Decade Of Action Research Articles

A cross-sectional study to assess the knowledge, attitude, and practice toward road safety rules and regulations among higher secondary school students in rural field practice area of a medical college

Background: India being a developing country faces a double burden of communicable disease and increasing burden of non-communicable disease like road traffic accidents. The year 2000–2011 was declared “Decade of action for road safety” by the UN General Assembly with a goal to reduce and stabilize road traffic accidents. Age groups from 15 to 19 years and second 5 to 14 years are more commonly exposed to road traffic accidents (RTAs), with this background, the study was focused on school-children. Objectives: The objectives of the study were as follows: (i) To study the sociodemographic profile of the study population and (ii) to study the knowledge, attitude, and practices of road safety rules and regulations among higher secondary school students. Materials and Methods: A cross-sectional study was conducted among 266 higher secondary school students in Lokikere, field practice area of S. S. Institute of Medical Sciences, Davangere. Data were collected using pre-tested questionnaire for a period of 2 months from October 2019 to November 2019. Results: Among 266 students, 97.7% of students have received knowledge from their teacher and 61.2% of higher secondary school students have adequate knowledge and positive attitude regarding road safety rules and regulations, even after 95.5% of students having adequate knowledge of age to attain driving license still 23.4% of them drive vehicle without obtaining license, of which 48.3% drive vehicle without parent’s knowledge and 29% of them have been exposed to RTA. Conclusion: Majority of the students have good knowledge of road safety. Around 95% of the students have adequate knowledge, 61.2% of students have positive attitude regarding road safety rules. About 23% of the students drove vehicles without license, among whom 48.3% drove vehicles without parents knowledge and 29% of them have been exposed to RTA.

Macro- and micro-nutrient intake among Hungarian general and Roma adults

Abstract Background Few studies have been conducted with reference to dietary intake among adults in Hungary and none among Roma. In this study, we assess dietary intake of both Hungarian general (HG) and Hungarian Roma (HR) adult population and provide an up-to-date preview on highly health-relevant macro- and micro-nutrient intakes and dietary profile of the HG and HR adult population. Methods The study population comprised 797 Hungarian adults (HG: N = 410, response rate=82% and HR: N = 387, response rate=79%), representative in terms of geographic, sex and age distribution with the general population aged 20-64 years, from the 2018 GINOP Complex Health Survey. Energy and selected nutrient intakes were calculated with NutriComp v.3.0, based on a qualitatively validated double 24 hours dietary recall, adopted for the Hungarian population. Results Total daily energy and selected nutrients intake among HG and HR adult subjects are reported. In spite of the presence of diluted underestimation effects, intake of nutrients with high relevance to health (i.e. sugars, sodium, saturated fats, cholesterol, etc.) remains relatively high, while consumption of fibre-rich products and beneficial nutrients appear to be low, particularly among Roma. Considering both health and environmental impact of the diet, animal-based proteins are way over the target value (i.e. 6%E) of the recent EAT-Lancet report. Conclusions Findings provide data on dietary patterns of HG and HR with nutrient-level estimations, highlighting the importance of establishing and integrating Roma nutrition in national surveillance and monitoring systems for key dietary risk factors. Public health strategies to modify current dietary patterns in Hungary are a great opportunity for improving nutrition, health and environmental impact of dietary choices, especially within the current framework of the UN Decade of Action on Nutrition (2016-2025). Key messages Our study highlights the importance of establishing and integrating Roma nutrition in national surveillance and monitoring systems for key dietary risk factors. Current findings warrant further investigations of the nutritional and dietary patterns among Hungarian General and Roma adult population and their impact on health and environment.

Double burden of underweight and overweight among women of reproductive age in Bangladesh.

Bangladesh, like many emerging economies of South-East Asia, has started to experience a double burden of continuing high rates of undernutrition and increasing rates of overweight and obesity. A lack of assessment of the nutritional shift leaves a gap in current policies: the growing overweight and obesity is yet to be addressed. The present paper investigates the change in nutritional status, particularly the shift in BMI, of Bangladeshi women of reproductive age (15-49 years) and characterizes the vulnerable households for both underweight and overweight status during a period of 10 years (2004-2014). Generalized linear mixed-effect models were fitted for both urban and rural residents to assess underweight and overweight status. Bangladesh Demographic and Health Surveys. Women aged 15-49 years (n53 077). The proportion of overweight increased during 2004-2014 from 10·7 to 25·1 % and the proportion of underweight decreased from 32·6 to 18·2 %. Prevalence of underweight status remained high in rural areas and prevalence of overweight increased rapidly in both rural and urban areas, creating a double burden. The significant contributors to this double burden were the change in women's level of education, increased household wealth, divisional location and rapid urbanization. The findings indicate that specific cohort- or area-based intervention policy studies in line with the UN Decade of Action on Nutrition are required to address the nutritional double burden in Bangladesh.

Governing Global Value Chains: The Role of Masculinities

Despite decades of action and research on labour governance mechanisms to address damaging inequities in global value chains (GVCs), progressive change remains slow. Our critical review proposes co...

Vehicle Safety Post-Decade of Action for Road Safety: The Way Forward

continues. The experiences from the Decade of Action will help us to define an effective roadmap for the next decade. Vehicle safety has been one the areas that has been subjected to significant changes over the past decade with advancements in technology, especially in the field of active safety. This change in the field has been more tangible in High Income Countries (HICs). This note suggests a path to determine the effect of vehicle safety in Iran as a Low/Middle Income Country (LMIC), considering the road safety management structure of the country and introduces the priorities that need to be the subject of focus in further stages. As the “Safe System Approach for Road Safety” focuses on reducing the fatalities and injuries, the interactions between human body and the surrounding area, the vehicle becomes an important issue. Therefore, vehicle designs that meet modern safety standards, with the goal of reducing the risk of occurrence of crashes and ensuing injuries become more prominent. As these advancements in active and passive safety features are being introduced in HICs, the nature of these technologies and limited resources in LMICs, require a deeper understanding of the effectiveness of these technologies would help us set more effective strategies in such countries. A profound understanding of the causes of crashes and the following injuries, is an essential step in setting precise strategies to continue reducing fatalities. This issue has been one of the targets during the decade of action, but a structured regime with independence from involved key stakeholders, must be established to precisely determine the role and details of the involvement of vehicle design and technical aspects in occurrence of the crashes and following injuries. As utilizing advanced technologies for upcoming future is a must to enhance the vehicle safety, considering the economic status of the country besides the evidences in the trend of crashes in Iran suggest effective interventions to achieve results in the shortest time, it would be important to examine the possibility of introducing some of the technologies in the shortest possible time, for example: New Car Assessment Program (NCAP) ratings for new car models. ABS/Combined Braking systems and daytime running lights for powered two-wheelers. Automatic Emergency Braking Systems for cars. Electronic stability control systems (ESC) Such interventions can also be considered as a platform that practices the utilization of new processes in LMICs that can improve in the next stages

Prevalence of nonuse of helmet and seat belt and distracted driving on national highway in Pakistan

Background: Pakistan is a developing country with high number of road traffic injuries. High magnitude of road traffic injuries highlights deficiencies in road traffic laws which are not at par with current safety requirements resultantly fail to address important risk factors such as distracted driving, non-use of seat belt and helmet. Purpose: - To assess effect of deficient traffic laws related of distracted driving, seat belt and helmet usage in term of estimate prevalence of different types of distractions and use of helmet by motorcycle riders and pillion riders and seat belts by the drivers and the passengers on National Highway in Pakistan that can lead to road crashes and increasing the injuries. Methods: Roadside survey was carried on N-5 National Highway to estimate number of distracted drivers, use of helmet by riders and pillion riders and use of seat belt by drivers and passengers. Results: Three types of distraction were observed i.e. Mobile Phone distraction (24%); Equipment related distraction (1%) and eating related distraction (1%) amounting to 29% of drivers distracted ;car drivers (29%), other vehicle drivers (6%), motorcyclists (3%) and trailer drivers (3%). Likewise; 64% drivers were found without seat belt, LTV drivers (85%), car drivers (74%) and truck drivers (69%). Similarly; 97% passengers were found without seat belt, LTV passengers (100%), truck passenger (99%), cars passenger (97%), Oil tanker and trailer passenger (90%). Helmet violation was high with 87.4% motorcycle riders and 100% pillion riders were found without helmet. Conclusion: Lack of enforcement due to deficient traffic laws result in RTIs in Pakistan. There is need to improve legislation on different forms of distractions, use of seat belt among passengers and helmet use by pillion riders; so that enforcement efforts can be made to address risk factors effectively to meet Decade of Action 2011-2020 targets.

The Importance of Humanistic Approach to Traffic Accidents

Iran has witnessed one the fastest decline in the road traffic mortality in past decade. Despite this great achievement, the number of death toll has increased in past two years although in a small manner. The global situation is similarly alarming and recent figures show an increase in the number of fatalities and injuries despite the proclaimed goals for decade of action by the united nation. The current situation does not mean that there were negligence but it indicates more importantly the urgent need to combine the current engineering approach to more humanistic approach to this modern world preventable disaster. Risk perception insufficiency has been found to be a major driver of fatal events especially in younger victims. Although law enforcement and environmental support could initiate the change in behavior but there is need for a humanistic approach for persistent change in behavior.

Cost-effectiveness of strategies to prevent road traffic injuries in eastern sub-Saharan Africa and Southeast Asia: new results from WHO-CHOICE

BackgroundRoad safety has been receiving increased attention through the United Nations Decade of Action on Road Safety, and is also now specifically addressed in the sustainable development goals 3.6 and 11.2. In an effort to enhance the response to Road Traffic Injuries (RTIs), this paper aims to examine the cost effectiveness of proven preventive interventions and forms part of an update of the WHO-CHOICE programme.MethodsGeneralized cost-effectiveness analysis (GCEA) approach was used for our analysis. GCEA applies a null reference case, in which the effects of currently implemented interventions are subtracted from current rates of burden, in order to identify the most efficient package of interventions. A population model was used to arrive at estimates of intervention effectiveness. All heath system costs required to deliver the intervention, regardless of payer, were included. Interventions are considered to be implemented for 100 years. The analysis was undertaken for eastern sub-Saharan Africa and Southeast Asia.ResultsIn Southeast Asia, among individual interventions, drink driving legislation and its enforcement via random breath testing of drivers at roadside checkpoints, at 80% coverage, was found to be the most cost-effective intervention. Moreover, the combination of “speed limits + random breath testing + motorcycle helmet use”, at 90% coverage, was found to be the most cost-effective package. In eastern sub-Saharan Africa, enforcement of speed limits via mobile/handheld cameras, at 80% coverage, was found to be the most cost-effective single intervention. The combination of “seatbelt use + motorcycle helmet use + speed limits + random breath testing” at 90% coverage was found to be the most cost-effective intervention package.ConclusionThis study presents updated estimates on cost-effectiveness of practical, evidence-based strategies that countries can use to address the burden of RTIs. The combination of individual interventions that enforces simultaneously multiple road safety measures are proving to be the most cost-effective scenarios. It is important to note, however, that, in addition to enacting and enforcing legislation on the risk factors highlighted as part of this paper, countries need to have a coordinated, multi-faceted strategy to improve road safety.

After the Road Came: Insights into the Nexus of Food Security and Malnutrition in Northwestern Nepal

The United Nations Decade of Action on Nutrition 2016–2025 and the 2030 Agenda for Sustainable Development call on all countries and stakeholders to work together to prevent all forms of malnutrition by 2030. In Nepal, these considerations are at the forefront of the country's Sustainable Development Goals. To aid in this effort, this article presents a case study from the mountainous Humla District, Nepal, that was designed to better understand how the arrival of the first road in this area is affecting food security and nutritional status, and how these 2 variables are interrelated. Data from participant observation, interviews, the Household Food Insecurity Access Scale questionnaire, and a region-specific food frequency questionnaire suggest that while the road provides more reliable access to market-sourced food than before, villagers' intake of many micronutrients remains below recommended levels, as most of the market-purchased foods are nutrient poor. Data also suggest that this population is experiencing the double burden of malnutrition: simultaneous cases of underweight and overweight. High food security levels among those in the malnourished/overweight group could easily mask this emerging public health concern. This study provides an analytical framework to better understand the nexus of food security and nutrition, and offers evidence-based recommendations for decreasing food insecurity and malnutrition in mountainous regions, which will help achieve the goal of preventing all forms of malnutrition by 2030.

Food Systems: Pathways for Improved Diets and Nutrition

The United Nations has declared 2016–2025 as the Decade of Action on Nutrition. The emphasis of this decade is on alleviating malnutrition in all its forms. Food systems are 1 of 6 priorities for achieving this goal. This brief uses a food-systems approach to analyze the effects of agriculture production, commercialization, and sex on diet quality and nutrition.

Development and challenges to breastfeeding in sub-Saharan Africa

Since there is no doubt concerning the superiority of breastfeeding compared to other forms of infant feeding, the promotion of exclusive breastfeeding up to six months and continued breastfeeding up to two years and beyond are again embraced at the highest global nutrition agenda. The latest is the United Nations decade of action on nutrition 2016-2025, building on research results and the work by the World Health Organization (WHO) over the last two decades, and extensive societal, clinical, and academic discussions in the field of breastfeeding.While the discussion was about the optimal duration of exclusive breastfeeding around the millennium shift, the focus is on the most effective measures for the promotion and protection of breastfeeding. Contemporary breastfeeding rates are well behind the goals. In sub-Saharan Africa, almost all infants are breastfed, while exclusive breastfeeding is more seldom and not sufficient. Africa, being avast and diverse continent with amyriad of cultural practices, has had some shared attitudes ranging from the west to east regarding views on motherhood, body fluids, including milk, infant feeding, and responsible others.The region still faces high maternal HIV infection rates and high infant and child mortality rates. However, due to effective antiretroviral therapies, it is now possible and safe for women living with HIV to breastfeed their infants and to ensure them HIV-free survival. However, there is need for improvement regarding availability, compliance, and adherence to these drugs. Research gaps include the long-term effects of antiretroviral therapy on the growth, health, and development of the exposed children.

Are doctors nutritionists? What is the role of doctors in providing nutrition advice?

AbstractDiet and nutritional status impact on health outcomes. The global rise of diet‐related non‐communicable diseases plus the double burden of obesity and malnutrition means that it is imperative more than ever that all healthcare professionals are able to provide at least basic evidence‐based nutrition advice. Improving an individual's diet requires more than just information provision, it requires consistent and long‐term support to change and maintain new behaviours. Doctors acknowledge that nutrition plays a crucial role in health and agree that providing nutrition advice is part of their role. However, providing sufficiently detailed nutrition advice that is relevant to a patient's health goals, useful for the patient, and that results in measurable changes, is not common in practice settings. Numerous challenges and barriers have been identified for why doctors do not provide nutrition recommendations to their patients. A lack of nutrition education and training, time constraints during appointments, and patients who have access to an ever‐growing body of nutrition and health information via the Internet and social media, together may explain why doctors tend not to include nutrition advice in their care plans. This paper outlines both short‐ and long‐term strategies for improving doctors' engagement with nutrition interventions and collaborative working with dietitians in the context of collaborative care. Having doctors support and advocate for evidenced‐based nutrition practice is a crucial element of the World Health Organization's Decade of Action on Nutrition achieving measurable success.

Food systems, nutrition, health and the environment

Nutritionists are classically concerned with the associations between nutrients and diets and nutrition and health outcomes. Understanding these associations is important. Insufficient and poor quality food, especially during pregnancy and in early childhood is a major contributor to the high burden of undernutrition: globally, 159 million children younger than 5 years are stunted (too short for their age), 50 million children globally are wasted (dangerously thin), and more than 3 million children die every year from causes associated with undernutrition. Simultaneously, nutrition-related chronic diseases such as obesity, diabetes, cardiovascular disease, and some forms of cancer are major contributors to the global burden of disease. Ambitious goals have been set by the international community to eliminate malnutrition in all its forms, and 2016 saw the start of a UN Decade of Action on Nutrition designed to reinvigorate national and international efforts for nutrition.

Motorcyclists’ Mortality Pattern in Colombia from 2000 to 2013: A Longitudinal Study

Background: Road traffic injuries and fatalities have increased in Colombia despite that 2011-2020 had been declared as the Decade of Action for Road Safety in the world. Then, this paper aims to describe the trends of motorcycle mortality patterns in Colombia from 2000-2013. Methods: A longitudinal study is carried out using mortality records from the Colombian National Department of Statistics, and following the International Classification of Diseases -ICD-10 V200 to V299. Results: From 2000 to 2013 the study founded a near 100% increase in the number of motorcycle fatalities in Colombia; the occurrence rate increased from 3.6 to 5.7 per 100,000 populations. 65.4% of the fatalities involve individuals from 15 to 34 years of age. Conclusions: Motorcycle fatalities have become a serious public health issue in Colombia. For the 14-year of the study period, slightly more than 28,800 motorcyclist’s deaths have been attributed to different factors and social determinants.

Streamlining efforts to fight against the global problem of malnutrition in the 2016-2025 decade of action on nutrition

Streamlining efforts to fight against the global problem of malnutrition in the 2016-2025 decade of action on nutrition

The poisoning of Flint and the moral economy of human rights

In late 2015, the United Nations was ending its International Decade for Action, “Water for Life,” which set targets for improving water and sanitation and called for global participation but estab...

Evaluation of the status of the pre-hospital trauma care in road traffic accidents in Kancheepuram district of Tamil Nadu

The recent global estimates suggest that about 1.24 million people die while almost 50 million people are exposed to injuries every year on the roads[1]. In fact, a large proportion of the road traffic accidents (RTAs) occurs in developing nations (which are already struggling to cope with their existing morbidities), it is extremely difficult to deal with the aftermaths of RTAs (viz. handling of acute complications, rehabilitation care, etc.)[1,2]. In view of the rising incidence of RTAs, the current decade 2011–2020 has been declared as the “decade of action for road safety”[2]. Epidemiological studies performed under heterogeneous settings have indicated that a wide gamut of parameters and potential risk factors contribute towards the causation or amplification of the consequences of accidents[1,3-6]. Findings of a descriptive study revealed that the precipitating cause in most of the accidents with fatal outcome was personal problems, recent conflicts, and intake of alcohol by the deceased person and that majority of the accidents were reported either at the beginning or towards the end of their journey[7]. In a retrospective study performed in hospital settings based on the information obtained from the trauma research center, motorcycle (59.2%) was the most common mechanism of injury and about one-fourth of trauma patients had more than two injured organs (the most common site: head and neck)[8]. In an analysis of RTAs with respect to road-users in Greece, brain trauma (among motorcyclists and pedestrians); abdominal injuries/ spinal cord trauma (among car occupants); and pelvic injuries (among pedestrians) were the most common body part involved[9]. Similar sort of trends and determinants have been identified in other studies done in different settings[10,11]. In a qualitative study done in Iran to assess the functioning of prehospital trauma care, it was demonstrated that very few victims received adequate and appropriate treatment at the accident site or during transport and were generally brought to the hospital by lay persons[12]. The scenario becomes dismal in rural areas where most of the deaths result, even before the victims reach the hospital[1316]. In fact, a cohort study concluded that efficient pre-hospital trauma system can remarkably minimize the death rates attributed to RTAs[17]. These facts have seriously necessitated the need for ARTICLE INFO ABSTRACT

Addressing the pandemic on our roads

Reviewing the progress made in UN's Decade of Action on Road Safety 2011-20, it is clear that much remains to be done. The problem of road safety is reaching pandemic proportions; there are 1.3 million traffic related deaths annually, 50 million are disabled because of injuries from road traffic accidents every year, people road accidents are the 8th leading cause of non-natural death, road accidents are the leading cause of death among 15-29 year olds, 60% of all traffic deaths are among 15-44 year olds, traffic accidents result in a loss equal to 1-2% of national GNP. As road infrastructure expands and becomes better in many parts of the world, and motorisation rates increase, the need to act to address this pandemic on our roads is becoming ever more urgent. In this presentation I will outline a strategy for countries to address the pandemic of death and injury from road accidents. This strategy is based on: • The UN's five pillars – Road safety management, safer roads and mobility, vehicles, road users, and post-crash response, • The safe system approach, • Building political commitment and stakeholder support for improving safety, • Performance management, • Evidence, and • Providing value for money

Beyond Legislation: Genuine Change in the Interaction between Victims of Sexual Crimes and the Criminal Law System

This article examines the changes in the encounter between sexual assault victims and representatives of the law enforcement and judicial systems in Israel as perceived by workers and volunteers in the sexual assault crisis centres. After more than four decades of action in legal contexts – from spurring changes in legislation, through the training of professionals within the legal system, up to escorting victims – it is still hard to find studies that describe any change beyond legislation and procedures in the forms that this encounter assumes in Israel and in the world.For the purpose of the study, this interaction was separated from the other aspects of the procedure, observed in depth and, with the interviewees' help, broken down into its relevant components. Data gathered and processed using quantitative and qualitative methods show that, according to the impression of the critical and experienced interviewees, representatives of the legal system truly endeavoured during the first decade of the second millennium to provide victims with better conditions than in the past, encouraging them to speak out in criminal proceedings.As a possible background for the changes in the interpersonal encounter, the article suggests focusing on two mutually related processes, historical but also ongoing. The first is a change in the modes of thought and action in the crisis centres that dealt with this matter and promoted specific changes in the interpersonal encounter. The second process is reflected in the way in which legislators chose to intervene in the interpersonal encounters through four sections in the Rights of Victims of Crime Law. These processes influenced one another and still largely accompany the developments in this sphere, teaching important lessons about change in systems that are not easily amenable to change.

Road safety - implications for sustainable development in Latin America

Road accidents cause more deaths than homicides in Latin America, nevertheless it is not highlighted as a major concern by media and society. World Health Organization put this issue in high priority by releasing the Decade of Action in Road Safety that establishes five pillars to guide national road safety plans and activities. This paper addresses the drawbacks in the implementation of these actions in Latin American countries and its implications to achieve a sustainable development. The main concerns are: lack of empowerment of the road safety management organisations; lower vehicular standards; corruption related to the enforcement of traffic safety laws to and to the construction of safer roads; absence of safety vehicular inspections; vehicle fleet increase, decrease of public transportation demand; and the absence of a safety culture. Without facing these problems, sustainable development in Latin America will be impaired, once road safety is a fundamental link to achieve sustainability.