Academic literature on the topic 'Public health (excl. specific population health)'
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Journal articles on the topic "Public health (excl. specific population health)"
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Shah, Sandip, Joseph Black, Vidya Ramesh, Dong Shao, and Siva Narayanan. "Conceptualization of an indication-specific pricing model to assess potential savings to a U.S. health plan." Journal of Clinical Oncology 35, no. 15_suppl (May 20, 2017): e18315-e18315. http://dx.doi.org/10.1200/jco.2017.35.15_suppl.e18315.
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e18315 Background: Value based pricing has become a topic of increasing public attention and scrutiny. An Indication Specific Pricing (ISP) allows price setting relative to the level of benefit provided in a given indication and patient population, with the potential for price to vary based on value in the concerned indication(s). We quantified the impact of deploying an ISP scheme on 5-year Afinitor (everolimus) expenditures for a hypothetical health plan of 5M covered lives in the U.S., taking into account three indications: HER2- breast cancer, renal cell carcinoma, and pancreatic cancer. Methods: We constructed an Excel-based model to understand future expenditures on an annual basis utilizing an ISP scheme against a more traditional single contracted price. Key inputs for the model include price per pill (average selling price (ASP)), forecasted annual number of patients per indication (based on 5M covered lives), and compliance rate. Results from the Sloan Kettering “DrugAbacus” pricing project were leveraged to estimate indication-level prices based on their assessment of efficacy, tolerability, and unmet need for Afinitor in each of the indications; actual ISP prices originally used by Sloan Kettering in their model were reweighted and adjusted. Results: As the DrugAbacus price calculated for each indication was lower than the current ASP for Afinitor, use of an ISP methodology resulted in a 9.3% decrease in five year expenditures for Afinitor ($136.9M for a traditional single price vs. $124.1M for an ISP model). Conclusions: US Payers could consider assessing the value a therapeutic intervention brings to each approved indication using ISP in an effort to lower total pharmaceutical-related healthcare costs. Drug manufacturers may benefit from considering relative product value in each potential indication to assess commercial attractiveness and focus evidence generation strategies on those indications seen as most valuable, to support price negotiations.
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Sadykov, M. N., V. B. Ziatdinov, I. D. Reshetnikova, N. M. Khakimov, D. V. Lopushov, and G. Sh Isaeva. "Study of the Level and Structure of Population Immunity to SARS-CoV2 in the Population of the Republic of Tatarstan during the Second Peak of the Spread of COVID-19." Epidemiology and Vaccinal Prevention 20, no. 5 (November 5, 2021): 39–51. http://dx.doi.org/10.31631/2073-3046-2021-20-5-39-51.
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Background. The COVID-19 pandemic has become a serious challenge for all of humanity due to the rapid global spread, high frequency of severe forms, increased mortality and required the development of new approaches to managing epidemiological processes. Serological studies are the most important tool for monitoring the infectious process, identifying risk groups, assessing the effect of vaccines used and epidemiological projections.Purpose. Conducting serological monitoring in relation to the modern transferred new coronavirus infection determining the level and structure of population immunity to SARS-CoV-2 in the population of the Republic of Tatarstan; maintaining the period of spread of COVID-19 from August to December 2020.Materials and methods. The study involved 41 444 residents of the Republic of Tatarstan, who filled out questionnaires that included clinical, anamnestic data and an epidemiological history in relation to COVID-19, who were tested for the presence of common antibodies (IgG, IgA and IgM) to the SARS coronavirus. CoV-2 by the method of enhanced chemiluminescence on the VITROS 3600 analyzer using the VITROS Anti-SARS-CoV-2 Total Reagent Pack test systems.Statistical processing was carried out by methods of variation statistics and correlation analysis according to the Pearson method using MS Excel and WinPepi.Results. Seropositivity to SARSCoV-2 in the population of the Republic of Tatarstan averaged 35.8 ± 0.235%. An increase in the level of seropositive persons was noted from 29.95 ± 0.674% in August to 68 ± 9.33% in December. The highest proportion of seropositive individuals was found in was found in the group of the able-bodied population aged 18–59 years. The average geometric titer of antibodies was 4.2 (4.09–4.31), among seropositive – 89.29 (88.13–90.46). In the social and professional structure of the population, the largest proportion of seropositive individuals was found in was found among production workers 40.35 ± 2.177, creative professions – 40 ± 9.798; health care 35.24 ± 0.389; 34.26 ± 1.218 unemployed and 33.06 ± 2.479 civil servants. Among the residents of the Republic of Tatarstan, seropositive to the SARS-CoV-2 virus, the proportion of asymptomatic forms of infection was 82.59 ± 0.446%.Сonclusions. There is a positive dynamics of seropositivity among the population of the Republic of Tatarstan. The results of sero-epidemiological monitoring can be used to predict the epidemiological situation, plan measures for specific and non-specific prophylaxis of COVID19.
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Bobyreva, N. S., Yana A. Korneeva, and G. N. Degteva. "Analysis of parasitological situation in nenets autonomous district." Hygiene and sanitation 95, no. 2 (October 28, 2019): 157–62. http://dx.doi.org/10.18821/0016-9900-2016-95-2-157-162.
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In the article there is presented an analysis of the own parasitological studies, as well as indices of the prevalence of parasitic diseases according to the official statistical reports of medical institutions, Service for Supervision of Consumer Rights Protection and Human Welfare in the Nenets Autonomous District (NAD) over the periodfrom 2002 to 2013. The survey on parasitoses was performed in the indigenous population - the Nenets reindeer herders and their families, as well as in the alien population residing in the territory of the NAD settlements: Varnek, Krasnoe, Karatayka, Nes, Haruta, Norey-Ver, Iskateley, village Oma, and city of Naryan-Mar. During this period, by means of the method of the native smear there were surveyed 5891 cases, method of Kato - 217,417 persons, by perianal scraping - 3054 persons, by ELISA for the presence of specific antibodies to the antigens of various parasites - 11556 cases. The statistical analysis was performed with the use of Statistical Software Package - Excel 2010. There were revealed both downward trends in the prevalence of the county's population for giardiasis, enterobiasis, diphyllobothriasis and the gain in indices of prevalence of ascariasis in the population of the District, also there were detected and found new types ofparasitoses for county - opisthorchiasis, toxocariasis in all age groups of the population of NAD.
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Taheri, Majid, Javad Nazari, Ali Arash Anoshirvani, Reza Aghabozorgi, Masoud Bahrami, and Amir Almasi Hashiani. "Incidence of Breast Cancer in Markazi, Iran, Population-based Cancer Registry Results." Open Public Health Journal 12, no. 1 (May 31, 2019): 228–31. http://dx.doi.org/10.2174/1874944501912010228.
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Background: Breast Cancer (BC) is the most prevalent malignancy and a significant cause of cancer deaths in females all around the world. BC includes 16 percent of all cancers. Objective: This study aimed at examining the epidemiology of BC in Markazi. Materials and Methods: This was an epidemiological study in which data resulted from the population-based cancer registry program in Markazi, Iran was used during the years 2010-2014. Data was recorded in Excel software and coded based on ICD-O and all duplicate reports were removed according to their unique codes. All cases out of Markazi were excluded from study and cases with code C-50 (all BC) were included in this study. SPSS ver.18 was used to analyze the data. Results: In this study, 1,254 new cases of BC in Markazi were included in the analysis. The highest cancer rate was reported in 2012 (319 cases). The highest crude rate of BC was reported in 2012 (45/100,000 people) and the lowest crude rate was reported in 2010 (26.2 /100,000 people). The Age-Specific Rates (ASR) of BC were 27, 37.3, 45.7, 39.8 and 31.5 per 100.000 people in 2010 to 2014, respectively. The highest ASR of BC was reported in 2012 (45.7/100,000 people) and the lowest ASR was reported in 2010 (27/100,000 people). Conclusion: The results showed similar incidence rate of BC in Markazi as compared to other provinces in Iran. Efficient approaches should be considered for cancer registry systems especially BC.
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Tomar, Shashi Prabha. "Cross-sectional Study on Sero-Prevalence of SARS-CoV-2 Infection in Jabalpur, Madhya Pradesh, India." Journal of Communicable Diseases 53, no. 01 (March 31, 2021): 82–88. http://dx.doi.org/10.24321/0019.5138.202114.
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Introduction: In India, laboratory diagnosis of SARS - CoV-2 infection has been mostly based on real-time reverse transcriptase polymerase chain reaction (RT-PCR). Studies have shown that Viral titres peak within the first week of symptoms, but may decline post this time frame, thereby hampering RT-PCR based diagnostic strategies. These reasons have prompted the call for adoption of antibody testing as a potential source of data to address the gap in data and inform public health and governance policies oriented towards COVID-19. Materials and Methods: A Cross-sectional study with a sample size of 9000 was conducted for 11 days (Dec 11-21, 2020) including all the 79 wards under Jabalpur Municipal Corporation. Serum samples were tested for the presence of specific antibodies to COVID19 using ICMR-Kavach IgG ELISA kits. The data collected was compiled on Microsoft Excel and data analysis was carried out using STATA 15E statistical software. Result: Overall seroprevalence of the study population was found to be 28.70% (weighted). Wards of the city of Jabalpur were classified into three categories based on the case prevalence - High (27 wards), Medium (26 wards) and Low (26 wards). Based on the overall seroprevalence, the estimated number of total infections were calculated to be 3, 54,870 for the study population. Overall Case Infection Ratio was 31.41. Conclusion: The current seroprevalence study rightly provides information on proportion of the population exposed, however, the correlation between presence and absence of antibodies is not a marker of total or partial immunity. Hence, the golden rule of Social distancing, sanitization, personal protective equipment and public health measures have to be continued.
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Jegnie, Mihretu, and Mekbeb Afework. "Prevalence of Self-Reported Work-Related Lower Back Pain and Its Associated Factors in Ethiopia: A Systematic Review and Meta-Analysis." Journal of Environmental and Public Health 2021 (September 23, 2021): 1–19. http://dx.doi.org/10.1155/2021/6633271.
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Introduction. Low back pain is the commonest musculoskeletal disorder affecting every socioeconomic group of the world’s population. The lifetime risk of developing low back pain is about 60%–80%. The pooled prevalence and associated factors of low back pain have not yet been determined in Ethiopia. Thus, this study was aimed at assessing the overall prevalence of low back pain and its associated factors in Ethiopia. Methods. A systematic search of PubMed, Scopus, Science Direct, and Google Scholar for observational studies reporting data on the prevalence and associated factors of low back pain was conducted. Relevant data were extracted with a standardized data extraction excel form. Stata 14 was employed for the meta-analysis. Heterogeneity was assessed by Cochran’s Q test and I2 values of a forest plot. Publication bias was checked using a funnel plot and Egger’s test. A random-effects model was used in the analysis. Result. A total of thirty-two studies were included for the systematic review. Twenty-four and sixteen studies were used to pool the overall low back pain prevalence and associated factors, respectively. The overall pooled annual prevalence of low back pain in Ethiopia was estimated to be 54.05% (95% CI: 48.14–59.96). Age, sex, body mass index, work experience, working hours, lack of safety training, awkward working posture, work shift, prolonged standing, lifting heavy objects, sleeping disturbance, history of back trauma, previous medical history of musculoskeletal disorder, and lack of adequate rest interval at work were significantly associated with low back pain. Conclusion. The current systematic review and meta-analysis revealed a higher prevalence of lower back pain in Ethiopia. Most of the low back pain epidemiological studies conducted in Ethiopia focused on specific occupational settings, making pooling of data and comparison with other countries challenging. Thus, further general population studies are recommended.
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Kolomin, Vladimir V., Natalya I. Latyshevskaya, Vladimir S. Rybkin, and Irina A. Kudryasheva. "Interregional analysis of the incidence as an instrument of improvement of the system of socio-hygienic monitoring." Hygiene and sanitation 100, no. 6 (June 28, 2021): 633–39. http://dx.doi.org/10.47470/0016-9900-2021-100-6-633-639.
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Introduction. The purpose of the study was to scientifically substantiate the unification of methods for analyzing the morbidity of the population, and comparative analysis of the morbidity of the child population at the interregional level within the framework of social and hygienic monitoring. Objective. The scientific substantiation of the feasibility of an inter-regional comparative analysis of the incidence of the population in the constituent entities of the Russian Federatio to increase the efficiency and effectiveness of management decisions developed as part of social and hygienic monitoring. Material and methods. A comparative analysis of the incidence in the regions of the Southern Federal District, the occurrence and development of which is associated with air pollution, was carried out. Statistical data processing was performed by linear regression using the Statgraphics and Microsoft Excel software packages. The calculation of the Pearson correlation coefficient r to evaluate the severity of the existing trend in the variation of the variation series and the determination coefficient (R2), taking into account the reliability coefficient p <0.05. Assessed approaches to the analysis of the incidence of children in the framework of socio-hygienic monitoring in the subjects. Results. The study revealed the lack of a unified approach to the analysis of the morbidity of the population in the constituent entities of the Russian Federation within the framework of socio-hygienic monitoring, both according to the criteria for determining the priority pathologies for the region, and the duration of the analyzed period. The comparative analysis of the morbidity of the child population at the interregional level showed a significant difference in the dynamics and levels of morbidity from ecologically caused pathologies in adjacent regions, with similar social and climatic parameters. The formation of human health takes place under the conditions of the multicomponent influence of various factors. The etiology of most of the nosological forms, the degree of their dependence on the state of the external environment have been scientifically established. The most determined by the components of the environment, ecologically caused pathologies, the nature of the incidence of which is considered by the authors as a possible manifestation of the impact of a specific factor that has a priority value in the occurrence and development of these diseases. Conclusions. The study shows the expediency of unifying methods for analyzing the incidence of the population, as well as conducting a comparative analysis of the incidence of the child population at the interregional level within the framework of socio-hygienic monitoring.
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Sharma, Nila, Elizabeth Harris, Jane Lloyd, Sabuj Kanti Mistry, and Mark Harris. "Community health workers involvement in preventative care in primary healthcare: a systematic scoping review." BMJ Open 9, no. 12 (December 2019): e031666. http://dx.doi.org/10.1136/bmjopen-2019-031666.
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ObjectivesTo review effective models of community health worker (CHW) involvement in preventive care for disadvantaged culturally and linguistically diverse (CALD) patients in primary healthcare (PHC) that may be applicable to the Australian context.DesignSystematic scoping review.Data sourcesThe studies were gathered through searching Medline, EMBASE, EMCARE, PsycINFO, CINAHL and online portals of relevant organisations.Eligibility criteriaAll selected studies were original research studies which essentially evaluated preventive intervention undertake by CHWs in PHC. The intervened population were adults with or without diagnosed chronic health disease, culturally and linguistically diverse, or vulnerable due to geographic, economic and/or cultural characteristics that impede or compromise their access to healthcare.Data extraction and synthesisData extraction was undertaken systematically in an excel spreadsheet while the findings were synthesised in a narrative manner. The quality appraisal of the selected studies was performed using effective public health practice project quality assessment tool.ResultsA total of 1066 articles were identified during the initial search of six bibliographic databases. After screening the title, abstract and full text, 37 articles met the selection and methodological criteria and underwent data extraction. A high-quality evidence-base supporting the positive impact of CHWs supporting patients’ access to healthcare and influencing positive behaviour change was found. Positive impacts of CHW interventions included improvements in clinical disease indicators, screening rates and behavioural change. Education-focused interventions were more effective in improving patient behaviour, whereas navigation interventions were most effective in improving access to services. Implementation was enhanced by cultural and linguistic congruence and specific training of CHWs in the intervention but reduced by short duration interventions, dropouts and poor adherence of patients.ConclusionThe evidence generated from this systematic scoping review demonstrates the contribution of CHWs to improving access to preventive care for patients from CALD and disadvantaged backgrounds by providing both education and navigational interventions. More research is needed on CHW training and the incorporation of CHWs into primary health care (PHC) teams.
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Niiazalieva, M. S., O. V. Tsvirkun, V. S. Toygombaeva, I. Sh Aldjambaeva, G. S. Ishenapysova, R. A. Frolov, and G. S. Dadanova. "The Characteristic of Measles Epidemic Process in Kyrgyz Republic." Epidemiology and Vaccinal Prevention 20, no. 4 (September 4, 2021): 79–88. http://dx.doi.org/10.31631/2073-3046-2021-20-4-79-88.
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Relevance. In the Kyrgyz Republic, the measles and rubella elimination program has been implemented in accordance with the strategy of the World Health Organization (WHO) for 20 years, which uses a two-fold immunization tactic against measles at the age of 12 months and 6 years, which is complemented by clean-up campaigns. Despite the high coverage of vaccinations with both the first and second doses, there are epidemic rises in infection, reaching in 2018 (15.9), 2019 (36.4) and 2020 (11.2) per one hundred thousand population. In the years of recent epidemic ups, a high incidence among young children revealed. The epidemiological situation with measles that has developed in recent years has made it necessary to study the state of specific measles immunity in different age groups, to determine the vulnerable population group and assess the quality of vaccination work.The aim of the work: to assess the epidemic process of measles at the present stage and the state of specific immunity in the population of the Kyrgyz Republic to identify groups at high risk of infection.Materials and methods. In the course of the work, descriptive-evaluative and analytical epidemiological research methods are used. The materials are statistical reporting data on the incidence of measles from 1987 to 2020 and 568 blood serum samples taken from residents of Bishkek and Jalal-Abat region in the following indicator age groups: 1-4 years old n = 122; 5-9 years old n = 108; 10-14 years old n = 114; 15-19 years old n = 77; 20-29 years old n = 103; 30 years and older n = 44. The level of anti-measles antibodies is determined by enzymelinked immunosorbent assay (ELISA) using the VectorMeasles-IgG test system manufactured by VEKTOR BEST, Russia. The method of retrospective analysis of the incidence of measles in the Kyrgyz Republic in long-term dynamics, by age groups, according to vaccination history is used. The method of retrospective analysis of the incidence of measles in the Kyrgyz Republic in longterm dynamics, by age groups, according to vaccination history is used. The data obtained statistically processed using the Excel program. The critical level of significance is p = 0.05. Descriptive statistics – mean and standard error of the mean (data are presented as M ± m) for quantitative variables, for qualitative variables – determination of proportion.Results and Discussions. The introduction of specific prophylaxis of measles led to decrease the incidence of measles, 15 times on average, mortality also decreased, however, despite the effectiveness of vaccination, cyclical increases in infection persisted, seasonality in intra-annual dynamics, school-age children began to get sick more often. To change the situation, including in order eliminating primary postvaccination failures, in 1986 a second dose of vaccine introduced into the vaccination schedule for children 6 years old, which led to decrease the incidence to single case and in some years to the complete absence of measles cases. However, in 2018, the importation of measles from bordering countries led to an epidemic outbreak with the number of cases of 1004. The incidence rate increased from 0.1 in 2017 to 15.9 per 100 thousand population in 2018. At the subnational level, a clean-up campaign carried out among children aged two to five years. However, due to the lack of vaccine, the target group covered less than 50% and the increase in the incidence of measles in 2019 continued to 2377 people (36.4 per 100 thousand population). A slight decrease in the incidence of measles outlined in 2020, when 733 cases were registered. The highest percentage of cases is among children under one year old, 43.3% (2019) and 52.7% (2020), who are not vaccinated by age. In second place in importance is the age group of children from one to four years old, an extensive incidence rate is 29.5% (2019) and 39.3% (2020). The data of serological studies confirmed the formation of a high-risk group for measles infection among preschool children, where the proportion of seronegatives is 36%; this is probably due to not post-vaccination failures, but rather to a high proportion of children who are not vaccinated for various reasons. This hypothesis confirmed by the high percentage of unvaccinated children of this age in the structure of the sickindividuals. All this casts doubt on the official data on the coverage of children of this age with preventive vaccinations (95.7%) and indicates the accumulation of contingents susceptible to measles. The results of our research are consistent with the data obtained by other researchers.Conclusion. The analysis showed the need for regular monitoring of the organization of the vaccination work to control the reliable accounting of the child contingent needed to immunization, based on the population census, as well as to identify the validity of medical withdrawals. To prevent the growth of refusals from vaccinations, it is advisable to expand the forms of work with the population to develop commitment to vaccination. We believe that in combination, this will increase the real coverage of measles vaccinations for children, reduce the number of sources of infection and indirectly reduce the risk of infection in children of the first year of life.
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Togni, Bianca, Thiago Dantas Soares Pinto, Lívia Marcela dos Santos, Verônica Oka Barancoski, and Rebeca Sewing de Paula. "ODP437 Assement of the behavior of the transgender population in the face of social isolation due to COVID-19." Journal of the Endocrine Society 6, Supplement_1 (November 1, 2022): A672. http://dx.doi.org/10.1210/jendso/bvac150.1390.
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Abstract Introduction During the pandemic caused by SARS-COVID-19, the transgender population faced difficulties in accessing health care. Proposal: The objective of this study was to understand the health condition of the transgender population. Justification: From the literature review, it was noted that there are few studies about the transsexual population in general and regarding their behavior during social isolation. For this reason, it was proposed to carry out a study capable of identifying the profile of the transsexual population and its main challenges during social isolation due to the COVID-19 pandemic. By identifying the profile and its main difficulties, more effective actions with 'individualized care' can be suggested for this specific audience in order to improve the confrontation during social isolation. In addition, new studies on this population may emerge, this being a future contributor to comparisons, increasing the visibility of the transsexual public. Kind of study: Cross-sectional, exploratory, quantitative study. Study Population: The population of this study will be composed of people who consider themselves Brazilian transgender. The sample will be defined by convenience, according to the participants’ availability to be part of the research, according to the following inclusion criteria: self-declared transgender, living during the pandemic period in Brazil and voluntarily accepting to participate. Methods To characterize the behavior of this population, we conducted an online questionnaire, with the approval of the ethics committee number 36186620.1. 0000. 0062. Data analysis: The information obtained will be stored in the Microsoft Excel 2010® application software and, later, will be analyzed by the Statistical Package for Social Sciences (SPSSR)® software for Windows, Chicago, United States, considering a significance level of 5% (p< 0). . 05) for the statistical tests. Descriptive analysis will be performed by calculating absolute and relative frequencies. Results We have 54 participants. 66% are transgender men and 30% are transgender women. The average age was between 25 and 40 years. 43% did not undergo gender surgery and do not want to. During the pandemic, 83% of those undergoing hormone treatments continued even during the isolation phase, of those who did not continue, the majority was due not having access to appointments or medication. Of those, their mood was observed to worsen during the period of social isolation. 48% had a diagnosis of altered mental health prior to the pandemic. Only 22% managed to maintain psychological monitoring in this period. 18% had suicidal ideation before and during the pandemic. Everyone who answered the questionnaire took at least 1 dose of vaccine. 18% did not keep studying or working and 57% reported a decrease in family income. Conclusion In this population sample of transgender people in Brazil, the majority maintained hormonal treatment, but not mental health monitoring. Family income declined during the pandemic period. Presentation: No date and time listed
Dissertations / Theses on the topic "Public health (excl. specific population health)"
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Gan, Cai Ru. "Future-proofing Hospitals Against Disasters in a Changing Climate: Opportunities and Strategies for Health Promoting Hospitals." Thesis, Griffith University, 2022. http://hdl.handle.net/10072/413313.
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Considerable scientific evidence showing climate change will amplify disasters and cause adverse health impacts. If not mitigated, climate change will push health systems beyond their limits and capacity. The projected trend of increasing climaterelated disasters will intensify existing health risks arising from more frequent and severe extreme weather events like floods, bushfires, poor air and water quality, and emerging and re-emerging infectious diseases. This incidents place enormous demands on the future of the healthcare sector, especially on hospitals. To prepare for and deal with the immense challenges ahead, hospitals need to incorporate climate change adaptation (CCA)1 strategies into planning for disaster risk reduction (DRR)2. It is, thus, timely to investigate the feasibility of and pathways to future-poof hospitals against disasters in a changing climate. Hospitals are no stranger to climate change as an issue. They are at the forefront of addressing the health impacts of disasters, treating the illnesses and injuries caused by them, and upholding critical response roles during and after disasters. This role will continue to expand as hospitals struggle to cope with the additional demands of climate change-related disasters. Many hospitals have in place their own emergency response procedures, but little information is available in terms of the extent of how they have incorporated CCA measures into their risk management plans. While hospitals are affected by climate change there is also the reality that they are in part responsible for accelerating climate change. Studies estimate that the healthcare sector is responsible for approximately 4.4% of anthropogenic greenhouse gas emissions. Therefore, it is important therefore for healthcare to start shifting to renewable and reliable energy sources and adopt environmentally responsible waste management practices. The problem remains to facilitate this; it would require leadership commitment, and full participation of other healthcare sector stakeholders. The organisation Health Promoting Hospitals Network (HPH), with members worldwide, promotes an integrative, eco-friendly partnership approach to improving hospital practices. The HPH is well-suited to leading the way to integrate DRR and CCA to future-proof hospitals, making it an ideal partner for this research. Among its network members, Taiwan, with its extensive HPH network and supportive government policies, was chosen for this study. Therefore, this study aims to examine opportunities and strategies for developing HPH’s work in Taiwan ensuring that hospitals are geared towards being future-proof against disasters brought about by climate change. The research began with an extensive critical literature review and then applied quantitative and qualitative methods to conduct a case study on Taiwan’s Health Promoting Hospitals. The study adopted the participatory action research (AR) approach, commonly used in health promoting settings, because it enables participants to develop strategies and actions for change and improve knowledge, strategies, and actions in the process. Overall, the study found that the AR process enabled HPH participants to lead the climate movement in the healthcare sector in Taiwan. This has led Taiwan’s health promoting hospitals to transform towards a sustainable future. Using the AR process, key challenges to effectively implement DRR and CCA efforts were identified, and it was determined that these issues could be addressed through standards that regulate hospitals. Therefore, the researchers and partners created and advocated for a new climate action standard under Taiwan’s Healthy Hospitals 2.0 Accreditation Program. As the study was being conducted, the whole world was affected by the COVID-19 and soon after a pandemic was announced. This led to the AR to modify its priorities in response to emergency needs. The result is the co-design of eco-friendly measures that could ensure healthcare workers’ protection and safety and to make healthcare reduce hazardous waste given that the pandemic has produced many unintentional health care wastes in the process of battling the virus. The research and its findings first synthesise the literature on the rationale for linking CCA and DRR in the hospital sector to inform health authorities and hospital decisionmakers on the need to incorporate these into future action plans. Second, it identifies useful indicators and strategies to guide climate action for building future-proof hospitals, especially in Taiwan. Third, it addresses organisational changes and ways HPH networks could advocate for and facilitate these changes, including strategies to leverage that hospital accreditation scheme to enhance adherence. Finally, the research adds to the evidence that HPHs can use participatory AR to deal with complex issues to better prepare for the future. This is not only timely but has practical implications for other settings-based health promotion movements such as Healthy Cities, Workplaces, and Health-Promoting Schools to help them integrate CCA and DRR into their future action plans in the pursuit of sustainable development.Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School of Medicine & Dentistry
Griffith Health
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Chu, Yue. "SVD-BAYES: A SINGULAR VALUE DECOMPOSITION-BASED APPROACH UNDER BAYESIAN FRAMEWORK FOR INDIRECT ESTIMATION OF AGE-SPECIFIC FERTILITY AND MORTALITY." The Ohio State University, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=osu1609638415015896.
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Crevecoeur, Thamarah. "Developing culturally specific, patient-centered maternity care models for high-risk immigrant populations: recommendations from a study of the Haitian population at Boston Medical Center." Thesis, 2021. https://hdl.handle.net/2144/42585.
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BACKGROUND: Haitian women in Massachusetts experience higher than average rates of low birth weight, C-section and inadequate prenatal care. Given the disparities in Black maternal health in the U.S., creative and innovative care models are necessary to improve outcomes. Culturally specific care models have been found to improve satisfaction and uptake of prenatal care among immigrants. A mixed methods case study was conducted at Boston Medical Center with the aims of describing maternal health outcomes of Haitian women, understanding Haitian women’s experiences and barriers to care and the feasibility of culturally specific maternity care models.
METHODS: Electronic medical records were used to obtain and analyze retrospective data about patients’ socio-economic factors, baseline health maternity characteristics, maternity care utilization characteristics, perinatal complications and obstetrical outcomes stratified by ethnicity from 2015-2019. Chi square analysis was performed to measure statistical significance. Four focus groups and three in-depth interviews were performed with Haitian pregnant and postpartum women (n=25). Key informant interviews (n=14) were conducted with hospital clinical providers and clinical program directors. The 3 delays model, respectful maternal care and cultural competence frameworks were applied, using Nvivo for coding and organizing emerging themes.
RESULTS: Haitian women demonstrate significantly higher than average proportions of advanced maternal age {40.9 %; (<.001)}, obesity {43.8.8%; (<.001)}; delayed entry to prenatal care {49.5; (.007)}; and pre-eclampsia {7.0%; (.001)}. Inadequate access to insurance and transportation contributed to delays in accessing care. Disrespectful and poor coordination of care negatively affected Haitian women’s experience and perceived quality of care. Haitian women desired culturally competent, personalized heath care services. Barriers to cultural competence and the development of culturally specific care models include lack of staff diversity, finances, health care structural design and lack of training.
CONCLUSION: Haitian women may benefit from additional social resources and culturally specific, tailored health programs such as group prenatal care. Recommendations to improve cultural competence include diversifying the workforce, collecting data on racial and ethnic disparities, and trainings to integrate culturally competent principles into clinical practice. Additional research needs include design, implementation and evaluation of culturally specific tailored maternal health interventions with the Haitian population.
Books on the topic "Public health (excl. specific population health)"
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Wright, Lauri, and Melody Chavez. Public Health Nutrition. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190238308.003.0009.
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The importance of nutrition and the prevention of illness and disease in public health has long been recognized and encouraged in the United States. These issues are now being recognized as key opportunities for pharmacists to engage in improving individual and population health as the Accreditation Council for Pharmacy Education Standards 2016 report emphasizes the importance of patient-centered care, health and wellness, and population-based care. This chapter starts with an overview of nutritional needs throughout the lifespan. It then discusses specific strategies and programs pharmacists can refer to in order to support healthy lifestyles and public health prevention strategies focused on nutrition.
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Levy, Barry S., ed. Social Injustice and Public Health. Oxford University Press, 2019. http://dx.doi.org/10.1093/oso/9780190914653.001.0001.
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The third edition of Social Injustice and Public Health provides a comprehensive, up-to-date resource on the relationship of social injustice to the broad field of public health. It includes 29 chapters and many text boxes on a wide range of relevant issues written by 78 contributors who are expert in their respective areas of work. The book includes many descriptions of social injustice and its adverse effects on health, supplemented with many tables, graphs, photographs, and case examples—and many recommendations on what needs to be done to address social injustice. Social Injustice and Public Health is divided into four parts. Part I describes the nature of social injustice and its overall impact on public health. Part II describes how the health of specific population groups is affected by social injustice. Part III describes how social injustice adversely impacts various aspects of health, such as infectious diseases, nutrition, noncommunicable diseases, mental health, and violence. Part IV broadly addresses what needs to be done, from a variety of perspectives, ranging from addressing social injustice in a human rights context, to strengthening communities, to promoting equitable and sustainable human development.
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Detels, Roger, Martin Gulliford, Quarraisha Abdool Karim, and Chorh Chuan Tan, eds. Oxford Textbook of Global Public Health. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199661756.001.0001.
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The Oxford Textbook of Global Public Health is the ultimate resource on the subject of public health and epidemiology. It has been thoroughly revised and updated, offering a global and comprehensive perspective on wide-ranging public health needs and priorities in modern health care. It is divided into three areas: 'The Scope of Public Health' discusses the development of the discipline, determinants of health and disease, public health policies, and law and ethics; 'The Methods of Public Health' covers the main science behind the discipline – epidemiology; 'The Practice of Public Health' examines specific public health problems and the options for prevention and control. As well as identifying these issues by system or disease, there is also an awareness of the unique needs of particular population groups. This sixth edition also includes new topics, including climate change, genetic testing and epidemiology; new methods for measuring the burden of disease; life course approaches to epidemiology, behavioural economics; and physical activity, health and wellbeing.
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Public Health Policies on Psychoactive Substance Use: A Manual for Health Planners. Pan American Health Organization, 2021. http://dx.doi.org/10.37774/9789275123508.
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The use of psychoactive substances has various social and health consequences. These can be addressed from the field of health and social welfare through policies formulated by government agencies in accordance with their specific mandates. An explicit policy on health and psychoactive substance use allows the development of the necessary responses to protect and promote the right to health of the population as it relates to this complex problem. This manual is an instrumental tool based on policy analysis techniques and methods developed with the purpose of facilitating the application of public health principles to define responses to problems associated with psychoactive substance use. To this end, the manual contains examples and exercises that illustrate the various phases of the planning process and can be used in workshops and other training activities. It is intended for those responsible for formulating, implementing, and evaluating policies, plans, and programs aimed at reducing the consequences of psychoactive substance use on collective health, from government health agencies and other relevant sectors to civil society.
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Sahay, Sundeep, T. Sundararaman, and Jørn Braa. Understanding Public Health Informatics in Context of Health in Low and Middle-Income Countries. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198758778.003.0002.
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This chapter places public health informatics within a public health context. An understanding of PHI must be built on the perspective of public health as the health of populations. In LMICs it is closely related to an understanding of the primary healthcare approach, and the role and functions of public health systems, including the measurement of health status and equity, the effective coverage of different health programmes, and the utilization of different health services. This requires an understanding of the social and environmental determinants of healthcare, which need relevant data from other sectors as well. The architecture and development of public health informatics varies across nations and is path-dependent and context-specific. Many have evolved as monitoring support to externally financed vertical programmes, some as support for comprehensive primary health programmes and some from support systems for health insurance. The current information needs of health systems, transcends their respective origins, and requires both individual-based clinical information and aggregate population-based data.
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Mastroianni, Anna C., Jeffrey P. Kahn, and Nancy E. Kass, eds. The Oxford Handbook of Public Health Ethics. Oxford University Press, 2019. http://dx.doi.org/10.1093/oxfordhb/9780190245191.001.0001.
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Public health is fundamentally concerned with promoting the health of populations through the prevention of disease and injury. It is, at its core, a moral endeavor, because the end it seeks is the advancement of human well-being. Vexing ethics issues are inherent in all aspects of public health practice and policy. They exist in top-of-the-news stories like infectious disease outbreaks and vaccine hesitancy, health disparities, and in more routine assessments of population health needs, data collection, program evaluation, and policy development. They may be distinctive or shared across diverse fields, such as environmental health, nutrition programs and policy, injury prevention, communicable and noncommunicable diseases, and reproductive health. This volume represents the first comprehensive examination of public health ethics in the United States and globally. The volume editors recruited top public health professionals, policy experts, and scholars in public health and ethics fields to offer varied perspectives on the diversity of the issues that define public health ethics. The volume begins with two sections examining the crosscutting conceptual foundations, ethical tensions, and ethical frameworks of and for public health and how public health does its work. It then proceeds topically, with thirteen sections analyzing the application of public health ethics considerations and approaches across the broad range of subject areas. While the fifteen sections can serve to orient the reader within a specific field, each of the more than seventy chapters is designed to serve as a stand-alone contribution. The approach makes the book, its sections, and individual chapters useful as part of course materials, as well as a seminal reference for students, scholars, and public health professionals.
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Ghebrehewet, Samuel, Alex G. Stewart, David Baxter, Paul Shears, David Conrad, and Merav Kliner, eds. Health Protection. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198745471.001.0001.
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This book is an accessible and practical core text on the three domains of health protection: Communicable Disease Control, Emergency Preparedness Resilience and Response (EPRR), and protection of the public from environmental hazards (Environmental Public Health). The editors have attempted to develop an “all hazards approach” to dealing with health protection situations. Most health protection books confine themselves to one of the three domains, whereas this book presents a practical and all hazards approach, with some account of the overarching principles of health protection on which day-to-day practice rests. The target audience is health protection practitioners, students, doctors, nurses and other non-medical professionals who may encounter health protection issues in their daily practice. From a clear introduction to the essential principles of health protection work, the book guides readers through how to manage real health protection incidents using a combination of case studies and quick reference action checklists. Each case study provides a common health protection scenario which develops in stages, in the same way as a real-life case or incident. As the story unfolds, the reader will learn about the nature and significance of the specific threat to population health, the practical steps and issues involved in an effective public health response and the health protection principles underpinning that response. Other chapters outline the general principles of health protection, providing a deeper understanding of key tools and mechanisms, as well as insights into new and emerging health protection issues. A series of individual checklists dealing with a broad range of commonly-faced diseases, hazards and incidents complete the book. These give concise and practically-focused information that can be used even by non-specialists in time-pressured situations. In particular, the variety of chapters covered throughout the book, on Communicable Diseases, Emergency Preparedness Resilience and Response, and Environmental Public Health, offer a unique perspective borne out of practical experience, not easily accessible elsewhere.
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Macnab, Andrew J., Abdallah Daar, and Christoff Pauw, eds. Health in Transition: Translating developmental origins of health and disease science to improve future health in Africa. African Sun Media, 2020. http://dx.doi.org/10.18820/9781928357759.
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At STIAS, the ‘Health in Transition’ theme includes a programme to address the epidemic rise in the incidence of non-communicable diseases (NCDs) such as Type 2 diabetes, hypertension, obesity, coronary heart disease and stroke in Africa. The aim is to advance awareness, research capacity and knowledge translation of science related to the Developmental Origins of Health and Disease (DOHaD) as a means of preventing NCDs in future generations. Application of DOHaD science is a promising avenue for prevention, as this field is identifying how health and nutrition from conception through the first 1 000 days of life can dramatically impact a developing individual’s future life course, and specifically predicate whether or not they are programmed in infancy to develop NCDs in later life. Prevention of NCDs is an essential strategy as, if unchecked, the burden of caring for a growing and ageing population with these diseases threatens to consume entire health budgets, as well as negatively impact the quality of life of millions. Africa in particular needs specific, focussed endeavors to realize the maximal preventive potential of DOHaD science, and a means of generating governmental and public awareness about the links between health in infancy and disease in adult life. This volume summarizes the expertise and experience of a leading group of international scientists led by Abdallah Daar brought together at STIAS as part of the ‘Health in Transition’ programme.
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Popeo, Dennis. The Elderly. Edited by Hunter L. McQuistion. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190610999.003.0014.
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Every day, approximately 20,000 Americans turn age 65 years. If the current prevalence of mental illness and substance abuse continues, in 2040 more than 15 million adults older than age 65 years will need services that are specifically tailored to older adults. As it is, the current population of older adults is underserved—a service gap to which public psychiatrists must respond. By presenting one representative case, this chapter addresses some of the specific needs of this cohort of patients, including complex and comorbid health issues, cognitive impairment, caregiver burden, elder abuse, and the unfortunate prevalence of homelessness among the elderly. Age-appropriate mental health treatment is discussed, with the goal of educating mental health practitioners to better serve this diverse and heterogeneous population.
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Parks, Courtney A., Eric E. Calloway, Teresa M. Smith, and Amy L. Yaroh. Policy Efforts Supporting Healthy Diets for Adults and Children. Oxford University Press, 2018. http://dx.doi.org/10.1093/oso/9780190626686.003.0006.
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Policy-level influences are impactful strategies to improve dietary behaviors, with the ability to strengthen food environments and with a broad population-level effect. Policies can alter the “choice architecture,” which may lead individuals to make healthier decisions by means of making the healthier option the default option. Policy levers such as taxation and regulation of businesses that influence the food environment are mechanisms through which positive change can be made. Specific legislation discussed in this chapter includes the Healthy Hunger Free Kids Act of 2010, the farm bill, and more recent proposals such as sugar-sweetened beverage taxation and labeling of genetically modified organisms. Finally, this chapter outlines ideas for how public health professionals can get involved and influence the political process.
Book chapters on the topic "Public health (excl. specific population health)"
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Streetly, Allison, and Nehmat Houssami. "Population screening." In Healthcare Public Health, 172–86. Oxford University Press, 2020. http://dx.doi.org/10.1093/oso/9780198837206.003.0014.
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This chapter outlines the concept and definition of population screening. It identifies key challenges and considerations in converting the simple concept of early identification of disease into population screening programmes. Ethical considerations are important in evaluating the potential benefits and harms of screening programmes. These inform the criteria used to determine whether it is appropriate to introduce screening. Screening tests must usually be sensitive to maintain public confidence in a screening programme, but specific tests are also required because false positives may often outnumber true positives in a population screening context. Assessment of screening programme effectiveness usually requires randomized controlled trials that minimize the potential effects of lead time and length bias. The chapter concludes by discussing policy decisions involving starting, stopping, and changing programmes, as well as how screening programme performance can be measured.
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Sinha, Samir K., and Brittany Ellis. "Health of older people." In Oxford Textbook of Global Public Health, edited by Roger Detels, Quarraisha Abdool Karim, Fran Baum, Liming Li, and Alastair H. Leyland, 507–22. Oxford University Press, 2021. http://dx.doi.org/10.1093/med/9780198816805.003.0091.
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Declines in mortality and fertility have largely contributed to population ageing and an accompanying epidemiological transition from infectious to chronic diseases. Significant improvements in life expectancy have occurred overall, although these have not been equally distributed between socioeconomic groups or across countries. Ageing is associated with increased health and social care needs due to the increased risk and prevalence of chronic diseases, dementia, multimorbidity, and disability that demand different types of and approaches to care. Older people benefit from a wide range of preventive interventions that reduce morbidity earlier in life, and prevent disability later on, as well as gerontological and geriatric expertise related to the delivery of care, support, and services to meet their unique needs. This chapter considers the phenomenon of population ageing, the unique health needs of older people, and specific approaches to providing health and social care to them.
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Cairney, Paul, and Emily St Denny. "Prevention Policy and Public Health." In Why Isn't Government Policy More Preventive?, 137–54. Oxford University Press, 2020. http://dx.doi.org/10.1093/oso/9780198793298.003.0007.
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Health policy is the traditional home of prevention policies. Public health is at the heart of policies designed to improve population health, and perhaps reduce health inequalities, often through changes in behaviour at an early age. Public health policy tends to be a hub for advocates of EBPM. In theory, healthcare and public health are symbiotic, particularly if early public health interventions reduce demand for acute healthcare. However, in practice, public health is an exemplar of the wide gap between expectations for ‘evidence-based’ prevention policy and actual outcomes. To demonstrate, first, we apply our theoretical approach, outlined in Chapters 1 to 3, to present a broad examination of health policy and the role of prevention within it, considering what a window of opportunity for prevention policy within a complex system means in relation to health and public health policy. Second, we show that the UK and Scottish governments have described different policy styles, but faced and addressed the ambiguity and complexity of preventive health policy in similar ways. Third, our comparison of broad prevention versus specific tobacco policies shows why substantive policy change is more apparent in the latter: there is a clearer definition of the policy problem, a more supportive environment for meaningful policy change, and more windows of opportunity for specific policy changes. These three conditions are not yet fulfilled in the broader prevention agenda.
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Ng, Roger M. K., and Che Kin Lee. "Psychological intervention as a measure for promoting public mental health." In Oxford Textbook of Public Mental Health, edited by Dinesh Bhugra, Kamaldeep Bhui, Samuel Y. S. Wong, and Stephen E. Gilman, 431–40. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198792994.003.0046.
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The chapter reviews the evidence base of brief psychological interventions for the treatment of common mental disorders and substance misuse delivered by primary care sector and lay health counsellors. The efficacy and acceptability of different modalities of delivery of such brief psychological interventions are also examined. The chapter also reviews the controversy of psychological interventions for primary prevention of common mental disorders and substance misuse when applied universally. Finally, the chapter examines the efficacy and acceptability of brief psychological interventions to target people with subclinical symptoms and specific population groups vulnerable to developing mental disorders. The chapter concludes with suggestions on the future direction of the content and mode of delivery of psychological interventions so as to enhance their accessibility and acceptability by potential users.
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Tennis, Gary, Kenneth J. Martz, and Jac A. Charlier. "Public Health and the Criminal Justice System." In A Public Health Guide to Ending the Opioid Epidemic, 225–40. Oxford University Press, 2019. http://dx.doi.org/10.1093/oso/9780190056810.003.0019.
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Approximately two-thirds of America’s incarcerated population suffers with untreated or undertreated substance use disorders, and many of those individuals commit several crimes related to drug use and addiction on a daily basis prior to being incarcerated. To end the opioid epidemic in the United States we not only need to bolster our health care and public health response to substance use disorders, we need to engage the criminal justice system as a specific touchpoint for public health intervention in communities and states across the country. The principal argument in the chapter is that while individuals with opioid and/or other substance use disorders should get treatment before ever being involved in crime—if they are justice-involved, it is imperative that the criminal justice system serve as a belated but necessary public health and health care intervention supportive of treatment, recovery, and prevention of addiction.
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Torales, Julio, and Israel Gonzalez-Urbieta. "Homelessness and mental health in Paraguay." In Homelessness and Mental Health, edited by João Mauricio Castaldelli-Maia, Antonio Ventriglio, and Dinesh Bhugra, 83–88. Oxford University Press, 2021. http://dx.doi.org/10.1093/med/9780198842668.003.0007.
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Homeless people constitute a vulnerable population in terms of mental health issues. Homelessness and inadequate housing are very prevalent conditions in Paraguay and this constitutes a major barrier for delivering healthcare, particularly in mental health, for this group. There are currently no public policy programmes aimed at meeting the specific needs of this group. Many steps can be taken to improve the mental health and the quality of life of these at-risk population. This chapter summarizes the current situation of homelessness in Paraguay, the barriers and the state of the access to mental health services for homeless people in the country. It also proposes various practical interventions that can constitute a way forward to enhance the living conditions of this vulnerable group of people.
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de Leeuw, Evelyne, Erik Martin, and Temo Waqanivalu. "Healthy Islands." In Oxford Textbook of Nature and Public Health, edited by Matilda van den Bosch and William Bird, 285–90. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198725916.003.0021.
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Small Island Developing States (SIDS) form a special setting where nature and (population) health become intimately connected. This chapter outlines the nature of such small states, their development and health challenges, and a common health solution that has been advanced in the Pacific. The Yanuca Declaration established a Healthy Island programme in 1995. It is a specific example of a ‘healthy settings’ approach (Nutbeam, 1996). Healthy Islands form an integrated element of the Pacific development agenda and explicitly pursue a comprehensive agenda at the interface of nature, health, and development. Examples of this agenda are provided in two case studies. First, the WHO-led ‘Healthy Island Recognition’ programme, and second, the commitments among Pacific islands to the Framework Convention on Tobacco Control.
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Robèrt, Karl-Henrik, Michael T. Hernke, Luke Fortney, and Rian J. Podein. "Systems thinking for global health and strategic sustainable development." In Oxford Textbook of Nature and Public Health, edited by Matilda van den Bosch and William Bird, 26–32. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198725916.003.0032.
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Population health can be considered the ultimate goal of sustainability. The planetary system, with its boundaries and constraints for civilization, is the necessary starting point for a systems perspective sufficiently broad to operationalize sustainability and advance global health. Both detailed scientific information and the basic aetiology of unsustainability are needed to inform specific strategies, and tools, to resolve current and potentially unrecognized nature–health problems. The Framework for Strategic Sustainable Development (FSSD) operationalizes sustainable development from a long-term, global perspective. It provides a thorough understanding of humans’ dependence on sustainable development, and utilizes scientifically robust, operational principles of social and ecological sustainability. The principles address the fundamental mechanisms that underpin health, enabling a backcasting approach—that is, ‘looking back’ from a robust idea of sustainability in the future, and then innovating smart transition routes to systematically pursue global health.
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Marilyn, Weaver Lewis, Wu Liyun, and Allan Hagen Zachary. "How Understanding the Nervous System Can Benefit Mental Health Clinicians." In STEM-H for Mental Health Clinicians, 10—C2P33. Oxford University PressNew York, 2023. http://dx.doi.org/10.1093/oso/9780197638514.003.0002.
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Abstract STEM-H for Mental Health Clinicians, Chapter 2, introduces the development of the nervous system, the structure and function of the central and peripheral nervous system (CNS and PNS, respectively), and specific brain areas in regard to STEM-H (science, technology, engineering, and mathematics as applied to health). Meningitis is introduced as the signature illness and discussed in terms of its association with poverty. Traumatic brain injury (TBI) is highlighted as the signature injury. Technological and engineering advances that treat TBIs are presented, including hyperbaric oxygen treatment and medications to reduce swelling of the brain after trauma. Epidemiological data that inform public health professionals are introduced that describe how to determine which population is at risk for illness or injuries. Caregiver burden, as it affects health of a patient and their family, is presented.
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Laraque, Fabienne, and Omolara Thomas Uwemedimo. "Epidemiology and Social Determinants of Global Health as the Basis for Education and Research." In Principles of Global Child Health: Education and Research, 61–80. American Academy of Pediatrics, 2018. http://dx.doi.org/10.1542/9781610021906-part01-ch04.
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This chapter describes the importance of using standard data for decision-making at local and national levels on reportable diseases and conditions of public health significance. In addition, the chapter will provide an overview of the use of data to monitor interventions and detect outbreaks and emerging conditions. Lastly, this chapter will cover the importance of data, data sources, key indicators of childhood health, the role of millennium and sustainable goals, and training needs. In all health care settings, whether population based or institution specific, the importance of effective use of data for planning and monitoring cannot be overstated. Implementing interventions and programs, even those that are evidence based, without the benefit of a local needs assessment and continuous data monitoring may not succeed due to erroneous targeting and inability to monitor progress. To ensure that public health and clinical programs are targeted to the setting and population in which they will be implemented, standard data collection and analysis is critical. The use of standard indicators allows for comparison across countries or regions.
Conference papers on the topic "Public health (excl. specific population health)"
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"Maternal health seeking behaviors and health care utilization in Pakistan." In International Conference on Public Health and Humanitarian Action. International Federation of Medical Students' Associations - Jordan, 2022. http://dx.doi.org/10.56950/xzpo9700.
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Background: Direct estimations of maternal mortality were carried out in Pakistan for the first time. Maternal health and health issues, maternal mortality and the specific causes of death among women must be studied to improve the health care of women and better utilization of maternal health services for better public health. Objective: The main objectives of this study are to analyze maternal health, morbidity and mortality indicators. The causes of death and health care utilization will be highlighted, hence, useful recommendations can be made to reduce maternal deaths and to attain the Sustainable Development Goal 3.1. Method: Utilizing the data of Pakistan Maternal Mortality Survey 2019, crosstabs and frequency tables are constructed and multivariant analysis was conducted to find out the most effective factors contributing to the deaths. IBM SPSS and STATA were used for the analysis. Results and Conclusion: 40% population surveyed was under 15, age 65 or above. Average household members were 6-7. Drinking water facility was majorly improved in both urban and rural areas. Hospital services in rural areas were mostly (54%) in the parameter of 10+ kms and Basic Health Units were mainly found inside the community. Very few urban households were in the poorest quantile while very few rural households were in the wealthiest quantile. Women education distribution showed that a high percentage of women (52%) were uneducated and only a 12% had received higher education. Maternal mortality ratio (MMR) for the 3-year period before the survey was 186 deaths per 100,000 live births while pregnancy related mortality rate was 251 deaths per 100,000 live births, which was higher compared to the MMR. Maternal death causes were divided into direct and indirect causes, where major causes were reported to be obstetric Hemorrhage (41%), Hypertensive disorders (29%), Pregnancy with abortive outcome (10%), other obstetric pregnancy related infection (6%) and non-obstetric (4%). 37% women who died in the three years before the survey sought medical care at a public sector health facility while 26% at private sector and 5% at home. A majority (90%) of women who had pregnancy complications in the 3 years before the survey received ANC from a skilled provider. Keywords: Maternal health, antenatal care, maternal mortality rates, pregnancy related diseases
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Tong, TYN, PN Appleby, MEG Armstrong, GK Fensom, A. Knuppel, K. Papier, A. Perez-Cornago, RC Travis, and TJ Key. "P16 Vegetarian diets and risks of total and site-specific fractures: results from the prospective EPIC-Oxford study." In Society for Social Medicine and Population Health Annual Scientific Meeting 2020, Hosted online by the Society for Social Medicine & Population Health and University of Cambridge Public Health, 9–11 September 2020. BMJ Publishing Group Ltd, 2020. http://dx.doi.org/10.1136/jech-2020-ssmabstracts.112.
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O’Neill, KN, E. Aubrey, and LM O’Keeffe. "OP25 The sex-specific association between mitochondrial DNA haplogroups and trajectories of cardiometabolic risk factors during childhood and adolescence: a prospective cohort study." In Society for Social Medicine and Population Health Annual Scientific Meeting 2020, Hosted online by the Society for Social Medicine & Population Health and University of Cambridge Public Health, 9–11 September 2020. BMJ Publishing Group Ltd, 2020. http://dx.doi.org/10.1136/jech-2020-ssmabstracts.25.
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Muhammad Afzal, Afifa. "The Moderating Effect of Beliefs on HPV Awareness and HPV Vaccination Acceptance among Female Patients in Islamabad City." In 2nd International Conference on Public Health and Well-being. iConferences (Pvt) Ltd, 2021. http://dx.doi.org/10.32789/publichealth.2021.1001.
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This research aimed to study the effect of awareness on the acceptability of human papillomavirus vaccination with belief acting as a moderator between the two variables. Quantitative research was conducted in a hospital with a specific focus on gynecological operations and family planning. The method of data collection comprised of a questionnaire, which was filled out by 50 women from various religious and cultural backgrounds. SPSS was used to conduct statistical analysis. The univariate, bivariate, and multivariate analyses indicated that the results were not conclusive with the hypothesis. The participants had no pre-existing information regarding vaccinations and the knowledge of the diseases being studied as opposed to the hypothesis. This research brings focus towards a deeply neglected area of reproductive healthcare in Pakistan. This includes a lack of awareness amongst the population regarding HPV. Lack of concrete and accurate knowledge directly affects the amount of awareness present in Pakistan regarding HPV, which is close to zero, as indicated by this study. This absence of awareness means that we, as healthcare practitioners, cannot research the current topic and expect it to produce any conclusive results.
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Sinaga, Lasrika S., Ciciilya Candi, and Mardiati Nadjib. "Nutritional Interventions to Reduce Stunting in Developing Countries: A Systematic Review." In The 7th International Conference on Public Health 2020. Masters Program in Public Health, Universitas Sebelas Maret, 2020. http://dx.doi.org/10.26911/the7thicph.03.78.
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ABSTRACT Background: Childhood stunting remains a major malnutritional problem in developing countries. Stunting occurred the adverse effects on children’s health in the short and long term, including failure to thrive, impairment of cognitive and motor development, stunted stature, metabolic disorders, and decreased intellectual capacity. Integrated nutritional intervention is important to prevent stunting. This study aimed to identify the nutritional interventions to reduce stunting in developing countries. Subjects and Method: A systematic review was conducted by searching from Wiley Online Library, and ProQuest databases. The research question was formulated in PICO-S format: (1) Population, (2) Intervention, (3) Comparison, (4) Outcome, and (5) Study design. The next step was identification, screening, and checking the eligibility of the studies. The keywords were nutrition intervention and stunting reduction. The inclusion criteria were openly accessed and English-language articles published between 2019 to 2020. The searched articles were conducted identification, screening, and eligibility. The data were reported by PRISMA flow chart. Results: Nine articles met the inclusion criteria. Integrated efforts to reduce stunting incidence were carried out through sensitive and specific nutritional interventions. A holistic approach involving the non-health sectors had significant impacts. Some limitations had still occurred in the capacity of implementing qualified nutritional interventions and their utilization. Conclusion: Implementation of nutritional interventions have been focused in developing countries with different approaches to reduce stunting incidence. Keyword: nutritional intervention, stunting, developing countries Correspondence: Lasrika S Sinaga. Masters Program in Public Health, Faculty of Public Health, Universitas Indonesia. Jl. Margonda Raya, Pondok Cina, Beji, Depok, 16424, East Java. Email: lasrikass20@gmail.com. Mobile: +62 81382375618. DOI: https://doi.org/10.26911/the7thicph.03.78
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"Emergence of SARS-CoV-2 Variant of Concern Omicron: Biological Features and Genomic Concern." In International Conference on Public Health and Humanitarian Action. International Federation of Medical Students' Associations - Jordan, 2022. http://dx.doi.org/10.56950/itrx2370.
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Abstract Corona virus infection is a worldwide health threat that has infected a substantial portion of the world's population and is caused by SARS-CoV-2. It is the natural tendency of a virus to change the genetic makeup through the point mutation, and such viruses are called the variant of the original virus. SARS-CoV-2 virus also undergoes such mutation (may be one or more and distinct from other) over time, and many genetically diverse variant has risen. Such variants might be of variants of concern (VOC) and variant of interest (VOI) based on the differences in virulence, transmissibility, pathogenicity, and vaccination efficacy. Omicron, a new VOC of SARS-CoV-2, has recently emerged as a global distress to more than 115 countries. The article provides a summary of the evolutionary, biological, and genomic aspects of different SARS-CoV-2 VOC with respect to Omicron and found that amino acid mutation in spike proteins such as A67V, Δ69-70, Q954H, N969K, L981F etc and other structural protein mutations such as D3G, Q19E, A63T in membrane protein, T9I in envelope protein and P13L, Δ31-33, R203K, G204R in nucleocapsid protein results major differences between different VOC/VOI of SARS-CoV-2. Further, effectiveness of the widely used SARS-CoV-2 vaccines has been reviewed specific to Omicron. The existing available COVID-19 vaccines developed and manufactured by Pfizer, AstraZeneca, Johnson & Johnson, Moderna, and Novavax show reduced efficacy against the latest VOC of SARS- CoV-2 Omicron. Based on the available literature of preliminary findings, people who get a booster shot or a third vaccine dosage may have better protected against Omicron. Keywords: SARS-CoV-2, Omicron, Variants of Concern, Variants of Interest, Mutation, Vaccine.
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Vito, Domenico, Manuel Ottaviano, Maria Fernanda Cabrera, José Gabriel Teriús Padrón, Vittorio Casella, and Riccardo Bellazzi. "Public Health Observatories: a learning community model to foster knowledge transfer for sustainable cities." In Sixth International Conference on Higher Education Advances. Valencia: Universitat Politècnica de València, 2020. http://dx.doi.org/10.4995/head20.2020.11285.
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A Public Health Observatory (PHO) is a platform to provide “health intelligence” as a service for a specific population. The World Health Organization (WHO) identifies the primary purposes of PHOs as “monitoring health situations and trends, including assessing progress toward agreed-upon health-related targets; producing and sharing evidence; and, supporting the use of such evidence for policy and decision making” For the purposes of the PULSE project, create an observatory to function as a unique point of access to the PULSE technology for people both inside and outside the project consortium.Specifically, we create a platform for e-learning and knowledge sharing that it can be easily navigated by lay persons that are interested in learning about or participating in the PULSE project. We targeted specifically policymakers, clinicians, as well as leaders and citizens in other cities. As a concept, it reflects the principles participation, sustainability, and collaboration across sectors and levels of government The Observatory leverages on the Health in All Policies (HiAP) framework. HiAP is a cross-sectoral approach to public policy that systematically takes into account the health implications of decisions, seeks synergies, and avoids harmful health impacts in order to improve population health and health equity.
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Kusuma, Mutiara Tirta Prabandari Lintang. "Understanding the Contextual Idiosyncrasies of Stunting Prevention Program at District and Village Levels in Indonesia Using the Ecological Approach." In The 7th International Conference on Public Health 2020. Masters Program in Public Health, Universitas Sebelas Maret, 2020. http://dx.doi.org/10.26911/the7thicph.04.34.
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ABSTRACT Background: Despite rapid economic growth, stunting affects one third of the children under five population in Indonesia. The Government of Indonesia (GoI) realizing the problem, established the National Strategy to Accelerate Stunting Prevention as a national priority program for 2017 to 2021. The GoI plans to maximize the use of resources, policies, and programs that encompasses nutrition-specific and sensitive interventions directed to the first 100 days of life. This study aimed to explore the extent of program planning, budgeting, and implementation related to stunting prevention at district and village level as well as to understand the challenges presented to converge intervention. Subjects and Method: A case study with ecological approach was conducted in 10 villages from five districts in Indonesia. The study method included focus group discussions with 70 district officials and 100 village representatives, interviews with 12 key informants from district planning agency, document analysis, and reflective journaling. The data were reported descriptively. Results: Most head districts, officials from relevant departments and village leaders committed to stunting prevention following the vice president decree of stunting as a national priority. As a result, programs and budget were in place and local initiatives to prevent stunting were on the rise. Despite the commitment, many expressed ambivalences and disregarded the issue as a mere short stature (genetic variation). Thus, problems related to efficiency, coverage, and sustainability persists as maintaining motivation among staffs were difficult. In some settings, the situation was exacerbated by factors such as high financial dependency, misconception, and poor gender relation. Conclusion: The policy and programs to control stunting among children in Indonesia are in place. However, challenges occur due to the complexity in governance system as well as lack of political will. Better communication and cooperation are essential for well implemented policies. Keywords: stunting, ecological approach, case study, nutrition intervention, nutrition policy Correspondence: Mutiara Tirta Prabandari Lintang Kusuma. Department of Health Nutrition, Faculty of Medicine, Nursing, and Public Health, Universitas Gadjah Mada, Indonesia. Jl. Farmako, Sekip Utara Yogyakarta 55281. Email: mutiara.tirta@gmail.com. Mobile: +628139880320 DOI: https://doi.org/10.26911/the7thicph.04.34
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Leitao, S., P. Corcoran, and E. Manning. "P32 The iveberg-effect of specific maternal morbidities in ireland: quantifying their magnitude." In Society for Social Medicine and Population Health and International Epidemiology Association European Congress Annual Scientific Meeting 2019, Hosted by the Society for Social Medicine & Population Health and International Epidemiology Association (IEA), School of Public Health, University College Cork, Cork, Ireland, 4–6 September 2019. BMJ Publishing Group Ltd, 2019. http://dx.doi.org/10.1136/jech-2019-ssmabstracts.183.
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Nicolson, H. "P75 Examining total and domain-specific sedentary behaviour using the socio-ecological model – a cross-sectional study of irish adults." In Society for Social Medicine and Population Health and International Epidemiology Association European Congress Annual Scientific Meeting 2019, Hosted by the Society for Social Medicine & Population Health and International Epidemiology Association (IEA), School of Public Health, University College Cork, Cork, Ireland, 4–6 September 2019. BMJ Publishing Group Ltd, 2019. http://dx.doi.org/10.1136/jech-2019-ssmabstracts.226.
Full textReports on the topic "Public health (excl. specific population health)"
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van Walbeek, Corné, and Senzo Mthembu. The Likely Fiscal and Public Health Effects of an Excise Tax on Sugar sweetened Beverages in Kenya. Institute of Development Studies, May 2022. http://dx.doi.org/10.19088/ictd.2022.007.
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Historically, non-communicable diseases (NCDs) have typically been associated with tobacco and alcohol use. However, in recent decades increased levels of overweightness and obesity, mostly caused by poor eating habits and a sedentary lifestyle, have increased diabetes, cancers, and cardiovascular diseases. There is a general agreement that sugar sweetened beverages (SSBs) are bad for one’s health. As such, measures to reduce their consumption would be expected to positively impact population health. In this working paper, we develop and report on an Excel-based model, in which we simulate the impact of an SSB tax on the prevalence of overweightness and obesity. The model starts with a baseline scenario, which takes cognisance that a 10 KES specific tax already exists on all soft drinks. A sugar-based SSB tax is then introduced. The tax is levied as an amount per gram of sugar, with or without a tax-free threshold. Other than reducing the demand for SSBs, a sugar-based SSB also creates strong incentives for manufacturers to reformulate their products to reduce the sugar content. The model predicts that the average BMI would decrease across all age groups decreasing the prevalence of overweightness and obesity. The magnitude of the decrease in the prevalence of overweightness and obesity depends on the size of the SSB tax. For realistic and politically feasible values of the SSB tax, the prevalence of overweightness and obesity is expected to decrease by between 5 per cent and 10 per cent. Should Kenya implement a sugar-based tax on SSBs, over and above the current excise tax on soft drinks, the government should clarify that such a tax aims to enhance public health; raising additional revenue should be a secondary consideration. Also, implementing a sugar based SSB tax should be part of a more comprehensive strategy to reduce overweightness and obesity, because by itself the impact of the tax is modest.
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Borgès Da Silva, Roxane. COVID-19 : Comprendre et agir sur l’acceptabilité sociale des mesures de santé publique. CIRANO, May 2022. http://dx.doi.org/10.54932/izck1391.
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As of May 14, masks will no longer be required to be worn in indoor public places such as businesses, schools and daycares. It will continue to be required in public transportation, hospitals, medical clinics and CHSLDs. A survey conducted by the Institut national de santé publique du Québec from April 15 to 27 shows that two-thirds of respondents still intend to continue wearing the mask. But in reality, how will Quebecers react? What will be their motivations? How can we ensure that they make informed choices based on their circumstances and the objective risk factors they - and those around them - face? And how do we avoid the ostracization of those who will continue to wear the mask? Research inspired by experimental economics provides insight into the role that awareness and improved knowledge of the real risks associated with COVID-19 can play in people's intentions and reactions following the implementation - or removal - of various measures. This short text presents the results of two experimental studies conducted in the specific context of the reopening of schools in September 2020. These studies allow us to draw two main conclusions about the social acceptability of health measures and individual choices in the face of the pandemic: It is essential to provide valid, accurate, and simple sources of information to inform and reassure the population about the risks of developing COVID-19, without causing "cognitive overload." Simple awareness tools, clear and evidence-based information can have an impact on people's perceptions and choices when it comes to their health or that of their loved ones.
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McCarthy, Noel, Eileen Taylor, Martin Maiden, Alison Cody, Melissa Jansen van Rensburg, Margaret Varga, Sophie Hedges, et al. Enhanced molecular-based (MLST/whole genome) surveillance and source attribution of Campylobacter infections in the UK. Food Standards Agency, July 2021. http://dx.doi.org/10.46756/sci.fsa.ksj135.
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This human campylobacteriosis sentinel surveillance project was based at two sites in Oxfordshire and North East England chosen (i) to be representative of the English population on the Office for National Statistics urban-rural classification and (ii) to provide continuity with genetic surveillance started in Oxfordshire in October 2003. Between October 2015 and September 2018 epidemiological questionnaires and genome sequencing of isolates from human cases was accompanied by sampling and genome sequencing of isolates from possible food animal sources. The principal aim was to estimate the contributions of the main sources of human infection and to identify any changes over time. An extension to the project focussed on antimicrobial resistance in study isolates and older archived isolates. These older isolates were from earlier years at the Oxfordshire site and the earliest available coherent set of isolates from the national archive at Public Health England (1997/8). The aim of this additional work was to analyse the emergence of the antimicrobial resistance that is now present among human isolates and to describe and compare antimicrobial resistance in recent food animal isolates. Having identified the presence of bias in population genetic attribution, and that this was not addressed in the published literature, this study developed an approach to adjust for bias in population genetic attribution, and an alternative approach to attribution using sentinel types. Using these approaches the study estimated that approximately 70% of Campylobacter jejuni and just under 50% of C. coli infection in our sample was linked to the chicken source and that this was relatively stable over time. Ruminants were identified as the second most common source for C. jejuni and the most common for C. coli where there was also some evidence for pig as a source although less common than ruminant or chicken. These genomic attributions of themselves make no inference on routes of transmission. However, those infected with isolates genetically typical of chicken origin were substantially more likely to have eaten chicken than those infected with ruminant types. Consumption of lamb’s liver was very strongly associated with infection by a strain genetically typical of a ruminant source. These findings support consumption of these foods as being important in the transmission of these infections and highlight a potentially important role for lamb’s liver consumption as a source of Campylobacter infection. Antimicrobial resistance was predicted from genomic data using a pipeline validated by Public Health England and using BIGSdb software. In C. jejuni this showed a nine-fold increase in resistance to fluoroquinolones from 1997 to 2018. Tetracycline resistance was also common, with higher initial resistance (1997) and less substantial change over time. Resistance to aminoglycosides or macrolides remained low in human cases across all time periods. Among C. jejuni food animal isolates, fluoroquinolone resistance was common among isolates from chicken and substantially less common among ruminants, ducks or pigs. Tetracycline resistance was common across chicken, duck and pig but lower among ruminant origin isolates. In C. coli resistance to all four antimicrobial classes rose from low levels in 1997. The fluoroquinolone rise appears to have levelled off earlier and among animals, levels are high in duck as well as chicken isolates, although based on small sample sizes, macrolide and aminoglycoside resistance, was substantially higher than for C. jejuni among humans and highest among pig origin isolates. Tetracycline resistance is high in isolates from pigs and the very small sample from ducks. Antibiotic use following diagnosis was relatively high (43.4%) among respondents in the human surveillance study. Moreover, it varied substantially across sites and was highest among non-elderly adults compared to older adults or children suggesting opportunities for improved antimicrobial stewardship. The study also found evidence for stable lineages over time across human and source animal species as well as some tighter genomic clusters that may represent outbreaks. The genomic dataset will allow extensive further work beyond the specific goals of the study. This has been made accessible on the web, with access supported by data visualisation tools.
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Yatsymirska, Mariya. KEY IMPRESSIONS OF 2020 IN JOURNALISTIC TEXTS. Ivan Franko National University of Lviv, March 2021. http://dx.doi.org/10.30970/vjo.2021.50.11107.
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The article explores the key vocabulary of 2020 in the network space of Ukraine. Texts of journalistic, official-business style, analytical publications of well-known journalists on current topics are analyzed. Extralinguistic factors of new word formation, their adaptation to the sphere of special and socio-political vocabulary of the Ukrainian language are determined. Examples show modern impressions in the media, their stylistic use and impact on public opinion in a pandemic. New meanings of foreign expressions, media terminology, peculiarities of translation of neologisms from English into Ukrainian have been clarified. According to the materials of the online media, a «dictionary of the coronavirus era» is provided. The journalistic text functions in the media on the basis of logical judgments, credible arguments, impressive language. Its purpose is to show the socio-political problem, to sharpen its significance for society and to propose solutions through convincing considerations. Most researchers emphasize the influential role of journalistic style, which through the media shapes public opinion on issues of politics, economics, education, health care, war, the future of the country. To cover such a wide range of topics, socio-political vocabulary is used first of all – neutral and emotionally-evaluative, rhetorical questions and imperatives, special terminology, foreign words. There is an ongoing discussion in online publications about the use of the new foreign token «lockdown» instead of the word «quarantine», which has long been learned in the Ukrainian language. Research on this topic has shown that at the initial stage of the pandemic, the word «lockdown» prevailed in the colloquial language of politicians, media personalities and part of society did not quite understand its meaning. Lockdown, in its current interpretation, is a restrictive measure to protect people from a dangerous virus that has spread to many countries; isolation of the population («stay in place») in case of risk of spreading Covid-19. In English, US citizens are told what a lockdown is: «A lockdown is a restriction policy for people or communities to stay where they are, usually due to specific risks to themselves or to others if they can move and interact freely. The term «stay-at-home» or «shelter-in-place» is often used for lockdowns that affect an area, rather than specific locations». Content analysis of online texts leads to the conclusion that in 2020 a special vocabulary was actively functioning, with the appropriate definitions, which the media described as a «dictionary of coronavirus vocabulary». Media broadcasting is the deepest and pulsating source of creative texts with new meanings, phrases, expressiveness. The influential power of the word finds its unconditional embodiment in the media. Journalists, bloggers, experts, politicians, analyzing current events, produce concepts of a new reality. The world is changing and the language of the media is responding to these changes. It manifests itself most vividly and emotionally in the network sphere, in various genres and styles.
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Rankin, Nicole, Deborah McGregor, Candice Donnelly, Bethany Van Dort, Richard De Abreu Lourenco, Anne Cust, and Emily Stone. Lung cancer screening using low-dose computed tomography for high risk populations: Investigating effectiveness and screening program implementation considerations: An Evidence Check rapid review brokered by the Sax Institute (www.saxinstitute.org.au) for the Cancer Institute NSW. The Sax Institute, October 2019. http://dx.doi.org/10.57022/clzt5093.
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Background Lung cancer is the number one cause of cancer death worldwide.(1) It is the fifth most commonly diagnosed cancer in Australia (12,741 cases diagnosed in 2018) and the leading cause of cancer death.(2) The number of years of potential life lost to lung cancer in Australia is estimated to be 58,450, similar to that of colorectal and breast cancer combined.(3) While tobacco control strategies are most effective for disease prevention in the general population, early detection via low dose computed tomography (LDCT) screening in high-risk populations is a viable option for detecting asymptomatic disease in current (13%) and former (24%) Australian smokers.(4) The purpose of this Evidence Check review is to identify and analyse existing and emerging evidence for LDCT lung cancer screening in high-risk individuals to guide future program and policy planning. Evidence Check questions This review aimed to address the following questions: 1. What is the evidence for the effectiveness of lung cancer screening for higher-risk individuals? 2. What is the evidence of potential harms from lung cancer screening for higher-risk individuals? 3. What are the main components of recent major lung cancer screening programs or trials? 4. What is the cost-effectiveness of lung cancer screening programs (include studies of cost–utility)? Summary of methods The authors searched the peer-reviewed literature across three databases (MEDLINE, PsycINFO and Embase) for existing systematic reviews and original studies published between 1 January 2009 and 8 August 2019. Fifteen systematic reviews (of which 8 were contemporary) and 64 original publications met the inclusion criteria set across the four questions. Key findings Question 1: What is the evidence for the effectiveness of lung cancer screening for higher-risk individuals? There is sufficient evidence from systematic reviews and meta-analyses of combined (pooled) data from screening trials (of high-risk individuals) to indicate that LDCT examination is clinically effective in reducing lung cancer mortality. In 2011, the landmark National Lung Cancer Screening Trial (NLST, a large-scale randomised controlled trial [RCT] conducted in the US) reported a 20% (95% CI 6.8% – 26.7%; P=0.004) relative reduction in mortality among long-term heavy smokers over three rounds of annual screening. High-risk eligibility criteria was defined as people aged 55–74 years with a smoking history of ≥30 pack-years (years in which a smoker has consumed 20-plus cigarettes each day) and, for former smokers, ≥30 pack-years and have quit within the past 15 years.(5) All-cause mortality was reduced by 6.7% (95% CI, 1.2% – 13.6%; P=0.02). Initial data from the second landmark RCT, the NEderlands-Leuvens Longkanker Screenings ONderzoek (known as the NELSON trial), have found an even greater reduction of 26% (95% CI, 9% – 41%) in lung cancer mortality, with full trial results yet to be published.(6, 7) Pooled analyses, including several smaller-scale European LDCT screening trials insufficiently powered in their own right, collectively demonstrate a statistically significant reduction in lung cancer mortality (RR 0.82, 95% CI 0.73–0.91).(8) Despite the reduction in all-cause mortality found in the NLST, pooled analyses of seven trials found no statistically significant difference in all-cause mortality (RR 0.95, 95% CI 0.90–1.00).(8) However, cancer-specific mortality is currently the most relevant outcome in cancer screening trials. These seven trials demonstrated a significantly greater proportion of early stage cancers in LDCT groups compared with controls (RR 2.08, 95% CI 1.43–3.03). Thus, when considering results across mortality outcomes and early stage cancers diagnosed, LDCT screening is considered to be clinically effective. Question 2: What is the evidence of potential harms from lung cancer screening for higher-risk individuals? The harms of LDCT lung cancer screening include false positive tests and the consequences of unnecessary invasive follow-up procedures for conditions that are eventually diagnosed as benign. While LDCT screening leads to an increased frequency of invasive procedures, it does not result in greater mortality soon after an invasive procedure (in trial settings when compared with the control arm).(8) Overdiagnosis, exposure to radiation, psychological distress and an impact on quality of life are other known harms. Systematic review evidence indicates the benefits of LDCT screening are likely to outweigh the harms. The potential harms are likely to be reduced as refinements are made to LDCT screening protocols through: i) the application of risk predication models (e.g. the PLCOm2012), which enable a more accurate selection of the high-risk population through the use of specific criteria (beyond age and smoking history); ii) the use of nodule management algorithms (e.g. Lung-RADS, PanCan), which assist in the diagnostic evaluation of screen-detected nodules and cancers (e.g. more precise volumetric assessment of nodules); and, iii) more judicious selection of patients for invasive procedures. Recent evidence suggests a positive LDCT result may transiently increase psychological distress but does not have long-term adverse effects on psychological distress or health-related quality of life (HRQoL). With regards to smoking cessation, there is no evidence to suggest screening participation invokes a false sense of assurance in smokers, nor a reduction in motivation to quit. The NELSON and Danish trials found no difference in smoking cessation rates between LDCT screening and control groups. Higher net cessation rates, compared with general population, suggest those who participate in screening trials may already be motivated to quit. Question 3: What are the main components of recent major lung cancer screening programs or trials? There are no systematic reviews that capture the main components of recent major lung cancer screening trials and programs. We extracted evidence from original studies and clinical guidance documents and organised this into key groups to form a concise set of components for potential implementation of a national lung cancer screening program in Australia: 1. Identifying the high-risk population: recruitment, eligibility, selection and referral 2. Educating the public, people at high risk and healthcare providers; this includes creating awareness of lung cancer, the benefits and harms of LDCT screening, and shared decision-making 3. Components necessary for health services to deliver a screening program: a. Planning phase: e.g. human resources to coordinate the program, electronic data systems that integrate medical records information and link to an established national registry b. Implementation phase: e.g. human and technological resources required to conduct LDCT examinations, interpretation of reports and communication of results to participants c. Monitoring and evaluation phase: e.g. monitoring outcomes across patients, radiological reporting, compliance with established standards and a quality assurance program 4. Data reporting and research, e.g. audit and feedback to multidisciplinary teams, reporting outcomes to enhance international research into LDCT screening 5. Incorporation of smoking cessation interventions, e.g. specific programs designed for LDCT screening or referral to existing community or hospital-based services that deliver cessation interventions. Most original studies are single-institution evaluations that contain descriptive data about the processes required to establish and implement a high-risk population-based screening program. Across all studies there is a consistent message as to the challenges and complexities of establishing LDCT screening programs to attract people at high risk who will receive the greatest benefits from participation. With regards to smoking cessation, evidence from one systematic review indicates the optimal strategy for incorporating smoking cessation interventions into a LDCT screening program is unclear. There is widespread agreement that LDCT screening attendance presents a ‘teachable moment’ for cessation advice, especially among those people who receive a positive scan result. Smoking cessation is an area of significant research investment; for instance, eight US-based clinical trials are now underway that aim to address how best to design and deliver cessation programs within large-scale LDCT screening programs.(9) Question 4: What is the cost-effectiveness of lung cancer screening programs (include studies of cost–utility)? Assessing the value or cost-effectiveness of LDCT screening involves a complex interplay of factors including data on effectiveness and costs, and institutional context. A key input is data about the effectiveness of potential and current screening programs with respect to case detection, and the likely outcomes of treating those cases sooner (in the presence of LDCT screening) as opposed to later (in the absence of LDCT screening). Evidence about the cost-effectiveness of LDCT screening programs has been summarised in two systematic reviews. We identified a further 13 studies—five modelling studies, one discrete choice experiment and seven articles—that used a variety of methods to assess cost-effectiveness. Three modelling studies indicated LDCT screening was cost-effective in the settings of the US and Europe. Two studies—one from Australia and one from New Zealand—reported LDCT screening would not be cost-effective using NLST-like protocols. We anticipate that, following the full publication of the NELSON trial, cost-effectiveness studies will likely be updated with new data that reduce uncertainty about factors that influence modelling outcomes, including the findings of indeterminate nodules. Gaps in the evidence There is a large and accessible body of evidence as to the effectiveness (Q1) and harms (Q2) of LDCT screening for lung cancer. Nevertheless, there are significant gaps in the evidence about the program components that are required to implement an effective LDCT screening program (Q3). Questions about LDCT screening acceptability and feasibility were not explicitly included in the scope. However, as the evidence is based primarily on US programs and UK pilot studies, the relevance to the local setting requires careful consideration. The Queensland Lung Cancer Screening Study provides feasibility data about clinical aspects of LDCT screening but little about program design. The International Lung Screening Trial is still in the recruitment phase and findings are not yet available for inclusion in this Evidence Check. The Australian Population Based Screening Framework was developed to “inform decision-makers on the key issues to be considered when assessing potential screening programs in Australia”.(10) As the Framework is specific to population-based, rather than high-risk, screening programs, there is a lack of clarity about transferability of criteria. However, the Framework criteria do stipulate that a screening program must be acceptable to “important subgroups such as target participants who are from culturally and linguistically diverse backgrounds, Aboriginal and Torres Strait Islander people, people from disadvantaged groups and people with a disability”.(10) An extensive search of the literature highlighted that there is very little information about the acceptability of LDCT screening to these population groups in Australia. Yet they are part of the high-risk population.(10) There are also considerable gaps in the evidence about the cost-effectiveness of LDCT screening in different settings, including Australia. The evidence base in this area is rapidly evolving and is likely to include new data from the NELSON trial and incorporate data about the costs of targeted- and immuno-therapies as these treatments become more widely available in Australia.
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Redmond, Paul, Seamus McGuinness, and Klavs Ciprikis. A universal basic income for Ireland: Lessons from the international literature. ESRI, December 2022. http://dx.doi.org/10.26504/rs146.
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A universal basic income (UBI) is defined as a universal, unconditional cash payment that is made regularly, is sufficient to live on, is not means tested, carries no work requirements and is paid on an individual basis. This study examines the international evidence on universal basic incomes and identifies key issues for consideration in the design of any UBI pilot for Ireland. Despite the mainstream interest in UBI as a potential policy tool, relatively little is known about the associated consequences of such policies. Even the definition of a UBI appears to be poorly understood and is often misused in the public discourse. Several pilot studies have been recently implemented across different countries. However, some pilot studies depart from the accepted definition of UBI. For example, some are not universal, in that they only target a specific subgroup of the population and/or have eligibility restrictions based on earnings. Others provide a relatively low level of payment, which may fall short of what an individual could reasonably be expected to live on. There are a number of potentially positive impacts associated with a UBI. A universal, unconditional payment could eliminate the stigma associated with welfare receipt. If replacing existing welfare payments, a UBI would also involve lower transaction costs, both on the recipient (in terms of the application procedure) and on Government (in terms of administering the payment). Universal, unconditional payments would also avoid situations where people choose not to work in order to retain means-tested benefits. UBI could give individuals the freedom to turn down or leave insecure, exploitative or low-paid work in pursuit of better or improved work opportunities. In addition, it would mean that persons in informal and often unpaid work, such as childcare and eldercare, which is mostly done by women, receive some compensation for their labour. Empirical results from several pilot studies have found evidence of positive health impacts following the implementation of a UBI. In terms of potential disadvantages, a UBI, by definition, may not target those that are most in need, as a large percentage of recipients will be high-earning individuals. Furthermore, the cost of a UBI is likely to be very expensive, even if other existing benefits (such as unemployment benefits) are no longer required. The net impacts of a UBI on labour supply are unclear, with both positive and negative influences on labour market participation potentially arising as a consequence of a UBI. In this study, we undertake some basic calculations relating to four possible UBI approaches, all of which would involve an unconditional payment to every individual aged over 18 in Ireland.
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Robinson, Andy. Monitoring and Evaluation for Rural Sanitation and Hygiene: Framework. Institute of Development Studies (IDS), December 2021. http://dx.doi.org/10.19088/slh.2021.027.
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The monitoring and evaluation (M&E) Guidelines and Framework presented in this document (and in the accompanying M&E Indicator Framework) aim to encourage stakeholders in the rural sanitation and hygiene sector to take a more comprehensive, comparable and people focused approach to monitoring and evaluation. Many M&E frameworks currently reflect the interests and ambitions of particular implementing agencies – that is, community-led total sanitation (CLTS) interventions focused on open-defecation free (ODF) outcomes in triggered communities; market-based sanitation interventions focused on the number of products sold and whether sanitation businesses were profitable; and sanitation finance interventions reporting the number of facilities built using financial support. Few M&E frameworks have been designed to examine the overall sanitation and hygiene situation – to assess how interventions have affected sanitation and hygiene outcomes across an entire area (rather than just in specific target communities); to look at who (from the overall population) benefitted from the intervention, and who did not; to report on the level and quality of service used; or examine whether public health has improved. Since 2015, the Sustainable Development Goals (SDGs) have extended and deepened the international monitoring requirements for sanitation and hygiene. The 2030 SDG sanitation target 6.2 includes requirements to: • Achieve access to adequate sanitation and hygiene for all • Achieve access to equitable sanitation and hygiene for all • End open defecation • Pay special attention to the needs of women and girls • Pay special attention to those in vulnerable situations The 2030 SDG sanitation target calls for universal use of basic sanitation services, and for the elimination of open defecation, both of which require M&E systems that cover entire administration areas (i.e. every person and community within a district) and which are able to identify people and groups that lack services, or continue unsafe practices. Fortunately, the SDG requirements are well aligned with the sector trend towards system strengthening, in recognition that governments are responsible both for the provision of sustainable services and for monitoring the achievement of sustained outcomes. This document provides guidelines on the monitoring and evaluation of rural sanitation and hygiene, and presents an M&E framework that outlines core elements and features for reporting on progress towards the 2030 SDG sanitation target (and related national goals and targets for rural sanitation and hygiene), while also encouraging learning and accountability. Given wide variations in the ambition, capacity and resources available for monitoring and evaluation, it is apparent that not all of the M&E processes and indicators described will be appropriate for all stakeholders. The intention is to provide guidelines and details on useful and progressive approaches to monitoring rural sanitation and hygiene, from which a range of rural sanitation and hygiene duty bearers and practitioners – including governments, implementation agencies, development partners and service providers – can select and use those most appropriate to their needs. Eventually, it is hoped that all of the more progressive M&E elements and features will become standard, and be incorporated in all sector monitoring systems.
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Robinson, Andy. Monitoring and Evaluation for Rural Sanitation and Hygiene: Framework. Institute of Development Studies (IDS), December 2021. http://dx.doi.org/10.19088/slh.2021.025.
Full textAbstract:
The monitoring and evaluation (M&E) Guidelines and Framework presented in this document (and in the accompanying M&E Indicator Framework) aim to encourage stakeholders in the rural sanitation and hygiene sector to take a more comprehensive, comparable and people focused approach to monitoring and evaluation. Many M&E frameworks currently reflect the interests and ambitions of particular implementing agencies – that is, community-led total sanitation (CLTS) interventions focused on open-defecation free (ODF) outcomes in triggered communities; market-based sanitation interventions focused on the number of products sold and whether sanitation businesses were profitable; and sanitation finance interventions reporting the number of facilities built using financial support. Few M&E frameworks have been designed to examine the overall sanitation and hygiene situation – to assess how interventions have affected sanitation and hygiene outcomes across an entire area (rather than just in specific target communities); to look at who (from the overall population) benefitted from the intervention, and who did not; to report on the level and quality of service used; or examine whether public health has improved. Since 2015, the Sustainable Development Goals (SDGs) have extended and deepened the international monitoring requirements for sanitation and hygiene. The 2030 SDG sanitation target 6.2 includes requirements to: • Achieve access to adequate sanitation and hygiene for all • Achieve access to equitable sanitation and hygiene for all • End open defecation • Pay special attention to the needs of women and girls • Pay special attention to those in vulnerable situations The 2030 SDG sanitation target calls for universal use of basic sanitation services, and for the elimination of open defecation, both of which require M&E systems that cover entire administration areas (i.e. every person and community within a district) and which are able to identify people and groups that lack services, or continue unsafe practices. Fortunately, the SDG requirements are well aligned with the sector trend towards system strengthening, in recognition that governments are responsible both for the provision of sustainable services and for monitoring the achievement of sustained outcomes. This document provides guidelines on the monitoring and evaluation of rural sanitation and hygiene, and presents an M&E framework that outlines core elements and features for reporting on progress towards the 2030 SDG sanitation target (and related national goals and targets for rural sanitation and hygiene), while also encouraging learning and accountability. Given wide variations in the ambition, capacity and resources available for monitoring and evaluation, it is apparent that not all of the M&E processes and indicators described will be appropriate for all stakeholders. The intention is to provide guidelines and details on useful and progressive approaches to monitoring rural sanitation and hygiene, from which a range of rural sanitation and hygiene duty bearers and practitioners – including governments, implementation agencies, development partners and service providers – can select and use those most appropriate to their needs. Eventually, it is hoped that all of the more progressive M&E elements and features will become standard, and be incorporated in all sector monitoring systems.