Workshop Discussions Research Articles

How can we strengthen partnership and coordination for health system emergency preparedness and response? Findings from a synthesis of experience across countries facing shocks

BackgroundDiscussions of health system resilience and emergency management often highlight the importance of coordination and partnership across government and with other stakeholders. However, both coordination and partnership have been identified as areas requiring further research. This paper identifies characteristics and enablers of effective coordination for emergency preparedness and response, drawing on experience from different countries with a range of shocks, including floods, drought, and COVID-19.MethodsThe paper synthesises evidence from a set of reports related to research, evaluation and technical assistance projects, bringing together evidence from 11 countries in sub-Saharan Africa and South Asia. Methods for the original reports included primary data collection through interviews, focus groups and workshop discussions, analysis of secondary data, and document review. Reports were synthesised using a coding framework, and quality of evidence was considered for reliability of the findings.ResultsThe reports highlighted the role played by coordination and partnership in preparedness and response, and identified four key areas that characterise and enable effective coordination. First, coordination needs to be inclusive, bringing together different government sectors and levels, and stakeholders such as development agencies, universities, the private sector, local leaders and civil society, with equitable gender representation. Second, structural aspects of coordination bodies are important, including availability of coordination structures and regular meeting fora; clear roles, mandates and sufficient authority; the value of building on existing coordination mechanisms; and ongoing functioning of coordination bodies, before and after crises. Third, organisations responsible for coordination require sufficient capacity, including staff, funding, communication infrastructure and other resources, and learning from previous emergencies. Fourth, effective coordination is supported by high-level political leadership and incentives for collaboration. Country experience also highlighted interactions between these components, and with the wider health system and governance architecture, pointing to the need to consider coordination as part of a complex adaptive system.ConclusionCOVID-19 and other shocks have highlighted the importance of effective coordination and partnership across government and with other stakeholders. Using country experience, the paper identifies a set of recommendations to strengthen coordination for health system resilience and emergency management.

Science for social licence to arrest an ecosystem-transforming invasion.

The primary role for scientific information in addressing complex environmental problems, such as biological invasions, is generally assumed to be as a guide for management decisions. However, scientific information often plays a minor role in decision-making, with practitioners instead relying on professional experience and local knowledge. We explore alternative pathways by which scientific information could help reduce the spread and impacts of invasive species. Our study centred on attempts to understand the main motivations and constraints of three local governance bodies responsible for the management of invasive (wilding) conifer species in the southern South Island of New Zealand in achieving strategic and operational goals. We used a combination of workshop discussions, questionnaire responses and visits to field sites to elicit feedback from study participants. We applied a mixed inductive-deductive thematic analysis approach to derive themes from the feedback received. The three main themes identified were: (1) impacts of wilding conifers and goals for wilding conifer control, (2) barriers to achieving medium- and long-term goals, and (3) science needed to support wilding conifer control. Participants identified reversal and prevention of both instrumental (e.g. reduced water availability for agriculture) and intrinsic (e.g. loss of biodiversity and landscape values) impacts of wilding conifer invasions as primary motivators behind wilding conifer control. Barriers to achieving goals were overwhelmingly social, relating either to unwillingness of landowners to participate or poorly designed regulatory frameworks. Consequently, science needs related primarily to gaining social licence to remove wilding conifers from private land and for more appropriate regulations. Scientific information provided via spread and impacts forecasting models was viewed as a key source of scientific information in gaining social licence. International experience suggests that invasive species control programmes often face significant external social barriers. Thus, for many biological invasions, the primary role of science might be to achieve social licence and regulatory support for the long-term goals of invasive species control programmes and the management interventions required to achieve those goals.

Leveraging Chennai’s Complex Governance Network for Addressing the City’s Water Woes

Chennai’s governance network plays a critical role in shaping the city’s waterscape. Through an urban political ecology (UPE) lens, this article investigates the intersection between water as part of nature and water as shaped by social context, with a focus on existing governance networks. Using a combination of social network analysis and thematic analysis, the article studies data gathered from in-depth semi-structured interviews, workshop discussions with stakeholders, and extensive literature and policy reviews. The analysis reveals a need to reconfigure the urban governance network and the relationships therein to work towards a sustainable future for Chennai’s water system. The article concludes by offering policy recommendations to leverage the strengths and weaknesses of the complex inter-agency relations that shape Chennai’s current waterscape.

Using science-based role-play simulations to inform payment for hydrological services program design in Mexico

Payments for hydrological services (PHS) apply an incentive-based approach to achieve conservation and socioeconomic goals. PHS policies are most successful when they are designed and implemented with participation from diverse stakeholders and respond to local needs and conditions. Role-play simulations (RPS) engage stakeholders from different organizations and decision-making roles in policy deliberations and innovations. This paper explores how a science-based RPS encourages participation from diverse actors to inform PHS policy innovation in Veracruz, Mexico. We present results from two RPS workshops which engaged 69 stakeholders in negotiations on the future design of a hypothetical PHS program. Our RPS integrated qualitative and quantitative information from operating PHS programs to inform a hypothetical, but realistic, decision-making scenario. This paper analyzes data collected from surveys of workshop participants, audio recordings of workshop discussions, and post-workshop, in-depth interviews. We found the RPS fostered collaborative decision-making by engaging participants in constructive conversations about PHS program design options to effectively contribute to forest conservation and socioeconomic well-being, including incentivizing environmentally friendly farm practices and complementing cash payment with in-kind transactions. We also found the collaborative method of RPS challenged the exclusive role of technical expertise in decision-making by eliciting ideas for improvement of PHS programs and fostering understanding and empathy towards others and their interests, particularly for small landowners who do not typically participate in decision-making. We conclude that a science-based RPS can be a valuable tool for encouraging multi-stakeholder participation in policy design that reflects local environmental and socio-economic values and needs.

141 THE INTENSE PROJECT: IMPROVING DEMENTIA CARE THROUGH SIMULATION OF SELF-EXPERIENCE

Abstract Background The EC is concerned about the growing shortage of experienced health and social care professionals to care for people with dementia. Although specialized dementia education programs have begun to appear in recent years, a lack of consistency and adequate level of knowledge of dementia to anticipate the required treatment remains across Europe. The Improving demeNtia care Through Self-Experience (INTENSE) project supports the creation of skills improvement paths for professionals across Europe that incorporate and promote successful self-experience methodologies and practices to increase knowledge and understanding of the lived experience of dementia (e.g., Virtual Dementia Tours, role plays and practices of theatre workshops). Methods A systematic review of self-experience tools, training and interventions was conducted. Participatory stakeholder workshops were then held in Ireland, Italy, Germany and the Netherlands to explore ways in which self-experience could be used to better understand the experience of the person with dementia and how the simulation of self-experience could be incorporated into existing (or new) training programmes. Workshop discussions were transcribed and thematically analysed along with workshop outputs to develop the INTenSE toolkit and supporting platform. Results An INTenSE toolkit was developed containing interactive no-tech, low-tech and high-tech approaches to simulating self-experience. Training scenarios, facilitation approaches and sustainability plans were designed and a prototype of the INTenSE Platform (website to house and support use of the toolkit) was developed. Beta versions of each will be presented. Conclusion INTenSE has illustrated how participatory research can strengthen cooperation and exchange of experiences between organizations working in the field of dementia care; improve social awareness of the ability of self-experience to improve dementia care; promote the integration of self-experience practices in the training of health and social care professional; and highlight the potential for self-experience simulation to be incorporated into carer training and dementia awareness education, subject to the provision of appropriate supports.

189 IMPROVING DEMENTIA CARE THROUGH SELF-EXPERIENCE; CO-DESIGNING A SIMULATION-BASED DEMENTIA EDUCATION TOOLKIT

Abstract Background Although specialised dementia education programmes have begun to appear in recent years, they lack consistency. Knowledge gaps persist, which results in a professional workforce who can struggle to anticipate the care needs of people with dementia. Self-experience or simulation practices (e.g., roleplays, virtual reality, sensory tools) are established teaching methods that can provide learning opportunities to experience aspects of illness. These innovative learning approaches can positively impact empathy, understanding, and quality of care; however, they are rarely implemented in specialised care for people with dementia. The Improving demeNtia care Through Self-Experience (INTENSE) project has co-designed a dementia simulation toolkit to educate, equip, and train professionals to better support people with dementia. Methods As part of the Erasmus+ INTenSE project, a series of three participatory, online workshops were conducted with people with dementia, informal caregivers, and dementia-care professionals in Ireland, Italy, Germany, and the Netherlands. The first explored the co-design of training scenarios using simulation tools to demonstrate the lived experience of dementia. The second involved the co-design of an online training platform. The third examined the sustainable implementation of INTenSE into practice. All workshops were inductively coded and analysed thematically. Results Recommended training scenarios demonstrate daily activities and environments that impact people with dementia using a combination of existing and newly developed simulation tools. Four themes arose from workshop discussions: 1) representation of dementia, 2) daily challenges that impact people with dementia, 3) applying a person-centred approach, and 4) implementing self-experience training. Together these were used to develop facilitation guides to support the implementation of the INTenSE simulation toolkit into practice. Conclusion These findings demonstrate the potential of simulating self-experience across a range of everyday scenarios as a means to increase professionals' empathy and understanding of the lived experience of dementia. Recommendations have been developed that support the use of self-experience tools in practice.

Educational Development - Challenges, Opportunities, Tools and Techniques

: As pointed out by many researchers, the ongoing pandemic has been a catalyst for educational development. With the increasing need for reskilling and lifelong learning, the current model of technology-enhanced learning needs updating, and so does also the university programmes for bachelor's and master's students. This study is based on an online brainstorming session and submitted development plans in the HEaD (Higher Education and Digitalisation) project, a five-year initiative for technology-enhanced educational development. HEaD is a development project aimed at supporting university teachers to work with research and development in the field of technology-enhanced and lifelong learning. As the research strategy, an action research approach was used, with the purpose of improving the educational process where authors also have the roles of teachers and facilitators. The aim of the study is to describe and discuss pilot project members' perceptions of challenges, opportunities, tools and techniques in higher education development. Data gathered from workshop discussion summaries and project plans were thematically analysed. Ideas from the workshop sessions were written down and saved with the use of the digital notice board Padlet. Results from the thematic analysis have been grouped into the four predefined categories of challenges, opportunities, tools and techniques. Findings show that course participants and project members have interesting ideas that have the potential to reinforce the current educational model at the university. Several tools and techniques that could support synchronous as well as asynchronous online learning will be tested and evaluated. Both the workshop summaries and the project plans show a high degree of creativity, but on the other hand, the method descriptions were scarce and would need improvement. The conclusion is that the project has had a good start if seen as development, but that there is a need for improvement and more input to achieve the intended core idea of research and development.

8.G. Workshop: European Health Data Space: Dialogue on TEHDAS JA data quality & semantic interoperability proposals

Abstract The EU Data Strategy foresees the development of shared European data infrastructures, enabling cross-border exchange and availability of comparable and high-quality data. The European Health Data Space (EHDS) is the first of these infrastructures to be launched, making use of the potential of health and social data for the purpose of advancing public health, research and innovation. Quality of digital health data has been the focus of research and debate for a long time and several proposals for improvement have been put forward. While these efforts are ongoing, secondary use or re-use of health data, combined with recent developments in data analytics, AI and real-world data (RWD), have raised new requirements on our understanding of data quality and the means for its assurance. Both the European Commission and Member States have underlined the need to support EU and national authorities, as well as the scientific community to agree on interoperability guidelines addressing data quality and semantic interoperability. The TEHDAS Joint Action has responded to these expectations through work undertaken in the context of WP6 - Excellence in data quality. With expected delivery deadline early 2023, the EUPHA conference offers an excellent platform to present the draft forthcoming proposals to the public health community and engage in meaningful dialogue with participants. Key members of the WP6 team will present the process through which the TEHDAS JA recommendations on data quality and semantic interoperability have been developed, the results achieved thus far and the remaining open questions. The workshop discussion section will allow the JA team to collect direct input and feedback for utilization in the production of the final version of the deliverables. Key messages • Increased awareness and understanding of background and rational of forthcoming proposals on data quality and semantic interoperability in the European Health Data Space. • Opportunity to raise concerns and proposals for improvement and thus have a direct impact on the final TEHDAS JA output on data quality.

Building a qualitative systems map: applying systems thinking to the commercial determinants of health and industry influence on health policy

Abstract Background Unhealthy commodities are major drivers of the global burden of noncommunicable diseases. Commercial actors attempt to influence policy to undermine regulation and existing literature draws attention to the underlying macro-level factors that enable this influence. Public health literature also suggests that industry adapts to regulation and such influence may thus be considered a complex adaptive system. Therefore, this study aimed to build a qualitative systems map to help communicate the complexity of industry influence and develop a tool to facilitate the identification of interventions in follow up research. Methods In-person group model grouping workshops were adapted for the online environment. A preliminary qualitative systems map was developed by synthesising two recent studies to facilitate workshop discussions and expedite the mapping process. Twenty-three small group system mapping workshops were conducted with a total of 52 stakeholders, representing researchers, civil society, and public officials from various geographical regions. Results The qualitative systems map identifies five pathways through which industry influences policy: a) direct access to public sector decisionmakers; b) creation of confusion and doubt about policy decisions; c) prioritisation of commercial growth; d) industry leveraging the legal and dispute settlement processes; and e) industry leveraging policymaking rules and processes. The pathways contribute to perpetuating macro-level factors that enable industry to deploy practices to influence policy. Conclusions A system thinking approach can be applied to industry influence on health policy to depict a complex adaptive system. Interventions need to take into consideration the system's complexity and adaptivity. Further research is needed to test, and improve the systems map and identify interventions to achieve systems change.

Methodologies of collective listening: What could be next for our cultural institutions?

This article focuses on the role of collective and collaborative conversation. It draws on a discussion that took place between Mark Sealy, director of Autograph; Dr Maggie Matić, curator, writer and researcher; Marie Smith, visual artist and writer; Becky Warnock, artist and organizer; Heather Agyepong, visual artist, performer and actor; Angela YT Chan, curator and artist, and Hannah Geddes, curator, writer and researcher. The event took place at London College of Communication (LCC), London, in November 2022. The conversation was centred on the provocation: What is next? How do we turn intentions into actions through social justice practice and curation? It started as an informal workshop, before concluding in a public discussion chaired by Sealy. The following article draws on the initial workshop discussion, surfacing the idea of listening as a form of collective and collaborative practice.

Research priorities for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS): the results of a James Lind alliance priority setting exercise

ABSTRACT Objective: To identify research priorities of people with myalgic encephalomyelitis / chronic fatigue syndrome (ME/CFS) and those who support and care for them. Method: Using the James Lind Alliance’s protocols, online surveys and workshops were held. The first survey asked participants from the U.K. to submit research questions about ME/CFS which were important to them. In the second, participants prioritised frequently submitted questions from the 1st survey. These were short listed and then workshop discussions were held to reach consensus on the top ten research priorities. Results: 1565 participated in the 1st survey and 5300 research priorities were submitted. 1752 participated in the 2nd. In both surveys, the predominant demographic was white, middle-aged women with ME/CFS. 15–17% were family/carers of people with ME/CFS and 4–6% were health and social care workers. From the 1st survey, 59 summary questions were identified. These were prioritised and short listed to 18 questions. Of these, the top 10 covered 1. Post-exertional malaise, 2. Use of existing drugs for other conditions, 3. Diagnosis, 4. Autoimmunity, 5. Sub-types, 6. Post-infective cause, 7. Neurological symptomology, 8. Genetics, 9. Severe ME/CFS, 10. Mitochronical dysfunction and 10 (equal) Oxygenation dysfunction. Conclusion: People with ME/CFS, their families and carers, and health care professionals worked together to identify, for the first time, the research priorities for ME/CFS. These focus on the biomedical causes of ME/CFS and how to diagnose, treat and manage it. Researchers and funding bodies should consider these in their plans for future research.

Perceptions of sugar-sweetened beverages among adolescents in North Carolina.

IntroductionSugar-sweetened beverage (SSB) consumption among adolescents contributes to diet-related chronic disease including obesity, type 2 diabetes, and poor oral health.ObjectiveTo better understand adolescents' perceptions, attitudes, and consumption behaviors around SSBs by conducting virtual workshop discussions with adolescents in NC.Materials and methodsAdolescents ages 11–17 in communities with a high proportion of Supplemental Nutrition Assistance Program (SNAP) eligible households were selected to participate in a series of virtual group workshops during summer 2021. A semi-structured discussion guide was used by a workshop facilitator. Workshop discussions centered around general health perceptions, SSB perceptions, and consumption behaviors. A thematic analysis was used to summarize knowledge, beliefs, attitudes, and perceptions around SSBs.ResultsApproximately 36 adolescents participated across four group workshops. Parents and caregivers influenced adolescents most when it came to making beverage choices. Positive SSB perceptions included liking the taste and the association with special times and social events. Negative opinions focused on associated health risks (diet-related chronic disease and poor oral health). Some adolescents acknowledged SSBs were not healthy but suggested they could be consumed occasionally. Very few participants mentioned any benefits from SSBs; those that mentioned benefits stated they provided energy, replaced electrolytes, and tasted good.ConclusionFindings provide several key insights that can contribute to the development of messages aimed at curbing SSB consumption among adolescents. For example, messages that focus on catching adolescents' attention and sharing short- and long-term health consequences of high SSB consumption resonated with adolescents, but because occasional SSB intake was not seen as consequential, messages that suggest abstinence from SSBs may not be helpful in reducing consumption.

Reducing the Inadvertent Spread of Retracted Science: recommendations from the RISRS report

BackgroundRetraction is a mechanism for alerting readers to unreliable material and other problems in the published scientific and scholarly record. Retracted publications generally remain visible and searchable, but the intention of retraction is to mark them as “removed” from the citable record of scholarship. However, in practice, some retracted articles continue to be treated by researchers and the public as valid content as they are often unaware of the retraction. Research over the past decade has identified a number of factors contributing to the unintentional spread of retracted research. The goal of the Reducing the Inadvertent Spread of Retracted Science: Shaping a Research and Implementation Agenda (RISRS) project was to develop an actionable agenda for reducing the inadvertent spread of retracted science. This included identifying how retraction status could be more thoroughly disseminated, and determining what actions are feasible and relevant for particular stakeholders who play a role in the distribution of knowledge.MethodsThese recommendations were developed as part of a year-long process that included a scoping review of empirical literature and successive rounds of stakeholder consultation, culminating in a three-part online workshop that brought together a diverse body of 65 stakeholders in October–November 2020 to engage in collaborative problem solving and dialogue. Stakeholders held roles such as publishers, editors, researchers, librarians, standards developers, funding program officers, and technologists and worked for institutions such as universities, governmental agencies, funding organizations, publishing houses, libraries, standards organizations, and technology providers. Workshop discussions were seeded by materials derived from stakeholder interviews (N = 47) and short original discussion pieces contributed by stakeholders. The online workshop resulted in a set of recommendations to address the complexities of retracted research throughout the scholarly communications ecosystem.ResultsThe RISRS recommendations are: (1) Develop a systematic cross-industry approach to ensure the public availability of consistent, standardized, interoperable, and timely information about retractions; (2) Recommend a taxonomy of retraction categories/classifications and corresponding retraction metadata that can be adopted by all stakeholders; (3) Develop best practices for coordinating the retraction process to enable timely, fair, unbiased outcomes; and (4) Educate stakeholders about pre- and post-publication stewardship, including retraction and correction of the scholarly record.ConclusionsOur stakeholder engagement study led to 4 recommendations to address inadvertent citation of retracted research, and formation of a working group to develop the Communication of Retractions, Removals, and Expressions of Concern (CORREC) Recommended Practice. Further work will be needed to determine how well retractions are currently documented, how retraction of code and datasets impacts related publications, and to identify if retraction metadata (fails to) propagate. Outcomes of all this work should lead to ensuring retracted papers are never cited without awareness of the retraction, and that, in public fora outside of science, retracted papers are not treated as valid scientific outputs.

Engaging faith communities in public health messaging in response to COVID-19: Lessons learnt from the pandemic in Ituri, Democratic Republic of Congo.

PurposeTo understand challenges faced by faith leaders in the Democratic Republic of Congo (DRC) in engaging with current public health strategies for the COVID-19 pandemic; to explain why long-standing collaborations between government, faith-based health services and leaders of faith communities had little impact; to identify novel approaches to develop effective messaging that resonates with local communities.MethodsA qualitative participatory research design, using a workshop methodology was deployed to seek opinions of an invited group of faith leaders in the DRC provinces of Ituri and Nord-Kivu. A topic guide was developed from data gathered in prior qualitative interviews of faith leaders and members. Topics were addressed at a small workshop discussion. Emerging themes were identified.FindingsLocal faith leaders described how misinterpretation and misinformation about COVID-19 and public health measures led to public confusion. Leaders described a lack of capacity to do what was being asked by government authorities with COVID-19 measures. Leaders' knowledge of faith communities' concerns was not sought. Leaders regretted having no training to formulate health messages. Faith leaders wanted to co-create public health messages with health officials for more effective health messaging.ConclusionPublic trust in faith leaders is crucial in health emergencies. The initial request by government authorities for faith leaders to deliver set health messages rather than co-develop and design messages appropriate for their congregations resulted in faith communities not understanding health messages. Delivering public health messages using language familiar to faith communities could help to ensure more effective public health communication and counter misinformation.

Research priorities to prevent and treat diabetic foot ulcers-A digital James Lind Alliance Priority Setting Partnership.

To establish outcomes of a priority setting partnership between participants with diabetes mellitus and clinicians to identify the top 10 research priorities for preventing and treating diabetic foot ulcers (DFUs). Due to the COVID-19 pandemic, the James Lind Alliance Priority Setting Partnership process was adapted into a digital format which involved a pilot survey to identify understandable uncertainties with high relevance for participants tested by calculating the content validity index; a main survey answered by 53 participants living with diabetes and 49 clinicians; and a final digital workshop to process and prioritise the final top 10 research priorities. The content validity index was satisfactory for 20 out of 25 uncertainties followed by minor changes and one additional uncertainty. After we processed the 26 uncertainties from the main survey and seven current guidelines, a list of 28 research uncertainties remained for review and discussion in the digital workshop. The final top 10 research priorities included the organisation of diabetes care; screening of diabetes, impaired blood circulation, neuropathy, and skin properties; vascular surgical treatment; importance of self-care; help from significant others; pressure relief; and prevention of infection. The top 10 research priorities for preventing and treating DFUs represent consensus areas from persons living with diabetes and clinicians to guide future research. These research priorities can justify and inform strategic allocation of research funding. The digitalisation of James Lind Alliance methodology was feasible.

Exploring the Experiences of Pharmacy Students and Their Transition to Online Learning during COVID-19.

Due to the heavy focus on development of communication skills, compounding laboratories and many practical workshops, undertaking a registerable pharmacist qualification in an online format is typically not an option for students. COVID-19 presented on-campus pharmacy students with the opportunity to experience online learning. The aim of this study was to explore the experiences of on-campus pharmacy students who were required to move their studies to online learning during the COVID-19 pandemic. An interpretive phenomenological methodology was adopted, and semi-structured interviews were conducted with pharmacy students who were originally enrolled in on-campus learning and had to transition to online learning. Data were analyzed using a hermeneutic phenomenological approach whereby themes were identified to aid in the development of the phenomena guided by ‘lived experience’. Seven interviews were conducted with pharmacy students. Four emergent themes resulted from the interviews: (1) life as an on-campus pharmacy student, (2) preconceived ideas of online learning, (3) learning differences as an online pharmacy student and (4) the future of online pharmacy programs. Students were initially hesitant to transition to online learning due to preconceived ideas and expectations that may have tainted their overall experience. Pharmacy students preferred face-to-face learning due to their sociable personality and heavy dependence on peer and teacher support. All participants reported that they preferred face-to-face learning and acknowledged that fully online programs were not suited to their learning style or to the discipline of pharmacy. After their experience of online learning, participants believed that there was a place for online learning components in pharmacy courses. Lectures and some discussion workshops could be delivered online, but some aspects, such as compounding; dispensing; counselling; and demonstration of medication delivery devices, such as asthma inhalers and injectable diabetes products, should be delivered on campus.

Communication to Reduce Dependency and Enhance Empowerment Using ‘New’ Media: Evidence from Practice in UK Flood Risk Areas

Sharing of risk knowledge for extreme events is taking place against a backdrop of changing societal communication patterns, in which the flow of information is increasingly multi-directional, within and between individuals, wider communities and a variety of authorities using online media. We present qualitative findings from the CASCADE knowledge exchange project and a case study, from a flood risk area, on the role of social networks using such ‘new’ media as engagement tools in building resilience to flooding. The data emerged from a workshop held in 2018, together with a study into changing communication practice in the Thames Valley near Windsor, UK. It was found that engagement is occurring both during events, as an emergency management tool, and between events, often linked to strategic management such as flood defense and related planning. The qualitative findings were analyzed to investigate whether knowledge and information sharing in emergencies may lead to co-operative sharing between emergencies. According to evidence from workshop discussions across the seminars, and empirical evidence from the flood risk zone, social networks formed and/or enhanced using new media can help promote consensus but also have the potential to accentuate distrust and divide managers and the community at risk. Relevant factors were the nature of the risk faced, nature of event-related protection activity, whether extreme weather events were occurring or had occurred in the recent past, and sociocultural aspects such as the degree of general engagement of civil society, linked to location. There is a possibility that new media may thus reinforce existing power structures, including acknowledged paternalistic attitudes by management authorities and pre-conceived ideas from at-risk communities. In terms of the contribution that social media can make toward the goal of social learning for resilience, the specific role of online social media as a communication tool continues to evolve. It was noted from the workshop that there is a potential for producers of information to act also as consumers (the ‘prosumer effect’), but gaining benefit from this trend requires some changes to existing interaction patterns within and between risk management authorities and communities. More investment may be required in forms of engagement that build relationships of trust, using ‘traditional’ (face-to-face) approaches.

Pragmatic randomised controlled trials in COPD and asthma: how to guide clinical practice

The use of real-world evidence (RWE) studies, including pragmatic randomised controlled trials (RCTs; randomised RWE studies), to aid the development of treatment guidelines, is gradually becoming a mainstay within clinical...

Medical informatics and digital health multilingual ontology (MIMO): A tool to improve international collaborations

BackgroundEven if English is the leading language for international communication, it is essential to keep in mind that research runs at the local level by local teams generally communicating in their local/national language, especially in Europe among European projects. ObjectiveTherefore, the European Federation for Medical Informatics - Working Group on Health Informatics for Inter-regional Cooperation” has one objective: To develop a multilingual ontology focusing on Health Informatics and Digital Health as a collaboration tool that improves international and, in particular, European collaborations. ResultsWe have developed the Medical Informatics and Digital Health Multilingual Ontology (MIMO). Hosted on the Health Terminology/Ontology Portal (HeTOP), MIMO contains around 1,000 concepts, 460 MeSH Descriptors, 220 MeSH Concepts, and more than 300 newly created concepts. MIMO is continuously updated to comprise as recent as possible concepts and their translations in more than 30 languages. Moreover, the MIMO’s development team constantly improves MIMO content and supporting information. Thus, during workshop discussions and one-on-one exchanges, the MIMO team has collected domain experts’ opinions about the community’s interests and suggestions for future enhancements. Moreover, MIMO will be integrated to support the annotation and categorization of research products into the HosmartAI European project involving more than 20 countries around Europe and worldwide. ConclusionMIMO is hosted by HeTOP (Health Terminology/Ontology Portal), which integrates 100 terminologies and ontologies in 55 languages. MIMO is freely available online. MIMO is portable to other knowledge platforms as part of MIMO’s main aims to facilitate communication between medical librarians, translators, and researchers as well as to support students’ self-learning.

P08-04 A protocol for the development of a systems map to identify the factors that influence walking in Cork, Ireland

BackgroundSystems approaches have been used in recent years in addressing complex public health problems such as obesity and physical inactivity. Depicting these ‘wicked' problems through systems maps has helped system actors better understand the entire systems in which these problems exist. Like physical activity (PA) promotion, there are multiple sectors and organisations who have a stake in the promotion of walking. However, their efforts are seldom combined, and stakeholders often work in conceptual silos when tackling the same problem. Walking has been described as a ‘best buy' for public health (Bull and Hardman, 2018). However, walking promotion requires efforts across the entire ecosystem if population-level PA goals are to be reached. The purpose of this study is to generate a systems map of the factors that influence walking in Cork.MethodsParticipants of the workshops all work in Cork, Ireland. Participants remotely attended two online Zoom workshops to develop the systems map. The Australian Systems Map for Physical Activity (Bellew et al., 2020) was used as a framework in the development of the map. Semi-structured interviews (n = 5) were used to supplement the online workshops. A third online workshop is planned for October 2020 to discuss identified interventions.OutcomesThe systems map provided stakeholders with a new perspective on the complexities of the system and provided a platform to network with organisations outside of their sectors. Semi-structured interviews helped identify barriers and facilitators to working collaboratively and explored the political and commercial environment of the system. Furthermore, 19 potential interventions were identified from the workshop discussions. A selection of these will be discussed in detail in a third workshop in October 2020.ConclusionsThe systems map alone will not increase walking levels across the entire system. However, it will provide stakeholders with a common visual language of the structure of the system. Thus, enabling them to identify where they sit within the system and potential leverage points they can influence. Furthermore, understanding the entire ecosystem of walking in Cork through a systems map may prove useful in other contexts when approaching the complex problem of population-level walking promotion.