of the text words contained in the title and abstract, and of the index terms used to describe article. A second search using all identified keywords and index terms will then be undertaken across all included databases. Thirdly, the reference list of all identified reviews, reports and articles will be searched for additional systematic reviews. Systematic reviews published in English will be considered for inclusion in this review, with no date limitation. The databases to be searched include: ARIF (Aggressive Research Intelligence Facility): Reviews database & Methodology database; Biological Abstracts; Campbell Library; CINAHL; Cochrane Library; EMBASE; ERIC; Google Scholar; INFORMIT: Education, Health and Social Science databases; Medline/PubMed; PAIS; Proquest; PsycInfo; Scopus; Sociological Abstracts; TRIP (Turning Research into Practice) database. The search for unpublished systematic reviews will include: DIPEx - Database of Individual Patient Experiences; EPPI Centre (particularly Obesity and Sedentary Behaviour Database); Google Advanced Search; Google Books; GreyNet; Mednar; Scirus; Social Care Online (SCIE); TROVE (for theses, books); WHOLIS. Major international institutional repositories will also be searched. Journals which will be hand searched include Childhood Obesity, International Journal of Pediatric Obesity, Obesity and Obesity Reviews. Initial search keywords to be used will be: (Obesity OR obese) AND (Child or paediatric or pediatric or adolescent or youth or infant) AND (prevent* or intervent*) AND (systematic review or meta-analys* or meta analys*). Where a thesaurus of descriptors or index terms exists, or the ability to “explode” headings, or limit to years of publication and/or document type, full advantage will be taken of these database-specific features. Searches will comprise of a combination of keywords and other available options designed to maximize the chances of retrieval of eligible studies. An example of a completed reproducible search strategy will be appended to the systematic review report. (Appendix I) All study titles and abstracts will be imported into reference management software, duplicates removed, and each title/abstract reviewed according to the inclusion criteria. The full text paper of each potentially relevant study will then be retrieved and again reviewed for eligibility according to the inclusion criteria. Reasons for exclusion will be documented. In cases where study eligibility is uncertain, a consensus decision will be reached by the co-authors. A final database of included systematic reviews will be produced. A PRISMA flowchart38 will be constructed so that the article selection process is transparent and can be replicated. Assessment of methodological quality Systematic reviews selected for retrieval will be assessed by two independent reviewers for methodological validity using the Joanna Briggs Institute (JBI) critical appraisal checklist for systematic reviews prior to inclusion in the review (Appendix II). Any disagreements that arise between the reviewers will be resolved through discussion, or with a third reviewer. Data collection Data will be extracted using the JBI standardised extraction tool for systematic reviews (Appendix III). The data extracted will include specific details about the phenomenon of interest, populations, study methods and outcomes of significance to the review question and specific objectives. Data synthesis The unit of interest is the pooled body mass index results from the eligible systematic reviews (whether presented as a mean difference in BMI or difference in proportions of underweight, healthy, overweight or obese), grouped according to type of obesity prevention program. As the eligible systematic reviews are likely to include studies presented in other eligible systematic reviews in the evidence base (ie duplicated data), it would not be appropriate to meta-analyse the pooled body mass index results for the same interventions reported in these systematic reviews as it would result in double-counting. As the objective of this systematic review is to determine the impact of grey literature on review results, for each type of childhood obesity prevention program an assessment of the concordance of pooled results between grey and black systematic reviews will be undertaken. ie overlapping confidence intervals of the pooled results, and evaluating the agreement of findings/discrepancy in findings. It will also be determined whether there are patterns or trends in pooled results according to the increasing levels/ratios of grey literature in the included systematic reviews. Potentially, sensitivity analysis will be undertaken and publication bias39 will be examined, both as tests of the impact of Grey Literature if there are a sufficient number of studies A narrative meta-synthesis (i.e. meta-synthesis and narrative summary) of the results for each pre-specified outcome will be presented within subheadings appropriate to each type of obesity prevention program identified and assessed in the included systematic reviews. In the event that any systematic reviews compare results from grey and black literature, these will be presented narratively and potentially meta-analysed if the data are homogenous and not duplicated between systematic reviews. Conflicts of interest No conflicts of interest Acknowledgements This review will form part of a submission for the Masters of Clinical Science and therefore a secondary reviewer Lisa Heuch (LH) will only be used for critical appraisal. LH is a Masters of Clinical Science Candidate, The Joanna Briggs Institute, The University of Adelaide.

Both internal knowledge – investment in internal R&D and information and communication technologies (ICT) as well as external knowledge – knowledge spillovers and active collaboration with partners are rapidly fostering firm productivity and innovation. In this study, we investigate the role of internal and external knowledge in firm productivity and innovation. In addition, we test interactions between investment in R&D and ICT as well as between knowledge spillovers and knowledge collaboration in their association to firm innovation and productivity. We use a recombinant innovation approach and four samples for firms in manufacturing, creative, ICT and science, and professional services industries during 2002–2014 and for pre‐and post‐crisis periods to perform our analysis. In addition to innovation and productivity, we also examine the role of internal and external knowledge as a conduit to the development of innovation internally and the co‐creation of innovation with external partners. Our results lead to managerial and policy implications.

Legal environment, government effectiveness and firms' innovation in China: Examining the moderating influence of government ownership

Purpose: A literature review is a thorough summary of the prior research in a topic that has been carried out by other scientists. For a novice researcher, a systematic literature review is the most important and standard step. The scientific discipline determines the methodology for systematic literature reviews. Design/methodology/approach: A comprehensive overview of the literature relevant to a research issue is provided by a systematic literature review, which also synthesizes earlier work to broaden our understanding of a particular topic. It adheres to the principles of accessibility and bias reduction. Although management research is a growing, complex, and dynamic field, relatively little has been published on how management researchers may employ systematic literature reviews Findings: This systematic review on a clearly defined subject that uses systematic and explicit processes to identify, select, and critically assess relevant research, and to acquire and analyse data from the research projects that are part of the review. Practical implications: In order to comprehend the purpose of systematic reviews, we explain one and talk about its rationale. Next, we discuss how conducting systematic literature reviews may enhance management research and correct its shortcomings. We provide a thorough manual to do systematic literature reviews, outlining the steps to follow and providing advice for effective implementation Originality/value: This review article, focus on the methodology adopted for the literature review in the field of management sciences. Keywords: Systematic reviews, Methodology, Management sciences. Category of the paper: Review article.

The American Psychiatric Association Practice Guideline for the Treatment of Patients With Eating Disorders.

This work studies the linkages between spatially bound knowledge spillovers, internal research, and innovation (R&I) activities and firm productivity. Spillovers are modeled to emanate from intra- and extra-sectoral R&I activities in the firms’ regional business environments. We specifically test for non-linearities in the complex relationship between these internal and external knowledge sources and quantify their joint marginal effect on firm productivity. Our empirical results for a large panel of German manufacturing firms (1) underline the overall importance of knowledge spillovers in driving productivity and (2) point at distinct interactions between the included knowledge sources: First, we find that intra-sectoral knowledge spillovers only have a statistically significant effect on firm productivity when extra-sectoral spillovers are sufficiently large. Secondly, the link between knowledge spillovers and productivity varies with the level of the firms’ internal R&I activities.

Current Resources for Evidence‐Based Practice January/February 2013

Background and Purpose of the Research The purpose of the research reported in this thesis was to explore the challenges of managing the 2009/A/H1N1 influenza pandemics in primary care in Australia, Israel and England. The influenza pandemic 2009/A/H1N1 was less devastating than originally anticipated; however, its burden on the health systems of many countries was substantial. It affected 214 countries and territories disproportionally afflicting young children and pregnant women. During this influenza pandemic, the main burden of the pandemic response fell on primary care services, and General Practitioners (GPs) were the ones who diagnosed and treated most of the patients. The prominent role of GPs in the 2009/A/H1N1 influenza pandemic presented an excellent opportunity to investigate the implications of pandemic policies for primary care and to tackle the potential problems that these policies may impose on the ability of GPs to participate effectively in the pandemic response. Method The research design consisted of three complementary studies: a systematic review of the literature, a document study, and qualitative semi-structured interviews with GPs. The systematic literature review (Study 1) was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and applied systematic approach to the literature search, study selection and data extraction. The objective of the systematic review was to examine evidence of challenges that primary care physicians encountered responding to past pandemics or large-scale epidemics. The document study (Study 2) involved analysis of the documents published by the health authorities in Australia, Israel and England during the 2009/A/H1N1 influenza pandemic. Information pertinent for the research question was separated from non-pertinent applying qualitative content analysis approach. Subsequent thematic analysis involved more focused reviewing of the retrieved data, which involved coding and category construction. The objective of the document study was to compare the approaches for management of the 2009/A/H1N1 influenza pandemic in primary care in these three countries. Qualitative semi-structured interviews with 65 GPs in Australia, Israel and England (Study 3) were conducted during June-September 2010. Thematic analysis of the qualitative data was applied. The objective was to explore the views of GPs on challenges they encountered managing the 2009/A/H1N1 influenza pandemic in these three countries. Findings The systematic review of the literature (Study 1) revealed that GPs from different countries experienced similar challenges during past epidemic or pandemic responses. These included: difficulties of communication with the health authorities; limited supply of Personal Protective Equipment (PPE) and difficulties with its use; challenges in performing public health responsibilities; limited support from the authorities; lack of appropriate training. However, the review did not allow a full-scale list of possible challenges of the pandemic response in primary care and yielded little systematic information concerning the nature of the identified challenges. The reasons for these were that only 10 studies met the inclusion criteria of the systematic review; the included studies had different objectives and designs; the studies provided little relevant information needed to consider the differences in patterns of the disease spread and GP involvement in the response in different countries. Study 2 and Study 3 of this thesis were designed to address the identified gap and to investigate the challenges of GP involvement in the 2009/A/H1N1 pandemic response in the selected examples of Australia, Israel and England. Study 2, document analysis, provided systematic evidence concerning the different approaches for involvement of GPs in the pandemic response in Australia, Israel and England. It showed that the involvement of GPs in the three countries differed in timing and allocated responsibilities. Study 3 of the thesis, qualitative interviews with GPs in Australia, Israel and England, elicited challenges in providing the pandemic response in primary care from the respective of GPs. The identified challenges were consistent with the findings of the systematic review of the literature. Systematic collection and analysis of the qualitative data from the three countries allowed identification of a full-scale list of challenges in three fields of the pandemic response: treatment of patients, performance of public health responsibilities and communication with the health authorities. Contribution of the Research to Knowledge This thesis adds to the existing knowledge concerning challenges of the pandemic response in primary care by differentiating between two types of challenges: (i) country specific challenges and (ii) cross country challenges intrinsic to the pandemic response in primary care in general. This was done by collating the data from the document study (Study 2) and qualitative interviews with GPs (Study 3). (i) Country specific challenges. These challenges were found to be influenced by the timing and severity of the disease spread, level of GP involvement in the response, support provided to GPs by the health authorities, and organization of primary care services in a country. (ii) Cross country challenges intrinsic to the pandemic response in primary care in general. These same difficulties were evident in each of the three countries and included difficulties in following pandemic guidelines (barriers affecting knowledge, attitudes and behaviour of GPs) and challenges related to the role delineation during the pandemic response that resulted in role ambiguity and role conflict. Conclusion and Recommendations for Future Pandemic Planning The experience of the 2009/A/H1N1 influenza pandemic management highlighted the centrality of primary care in the pandemic response. The findings of this thesis showed that GPs were intensively involved in the pandemic response in the three investigated countries, despite the differences in the responsibilities that were allocated to them. The connection of GPs to the populations they routinely serve and trust that these populations have in GPs, positioned them as the pivotal figures when people were concerned about their health or the possibility of getting sick. This situation is not likely to change in the future. In order to overcome challenges identified in this research, improvements in planning for involvement of GPs in the pandemic response should be introduced. Based on the thesis findings, the following recommendations were made: First, broader involvement of GPs in the process of planning should be targeted. This includes engagement of GPs and public health representatives in pre-pandemic drills, collaborative meetings and knowledge transfer; engagement of GP representatives and health authorities in pandemic policy evaluation; inclusion of GP representatives in decision making and planning committees. Second, improvement in clarity and strategy of the pandemic policies and guidelines communication to GPs should be introduced. This includes the establishment of one body that is responsible for communicating pandemic policy updates to GPs; making policy updates oriented to primary care by engaging GPs in pre-pandemic policy planning committees; engagement with GP professional bodies that develop and distribute guidelines for primary care; and establishment of mechanisms for GP feedback provision during the pandemic response. Third, planning the support to be provided to GPs during the pandemic response is imperative. This should include planning for rapid distribution of PPE and antiviral drugs in primary care; reimbursement for the pandemic vaccine administration; coordination during the mass vaccination campaign in primary care; and detailed guidelines to treat complicated pandemic cases.

Recurrence after primary treatment of prostate cancer is one of the major challenges facing urologists. Biochemical recurrence is not rare and occurs in up to one third of the patients undergoing radical prostatectomy. Management of biochemical recurrence is tailored according to the site and the burden of recurrence. Therefore, developing an imaging technique to early detect recurrent lesions represents an urgent need. Positron emission tomography (PET) of 68Ga-labelled prostate-specific membrane antigen (68Ga-PSMA) is an emerging imaging modality that seems to be a promising tool with capability to localize recurrent prostate cancer. A systematic review of literature was done to evaluate the role of 68Ga-PSMA PET/CT scan in patients with recurrent prostate cancer after primary radical treatment. A systematic and comprehensive review of literature was performed in September 2017 analyzing the MEDLINE and Cochrane Library following the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) statement. The following key terms were used for the search "PSMA," "prostate-specific membrane antigen," "positron emission tomography," "PET," "recurrent," "prostate cancer," "prostate neoplasm," "prostate malignancy," and "68Ga." Risk of bias was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. Thirty-seven articles met our inclusion criteria and were included in the analysis of this systematic review. Of the 37 articles selected for analysis only four studies were prospective. The overall detection rate of 68Ga-PSMA PET scan ranged from 47% up to 96.6%. The main advantage of this imaging technique is its relatively high detection rates at low serum PSA levels below 0.5 ng/mL (ranging from 11.1% to 75%). Higher serum PSA level was strongly associated with increased positivity on 68Ga-PSMA PET scan. 68Ga-PSMA PET scan was found superior to conventional imaging techniques (CT and MRI) in this setting of patients and even it seems to outperform choline-based PET scan. This technique provided significant changes in the therapeutic management of 28.6-87.1% of patients. After biochemical recurrence, the primary goal is to locate the recurrent lesions' site. 68Ga-PSMA PET/CT seems to be effective in identifying recurrence localization also for very low levels of PSA (<0.5 ng/mL) thus permitting to choose the best therapeutic strategy as early as possible. However, data available cannot be considered exhaustive and prospective randomized trials are needed.

Background: The COVID-19 pandemic is a global phenomenon to which state governments have been forced to take unprecedented action. According to the scientific community, the most effective way to return to normalcy is to vaccinate a large percentage of citizens. However, the short period of time in which the first types of vaccines were created creates an insecurity and reluctance towards vaccines, which, however, is evolving into a global phenomenon. Of course, vaccine-related misinformation on coronavirus, which poses a serious threat not only to public health but also to national security and the global economy, also plays a role. Objective: The purpose of this study is to investigate and clarify the risk of misinformation arising in relation to the COVID-19 pandemic vaccination. In addition, it carries out a development of the reasons that push the population to movements of distrust and challenge through a literature review in research studies that collect data on the anti-vaccination movement during the COVID-19 pandemic. This issue is a burning issue in everyday life and is of particular interest because it undermines the impact of media misinformation on disseminating false news and shaping views against public health and the well-being of the population, promoting panic and fear. Methods & Material: The material used for this study is a product of systematic review and critical evaluation of the most important published articles and studies in the international printed and electronic literature, as well as technical manuals and legislation by international governmental and non-governmental organizations regarding the risk of misinformation arising in connection with the COVID-19 pandemic vaccination. In order to approach the development of the anti-vaccination movement and its presentation through the media, as well as the risk posed by this issue for Public Health, the methodology of the systematic literature review was chosen, using the PRISMA analysis, studies of the international literature related to the issue. The search was conducted through the online academic research databases of Google Scholar, PubMed and Scopus, with the limitation that the studies have been carried out in the last 4 years. Results: Following the methodology of the PRISMA analysis and after the exclusion of some articles, the research ended up focusing on 11 articles that met the criteria of the research and which were included in the review. The results of the research showed that participants are not able to distinguish between true and false content of events and news posted and shared on social networks related to the COVID-19 pandemic and vaccination issues. In addition, the dissemination of information seems to be guided by the interaction that characterizes each social media as well as by the specific patterns of interaction of user groups dealing with the issue. However, although social media is recognized as a major source of misinformation regarding COVID-19 and vaccination issues, the same problem is found in the print media and a more rigorous evaluation of the information by their authors is recommended. Finally, when the use of the Internet poses risks to public health, governments should develop strategies for controlling health information on the Internet, but without censoring the population. Conclusions: In the present systematic literature review, misinformation is evaluated as an important factor in dealing with the pandemic. Accompanied by false information, the content of the media and social networking is hampering the efforts of the global community. Although the World Health Organization (WHO) and other stakeholders are aware of the misinformation and are trying to reduce it, myths and rumors are widespread. This review identifies the carriers of misinformation and its possible effects during the COVID-19 pandemic. Eleven research articles published from 2017 to 2020 were selected, the findings of which misinformation appears to be a strong risk factor and a significant obstacle to tackling the global health crisis. Myths and rumors through traditional and new platforms of news and social media cause xenophobia, human rights violations and psychological disorders in the population. Despite the efforts of the World Health Organization, much more is needed to neutralize the effects of misinformation. Improved global health care policies and strategies are therefore recommended to combat misinformation and mitigate the related effects of COVID-19. Key-words: Vaccine Movement, COVID-19 Legislation, Misinformation, Mass Media, Public Health, Fake News, Conspiracy Theories

Systematic Reviews of the Literature: So What? Why Bother? Who Cares

New knowledge generated by an economic agent in a region will tend over time to flow to other economic agents in the same region but also to economic agents in other regions. It is quite common in the literature to use the concept of knowledge spillovers for such knowledge flows, irrespective of whether they are intended or non-intended. The potential for intra-regional knowledge spillover effects depends on the volume and character of the generation on new knowledge in each region as well as of the general characteristics of the individual regional economic milieu, i.e., those location attributes, which are regionally trapped and which include how well integrated it is with other regions. The larger this potential, the higher the probability that firms dependent upon knowledge spillovers will locate there and the higher the probability that entrepreneurs will take advantage of this potential to launch innovations and to create new knowledge-based firms. To the extent that firms and entrepreneurs can enjoy these knowledge spillovers, they represent an externality or more specifically a knowledge externality in the regional economy.Immense importance in the literature is attributed to knowledge spillovers and knowledge externalities as drivers of regional economic development. Some authors, for example, claim that regional variations in localized knowledge spillovers are one of the main reasons behind regional variations in innovation performance. Against this background, the purpose of this chapter is, based upon a general characterization of knowledge flows, to analyze the character of knowledge externalities and, in particular, their sources, their economic nature, their recipients, their mechanisms and channels, their geographic reach, and their economic consequences generally and for regional economic development in particular.KeywordsKnowledge flowsKnowledge spilloversKnowledge externalitiesProximityInnovationEconomic development