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Public health policies

Mireia Diaz, David Moriña, Vanesa Rodríguez-Salés, Raquel Ibáñez, Josep Alfons Espinás, Silvia de Sanjosé
Background: HPV screening has been shown to be more cost-effective than cytology screening under most scenarios. Furthermore, it should be offered only in organized programmes with good quality assurance mechanisms. This study analyses the comparative cost of the current policy of opportunistic cytology screening vs. a hypothetical organized programme based on primary HPV screening. Methods: Total cervical cancer expenditure was defined as the sum of three cost elements: (i) direct (medical and non-medical) costs, obtained from a calibrated Markov model of the natural history of HPV and cervical cancer; (ii) programmatic costs, estimated based on other organized screening programmes; and (iii) indirect costs, extrapolated from previously published data...
April 18, 2018: European Journal of Public Health
Fran Baum, Adam Graycar, Toni Delany-Crowe, Evelyne de Leeuw, Carol Bacchi, Jennie Popay, Lionel Orchard, Hal Colebatch, Sharon Friel, Colin MacDougall, Elizabeth Harris, Angela Lawless, Dennis McDermott, Matthew Fisher, Patrick Harris, Clare Phillips, Jane Fitzgerald
There is strong, and growing, evidence documenting health inequities across the world. However, most governments do not prioritize policies to encourage action on the social determinants of health and health equity. Furthermore, despite evidence concerning the benefits of joined-up, intersectoral policy to promote health and health equity, it is rare for such policy approaches to be applied systematically. To examine the usefulness of political and social science theory in understanding the reasons for this disjuncture between evidence and practice, researchers and public servants gathered in Adelaide for an Academy of the Social Sciences in Australia (ASSA) Workshop...
April 19, 2018: Health Promotion International
Carl D Britto, Zoe A Dyson, Sebastian Duchene, Michael J Carter, Meeru Gurung, Dominic F Kelly, David R Murdoch, Imran Ansari, Stephen Thorson, Shrijana Shrestha, Neelam Adhikari, Gordon Dougan, Kathryn E Holt, Andrew J Pollard
BACKGROUND: Children are substantially affected by enteric fever in most settings with a high burden of the disease, including Nepal. However pathogen population structure and transmission dynamics are poorly delineated in young children, the proposed target group for immunization programs. Here we present whole genome sequencing and antimicrobial susceptibility data on 198 S. Typhi and 66 S. Paratyphi A isolated from children aged 2 months to 15 years of age during blood culture surveillance at Patan Hospital, Nepal, 2008-2016...
April 23, 2018: PLoS Neglected Tropical Diseases
Eveline Ndii Kalomo, Kyoung Hag Lee, Elizabeth Lightfoot, Rachel Freeman
BACKGROUND: Namibia has one of the highest human immunodeficiency virus (HIV) prevalence rates and one of the highest rates of orphanhood in the world, and older caregivers provide much of the care to Namibians living with HIV and acquired immune deficiency syndrome (AIDS) (UNAIDS, 2014). In this study, the authors explore how financial status, social support, and health were related to the resilience of caregivers caring for people affected by HIV and AIDS in rural northern Namibia, Africa...
April 23, 2018: Journal of Gerontological Social Work
Jie Chen, Priscilla Novak, Howard Goldman
The objective was to estimate the association between health care expenditures and implementation of preventive mental health programs by local health departments (LHDs). Multilevel nationally representative data sets were linked to test the hypothesis that LHDs' provision of preventive mental health programs was associated with cost savings. A generalized linear model with log link and gamma distribution and state-fixed effects was used to estimate the association between LHDs' mental illness prevention services and total health care expenditures per person per year for adults aged 18 years and older...
April 23, 2018: Population Health Management
Alexandra Greenberg, Georgia J Michlig, Elizabeth Larson, Ilona Varallyay, Karen Chang, Blessing Enobun, Ellen Schenk, Benjamin Whong, Pamela Surkan, Caitlin E Kennedy, Steven A Harvey
The 2014 West African Ebola outbreak was unprecedented in scale and required significant international assistance. Many U.S.-based health professionals traveled to West Africa to participate in the response, whereas others considered participation, but ultimately decided against it. This study explores motivators, facilitators, and barriers to international health care worker mobilization. We conducted 24 semistructured in-depth interviews and one focus group discussion with clinical and nonclinical responders and nonresponders...
April 1, 2018: Qualitative Health Research
Rachel A Leonard, Mark Linden, Anne Grant
Maternal mental illness is a major public health issue and can adversely affect the whole family. Increasingly, research and policy are recognizing the benefits of a family-focused approach to practice, an approach that emphasizes the family as the unit of care. This review was conducted with the aim of systematically analyzing the qualitative literature surrounding health visitors' family-focused practice with mothers who have mental illness and/or substance misuse. Through the synthesis, we developed three main findings: (a) parents' needs regarding health visitors' family-focused practice, (b) the ambiguity of mental illness in health visiting, and (c) the challenges of family-focused practice in health visiting...
April 1, 2018: Journal of Family Nursing
Charles Chungu, Mpundu Makasa, Mumbi Chola, Choolwe Nkwemu Jacobs
Objective: Postnatal care (PNC) utilization is critical to the prevention of maternal morbidity and mortality. Despite its importance, the proportion of women utilizing this service is still low in Zambia. We investigated if place of delivery was associated with PNC utilization in the first 48 h among childbearing women in Zambia. Methods: Data from the 2013/14 Zambia Demographic and Health Survey for women, aged 15-49 years, who reported giving birth in the 2 years preceding the survey was used...
2018: Frontiers in Public Health
Marie Laure Baranne, Bruno Falissard
Background: The global burden of disease (GBD) study provides information about fatal and non-fatal health outcomes around the world. Methods: The objective of this work is to describe the burden of mental disorders among children aged 5-14 years in each of the six regions of the World Health Organisation. Data come from the GBD 2015 study. Outcomes: disability-adjusted life-years (DALYs) are the main indicator of GBD studies and are built from years of life lost (YLLs) and years of life lived with disability (YLDs)...
2018: Child and Adolescent Psychiatry and Mental Health
Jorge Armando Barriguete-Meléndez, Serge Hercberg, Pilar Galán, André Parodi, Jacques Baulieux
Background: NutriNet-Salud Mexico is a digital health information system, e-epidemiology instrument, online, open and free, to recording and analysis the determinants of dietary habits and nutritional status of the Mexican population, for the prevention of overweight, obesity and noncommunicable diseases for the period 2018-2028. Objective: Describe the design, development and implementation of NutriNet-Salud Mexico from the French model NutriNet-Santé France 2008-2018...
2018: Cirugia y Cirujanos
Andrew Georgiou, Farah Magrabi, Hannele Hypponen, Zoie Shui-Yee Wong, Pirkko Nykänen, Philip J Scott, Elske Ammenwerth, Michael Rigby
OBJECTIVES:  The paper draws attention to: i) key considerations involving the confidentiality, privacy, and security of shared data; and ii) the requirements needed to build collaborative arrangements encompassing all stakeholders with the goal of ensuring safe, secure, and quality use of shared data. METHOD:  A narrative review of existing research and policy approaches along with expert perspectives drawn from the International Medical Informatics Association (IMIA) Working Group on Technology Assessment and Quality Development in Health Care and the European Federation for Medical Informatics (EFMI) Working Group for Assessment of Health Information Systems...
April 22, 2018: Yearbook of Medical Informatics
Eric Crosbie, Robert Eckford, Stella Bialous
OBJECTIVE: To analyse the tobacco industry's strategy of using trade and investment agreements to prevent the global diffusion of standardised packaging (SP) of tobacco products. METHODS: Review of tobacco industry documents, relevant government documents and media items. The data were triangulated and thematically analysed. RESULTS: Internal tobacco industry documents reveal that during the early 1990s, tobacco companies developed a multipronged trade strategy to prevent the global diffusion of progressive tobacco packaging and labelling proposals, including SP...
April 21, 2018: Tobacco Control
S M Skevington, J R Böhnke
Subjective well-being (SWB) and subjective quality of life (QoL) are key concepts describing experience, capacities, states, behaviours, appraisals, and emotional reactions to circumstances. Used widely in public discourse, policy, and research, their theoretical and empirical relations remain little explored. The present research aimed to develop an integrated model of SWB and QoL through empirically testing its overlapping and exclusive dimensions. Survey data was obtained from N = 2533 in 11 countries...
April 6, 2018: Social Science & Medicine
Lisa M Knowlton, Arden M Morris, Lakshika Tennakoon, David A Spain, Kristan L Staudenmayer
BACKGROUND: Level I trauma centers often exist within Safety-Net Hospitals (SNHs), facilities servicing high proportions of low-income and uninsured patients. Given the current healthcare funding environment, trauma centers within SNHs may be at particular risk. Using California as a model, we hypothesized that SNHs with trauma centers vary in terms of financial stability. STUDY DESIGN: A retrospective cohort study using data from publically-available financial disclosure reports from California's Office of Statewide Health Planning and Development...
April 19, 2018: Journal of the American College of Surgeons
Cheryl Kelly, Julie George, Eliza R Lanman
The goal of the Healthy Eating/Active Living (HEAL) Cities and Towns Campaign is to provide municipal leaders with the information, tools, and personalized assistance they need to promote and adopt policies that advance population health. Colorado is composed of 271 cities and towns and has one of the fastest-growing obesity rates in the nation. Colorado's Campaign began in 2012 with a partnership between LiveWell Colorado and the Colorado Municipal League. As a grantee of a regional public health organization, the Campaign Coordinator provides technical assistance to municipal leaders and recognizes cities and towns that adopt varied HEAL policies with four designations: Eager, Active, Fit, and Elite...
May 2018: American Journal of Preventive Medicine
Rebecca D Ochtera, Claire J Siemer, Leslie T Levine
INTRODUCTION: Considerable research has been done to define, conceptualize, and study sustainability for public health initiatives. New research suggests evaluating sustainability through additional characteristics, like type of intervention or focus of change, may help uncover differences in approaches and resources needed for sustainability. Additionally, available research often misses perspectives from those involved on what is necessary to sustain strategies long term. METHODS: Data collected through community reports and interviews with eight Colorado communities implementing large-scale community-based healthy eating and active living initiatives were used to document strategy characteristics, barriers to sustainability, and community-based perspectives on supports needed for long-term sustainability...
May 2018: American Journal of Preventive Medicine
Tam Truong Donnelly, Tak Shing Fung, Al-Anoud Bint Mohammad Al-Thani
OBJECTIVES: Physical inactivity and unhealthy diets increase the risk for diabetes, cardiovascular diseases and cancer. Many people in Qatar are sedentary and consume diets high in fats, salt and sugar. The purpose of this study was to determine physical activity levels, food habits and understand the variables that might predict physical activity and healthy eating behaviours among Arabic-speaking adults living in the State of Qatar. SETTING: A cross-sectional community-based survey was conducted with 1606 Arab adults ≥18 years of age from March 2013 to June 2015...
April 20, 2018: BMJ Open
Miao-Ling Lin, Joh-Jong Huang, Hung-Yi Chuang, Hsiu-Min Tsai, Hsiu-Hung Wang
OBJECTIVES: Public health nurses are responsible for promoting and managing the health of community members, and if they do not have enough physical activity or ignore their own health, not only will their own health decline but the quality of life of the public will also be affected. This study investigated the physical activity of public health nurses and analysed the effects of attitudes, subjective norms, perceived behavioural control and behavioural intention to engage in physical activity...
April 20, 2018: BMJ Open
Rachel Anderson de Cuevas, Lotta Nylén, Bo Burström, Margaret Whitehead
BACKGROUND: Public involvement in research is considered good practice by European funders; however, evidence of its research impact is sparse, particularly in relation to large-scale epidemiological research. OBJECTIVES: To explore what difference public and stakeholder involvement made to the interpretation of findings from an evaluation of a natural policy experiment to influence the wider social determinants of health: 'Flexicurity'. SETTING: Stockholm County, Sweden...
April 20, 2018: BMJ Open
Ronald McDowell, Kathleen Bennett, Frank Moriarty, Sarah Clarke, Michael Barry, Tom Fahey
OBJECTIVE: To examine the impact of the Preferred Drugs Initiative (PDI), an Irish health policy aimed at enhancing evidence-based cost-effective prescribing, on prescribing trends and the cost of prescription medicines across seven medication classes. DESIGN: Retrospective repeated cross-sectional study spanning the years 2011 - 2016. SETTING: Health Service Executive Primary Care Reimbursement Service pharmacy claims data for General Medical Services (GMS) patients, approximately 40% of the Irish population...
April 20, 2018: BMJ Open
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