Development Of Public Health Policies Research Articles

Encuadre mediático de la obesidad infantil en las noticias de prensa generalista en España

ObjectiveTo explore the frame, individual or collective, of childhood obesity in the main Spanish lay media. MethodAnalysis of a convenience sample of 132 publications regarding childhood obesity (August 2016-September 2018). Descriptive analysis about approach, measures and causes of obesity and food industry influence in the development of the publication. Results47% of the publications presented an individual approach. 54% included eating and physical activity as cause. 29% of the measures propose a healthy environment and 27% individual recommendations. Individual frame was present in 77% of the news influenced by the industry. ConclusionPublications on childhood obesity of the main Spanish lay press reveal a predominance of the individual approach to the problem. This majority perception may condition the development and implementation of public health policies or interventions.

Developing a strategic model of participation in policy development for nurses.

To develop a strategic model of participation in policy development for nurses in Thailand. Public health policies inevitably affect nursing practice, service delivery and the nursing workforce. Available evidence indicates that nurses have minimal participation in policy development. Nurses' participation in public health policy development is essential to developing and maintaining an efficient, high-quality healthcare system. The Delphi method was used to develop the strategic model based on the input of fifteen nurse experts who were interviewed over three Delphi rounds. Data were analysed descriptively to identify items to be retained or dropped, and the final list of statements was verified by all participants to establish the strategic model of participation. The strategic model contains twenty-five participation strategies for nurses wishing to engage with public health policy development. Within the model, the priorities as identified by clinical nurses, nurse leaders, nurse researchers and scholars, nursing educational institutions and nursing professional organizations are acknowledged. The model represents a consensus of values related to policy participation by nurses and the results align with similar studies. The inclusion of different nursing groups in promoting and developing strategies to participate in policy development ensures that all nurses have a role to play in developing nursing capacity for effective health policy engagement. Nursing involvement in policies that affect them and their practice is fundamental to establishing good public policy. This research provides a clear mechanism for the development of nurses' awareness and abilities to become involved in policy development and review processes.

Immunoprevention: a course of decades and the challenge to tackle false information

Despite the growing structure of the National Immunization Program, it was possible to witness the resurgence of immunopreventable diseases that were supposed to be controlled. Such phenomenon motivates unrest and discussion in the field of public health, encouraging the academic and scientific community to seek answers, because clearly factors are interfering with the quality of the intended end product, which is the immunogenic protection of populations. In this way, it was evidenced that the media has favored the circulation of dubious and falsely articulated information, causing a fear in the populationthat makes it difficult to adhere to receiving vaccines. Frequently, those attitudes are based on concepts,values, philosophical and religious beliefs that hinder the effective communication of health professionals and the population eligible to receive the immunobiological. In this scenario , false news can cause health problems, hence, it is important to stands out the significance of scientific information. False publications were determinants in the worldwide expansion of the anti-vaccine movement. Indicators of morbidity and mortality are important in the delineation of coping priority in healthcare, but understanding the phenomena that permeate the decision making of populations is of paramount importance for the design of strategies. Research methodologies with different perspective on the same topic complement each other. It is not enough to quantify the problem, but it is also necessary to look for the social changes that occur inthe group and to determine the diversification of behavior in society, mixed research methodologies often propose results that broaden understanding. It is emphasized that providing false information implies the deconstruction of science, considering that scientific information supports decisions that involve the health of the population in different contexts and support the development of public health policies.

Modelling excess mortality among breast cancer patients in the North East Region of Peninsular Malaysia, 2007\u20132011: a population-based study

BackgroundMeasurement of breast cancer burden and identification of its influencing factors help in the development of public health policy and strategy against the disease. This study aimed to examine the variability of the excess mortality of female breast cancer patients in the North East Region of Peninsular Malaysia.MethodsThis retrospective cohort study was conducted using breast cancer data from the Kelantan Cancer Registry between 2007 and 2011, and Kelantan general population mortality data. The breast cancer cases were followed up for 5 years until 2016. Out of 598 cases, 549 cases met the study criteria and were included in the analysis. Modelling of excess mortality was conducted using Poisson regression.ResultsExcess mortality of breast cancer varied according to age group (50 years old and below vs above 50 years old, Adj. EHR: 1.47; 95% CI: 1.31, 4.09; P = 0.004), ethnicity (Malay vs non-Malay, Adj. EHR: 2.31; 95% CI: 1.11, 1.96; P = 0.008), and stage (stage III and IV vs. stage I and II, Adj. EHR: 5.75; 95% CI: 4.24, 7.81; P < 0.001).ConclusionsPublic health policy and strategy aim to improve cancer survival should focus more on patients presented at age below 50 years old, Malay ethnicity, and at a later stage.

Tobacco Product Use and Associated Factors Among Middle and High School Students - United States, 2019.

Tobacco Product Use and Associated Factors Among Middle and High School Students - United States, 2019.

The system of measures to improve the health of the population of Ukraine based on the analysis of the global burden of diseases and its risk factors.

In the modern world, the use of the global burden of diseases and the quantitative assessment of the factors leading to the loss of a healthy life provides fundamental evidence for the development of an adequate public health policy. The purpose of the study is to substantiate the system of measures on improvement of the health of the population of Ukraine on the basis of an in-depth analysis of the global burden of diseases and injuries and associated risks. The study used materials from the Institute of Health Metrics and Evaluation of the University of Washington, Human Development Network of the World Bank and the «Disease Burden Unit» of the World Health Organization, collected during 1990-2017 years. The bibliosemantic, historical, epidemiological, conceptual modeling methods and benchmarking were used in the course of study. The loss rate of age-standardized disability-adjusted life year (DALY) in Ukraine in the period between 1990-2017 practically unchanged and in 2017 it was 34 975.04 DALYs per 100 000, which is almost a quarter more than in the countries of Eastern Europe and twice as much as in the countries of Western Europe. In the structure of Global diseases burden in Ukraine, 3/4 falls on non-communicable diseases, about 15 % depend on external causes and less than 1/10 – on infectious and other diseases and conditions. Shares of the disease burden associated with specific risk factors and diseases related to the relevant factor were identified. The evidence-based system of measures is aimed at achieving goals to reduce the global burden of disease and the risk factors affecting it, being based on an inter-sectoral approach and combines population and individual risk strategies. The subjects of the system are parliament, central and local governments / communities, private campaigns, the media, public health structures and primary health care.

The EU Health Promotion and Disease Prevention Knowledge Gateway

Abstract Issue/ problem Unhealthy diets, physical inactivity, alcohol and tobacco use are leading risk factors for non-communicable diseases. They are all modifiable and health promotion policies can support that. Description of the problem However, information overload, controversies and uncertainties, budget constraints and difficulties in balancing disparate interests are common challenges that can hamper action by policy makers in the field of public health. To support them, the European Commission has created the Health Promotion and Disease Prevention Knowledge Gateway. It is a reference point for independent and reliable information to assist policy making; it summarises both the data and knowledge needed to support prioritisation of public health policies and justify investments in health promotion. Results The Knowledge Gateway currently covers the areas of nutrition, physical activity, alcohol, marketing of foods and beverages, and related societal impacts such as disease burden and health inequalities. These topics have been prioritised by Member States representatives and policy makers. The content is organised into concise, well-structured briefs which include definition of each issue, health related effects, and examples of policy recommendations and implemented policies. The high-quality source documents are selected in a tiered approach and are mainly authored or endorsed by authoritative public health organisations. Lessons Judging by the positive feedback received, the Knowledge Gateway is being used widely across Member States and stakeholders. The content of the Knowledge Gateway will be further expanded to support other health priorities such as mental health promotion. Policy makers have a unique, trusted “one-stop-shop” with high quality information to support, justify and strengthen the development of public health policies and health promotion. Key messages The use of reliable authoritative information for the development of public health policies can support the prevention of major non-communicable disease risk factors. The EU Knowledge Gateway is a unique reference point of reliable, independent information to support policy making in the area of public health.

Youth engagement on health as a political issue

Abstract Background In France, young people do not participate in the development of health policy. The latter is built on a representation of the young person who, because of his age, cannot have an opinion and proposals for his health and improve that of others. However, different young people are involved in health actions and propose improvements for the health system and prevention. The communication concerns the ’Re’Pairs Santé’, young people who are committed with Unis-Cité, a national association, to developing health actions with other young people. Methods 20 ’Re’Pairs santé’ were interviewed in 3 French cities on their motivation for this engagement. Similarly, 80 young beneficiaries of their actions were met in focus groups to get their perception of Re’Pairs santé. Results The engagement of Re’Pairs santé is part of a dimension of solidarity, and on their experience as young people to change the way adults and public policies are represented. For other young people, if there is an improvement in their health knowledge, half of them are involved in other local associations and/or are involved in changing health within their own structure. Conclusions Health is not a minority issue both in the daily lives of young people and as a potential source of engagement. The Re’Pairs santé investment allows other young people to get involved in other structures. Thus, the social impact is not limited to the transmission of health information but promotes social cohesion and the development of social capital. The place and role of young people in the development of public health policies must be better valued and legitimized in order to better meet their expectations but also to destigmatize a population that has many resources. Key messages Fostering youth engagement on health. Youth should be considered as a resource for health policies.

Effects of physical activity interventions on the body mass index of children and adolescents in Latin America: a protocol for a systematic review and meta-analysis

IntroductionIn Latin America, the number of children and adolescents who are overweight or obese has significantly increased in recent decades, and this situation has become a major public health concern....

Development of composite indicators to monitor burden of disease across Member States

Abstract Background The burden of disease (BoD) methods are not part of routine public health activities and policy development process across all Member States (MSs). The main reasons for this are varying levels of knowledge, experience, and capability to apply and use BoD methods. Therefore, MSs need support, guidance and training to adopt and integrate BoD approaches in their public health systems. In this context, two workshops have been organised by InfAct. The main objectives of the workshops are to raise awareness, share knowledge and experience, and to provide mutual support to to integrate BoD indicators in the public health policies across Europe. Methods The workshops were about the BoD concept and methodologies, and the use of BoD data in public health policy. These workshops were supported by technical presentations describing methods and the use of BoD data in health policy with various case studies, followed by expert exchange with facilitated discussions and group work. The case studies included national BoD studies from Belgium, Germany, Netherland, and Scotland. Results Two workshops were held at Santé Publique France, and attended by 16 BoD experts and 40 participants from 25 MSs. The workshops were well received by the participants particularly with regards to the diversity of the group and the possibility to share knowledge and experience from various perspectives. Three areas of action were highlighted: 1. the need for methodological trainings to strengthen skills in interpreting and calculating BoD estimates; 2. the encouragement of more collaborations across MSs to share or exchange good practices on BoD; and 3. the importance of the implications of BoD data to guide policies across MSs. Conclusions The workshops highlighted the need for capacity building activities to implement BoD approaches across MSs in routine public health activities and to use BoD data to guide health policy. More collaborations among MSs on BoD activities are needed in the future.

The joint action of health information

Abstract Presentation of the joint action of health information objectives and the burden of disease action of the workpackage 9 (Innovation in health information for public health policy development).

Isolation, genotyping and antimicrobial susceptibility of pathogenic Escherichia coli serotypes in ready to eat foods

In this study, pathogenic Escherichia coli serotypes (E. coli O157:H7, O26, O111) and their molecular proximity and antimicrobial susceptibility were investigated in RTE foods. A total of 240 samples; consist of 105 stuffed mussel, 56 meatless cig kofte, 54 Russian salad, 25 cheese halva, were analyzed. The conventional culture and serotyping methods for determination of the organisms were performed and further confirmation by PCR was carried out. Confirmed E. coli O157 isolates were genotyped by the enterobacterial repetitive intergenic consensus(ERIC)-PCR. Antibacterial susceptibility testing of the isolates was performed by disc diffusion method. E. coli was detected in 7 (2.9 %) of 240 samples, including 3 (5.5%) Russian salad, 3 (2.8%) stuffed mussel, 1 (4 %) cheese halva. Two isolates from Russian salad, 1 from stuffed mussel and 1 from cheese halva were identified as E. coli O157 . In addition, stuffed mussel isolate was found to carry stx1 ve hlyA genes whereas one Russian salad isolate carried the stx1 gene. E. coli isolates were found to be resistant to amoxycillin/clavulonic acid, gentamicin and ciprofloxacin, at the rate of 29%, 14% and 29 %, respectively. Only one (14 %) isolate from stuffed mussel was classified as multidrug resistant to three antimicrobials. Furthermore, the isolates, related to O157 and O157:H7, presented different ribotypes in this study. The results provide useful data for the development of public health policy concerning the potential presence of pathogenic antimicrobial resistant E. coli serotypes in RTE foods. Strict surveillance of RTE foods at retail points for emerging pathogens, their antimicrobial resistance patterns and the potential likelihood of cross-contamination is required.

Application of kernel smoothing to estimate the spatio-temporal variation in risk of STEC O157 in England

Identifying geographical areas with significantly higher or lower rates of infectious diseases can provide important aetiological clues to inform the development of public health policy and interventions designed to reduce morbidity. We applied kernel smoothing to estimate the spatial and spatio-temporal variation in risk of STEC O157 infection in England between 2009 and 2015, and to explore differences between the residential locations of cases reporting travel and those not reporting travel. We provide evidence that the distribution of STEC O157 infection in England is non-uniform with respect to the distribution of the at-risk population; that the spatial distribution of the three main genetic lineages infecting humans (I, II and I/II) differs significantly and that the spatio-temporal risk is highly dynamic. Our results also indicate that cases of STEC O157 reporting travel within or outside the UK are more likely to live in the south/south-east of the country, meaning that their residential location may not reflect the location of exposure that led to their infection. We suggest that the observed variation in risk reflects exposure to sources of STEC O157 that are geographically prescribed. These differences may be related to a combination of changes in the strains circulating in the ruminant reservoir, animal movements (livestock, birds or wildlife) or the behavior of individuals prior to infection. Further work to identify the importance of behaviours and exposures reported by cases relative to residential location is needed.

Epidemiology of invasive meningococcal disease in Greece, 2006-2016.

The present study describes the epidemiology of invasive meningococcal disease (IMD) in Greece for the period 2006-2016. Combined data from notified and laboratory-confirmed IMD cases were obtained from the two involved National Centres (Epidemiology and Reference Laboratory). Laboratory identification and typing was carried out by both conventional (culture) and molecular methods (PCR, MLST, PorA, and FetA typing). A total of 796 IMD cases were notified; of those, 720 (91%) were laboratory confirmed. Overall, a decline on the annual incidence of confirmed cases was observed, ranging from 0.91 (2006) to 0.47 (2016) /100,000. A similar trend was observed in most age groups especially in children 0-4years (7.7 to 2.9/100,000), with the exception of an increase in the incidence rate in adults > 20years (0.21 to 0.32/100,000). The overall case fatality rate was 6.5% (52/796), annual range 2-13%. Among 658 strains which were typed by sero/genogroup, 80% were identified as MenB (annual range 65-92%); however, a decline was observed in MenB incidence from 5.3 (2006) to 2.7 (2016), among infants and toddlers, while MenW (1%), MenY (2%), and MenA (1%) remained low. During the 11years, the annual incidence of IMD declined by 50%, especially in the 0-4-year age group, due mainly to MenB. Continuous surveillance of IMD is important for the development of future vaccination and public health policies.

Field Test and Validation of the Multiplier Measles, Mumps, Rubella, and Varicella-Zoster Multiplexed Assay System in the Democratic Republic of the Congo by Using Dried Blood Spots.

Here we describe baseline validation studies and field performance of a research-use-only chemiluminescent multiplex serology panel for measles, mumps, rubella, and varicella-zoster virus used with dried blood spots in support of the 2013-2014 Democratic Republic of the Congo Demographic and Health Survey. Characterization of the panel using U.S. FDA-cleared commercial kits shows good concordance for measles, mumps, rubella, and varicella-zoster with average sensitivity across assays of 94.9% and an average specificity of 91.4%. As expected, performance versus available standards validated for plaque-reduction assays does not provide a 1:1 correspondence with international units and yet demonstrates excellent linearity (average Hill's slope = 1.02) and ∼4 logs of dynamic range. In addition, for the four assays, the multiplexed format allowed for inclusion of three positive and two negative controls for each sample. A prototype Dynex Multiplier chemiluminescent automated immunoassay instrument with a charge-coupled device camera provided a rugged and robust processing and data acquisition platform. Performance of a multiplex instrument for serological testing in a substantially resource-limited environment shows excellent reproducibility, minimal cross-reactivity, and a clear discrimination between specific assays and should be considered a viable option for future serosurveys.IMPORTANCE The critical evaluation of immunization programs is key to identifying areas of suboptimal vaccination coverage, monitoring activities, and aiding development of public health policy. For evaluation of vaccine effectiveness, direct antibody binding assay methods, including enzyme immunoassay, enzyme-linked fluorescence assays, and indirect immunofluorescence assay, are most commonly used for detection of IgG antibodies. However, despite their well-demonstrated, reliable performance, they can be labor-intensive and time-consuming and require separate assays for each individual marker. This necessitates increased sample volumes, processing time, and personnel, which may limit assessment to a few key targets in resource-limited settings, that is, low- and middle-income locations where funding for public health or general infrastructure that directly impacts public health is restricted, limiting access to equipment, infrastructure, and trained personnel. One solution is a multiplexed immunoassay, which allows for the detection of multiple analytes in a single reaction for increased efficiency and rapid surveillance of infectious diseases in limited-resource settings. Thus, the scope of the project precluded a full validation, and here we present abbreviated validation studies demonstrating adequate sensitivity, specificity, and reproducibility.

What arguments and from whom are most influential in shaping public health policy: thematic content analysis of responses to a public consultation on the regulation of television food advertising to children in the UK.

ObjectivesWe explore one aspect of the decision making process—public consultation on policy proposals by a national regulatory body—aiming to understand how public health policy development is influenced by different stakeholders.DesignWe used thematic content analysis to explore responses to a national consultation on the regulation of television advertising of foods high in fat, salt and sugar aimed at children.SettingUK.Results139 responses from key stakeholder groups were analysed to determine how they influenced the regulator’s initial proposals for advertising restrictions. The regulator’s priorities were questioned throughout the consultation process by public health stakeholders. The eventual restrictions implemented were less strict in many ways than those originally proposed. These changes appeared to be influenced most by commercial, rather than public health, stakeholders.ConclusionsPublic health policy making appears to be considered as a balance between commercial and public health interests. Tactics such as the questioning and reframing of scientific evidence may be used. In this example, exploring the development of policy regulating television food advertising to children, commercial considerations appear to have led to a watering down of initial regulatory proposals, with proposed packages not including the measures public health advocates considered to be the most effective. This seems likely to have compromised the ultimate public health effectiveness of the regulations eventually implemented.

Removal of Chlorophyll-a Spectral Interference for Improved Phycocyanin Estimation from Remote Sensing Reflectance

Monitoring cyanobacteria is an essential step for the development of environmental and public health policies. While traditional monitoring methods rely on collection and analysis of water samples, remote sensing techniques have been used to capture their spatial and temporal dynamics. Remote detection of cyanobacteria is commonly based on the absorption of phycocyanin (PC), a unique pigment of freshwater cyanobacteria, at 620 nm. However, other photosynthetic pigments can contribute to absorption at 620 nm, interfering with the remote estimation of PC. To surpass this issue, we present a remote sensing algorithm in which the contribution of chlorophyll-a (chl-a) absorption at 620 nm is removed. To do this, we determine the PC contribution to the absorption at 665 nm and chl-a contribution to the absorption at 620 nm based on empirical relationships established using chl-a and PC standards. The proposed algorithm was compared with semi-empirical and semi-analytical remote sensing algorithms for proximal and simulated satellite sensor datasets from three central Indiana reservoirs (total of 544 sampling points). The proposed algorithm outperformed semi-empirical algorithms with root mean square error (RMSE) lower than 25 µg/L for the three analyzed reservoirs and showed similar performance to a semi-analytical algorithm. However, the proposed remote sensing algorithm has a simple mathematical structure, it can be applied at ease and make it possible to improve spectral estimation of phycocyanin from space. Additionally, the proposed showed little influence from the package effect of cyanobacteria cells.

Diego Rivera, The History of Medicine in Mexico: People's Demand for Better Health, mural in 1953 still current

Although public health and social medicine have a long history in Latin America going back to Co lonial times, their relevance has ebbed and flowed as a result of the development of a variety of social and political movements. The Mexican Revolution accelerated implementation of public health po licies in Mexico and resulted in the creation of the Mexican Institute of Social Security to serve the health and social security needs of the country's population. Construction of the Hospital La Raza and its embellishment by the mural paintings of Diego Rivera and David Alfaro Siqueiros correspon ded to the heyday of public health ideas in Mexico. This is clearly reflected in Rivera's mural painting from 1953, The History of Medicine in Mexico: People's Demand for Better Health. The left side of the painting, representing the history of modern medicine in Mexico, exemplifies the tensions between individuals and social groups demanding the fruits of modern medicine and public health, and en trenched bureaucracy and private interests resisting their demands. Rivera's artistry illustrates this tension by depicting urban social groups and a family with a pregnant mother and children reques ting medical attention on one side of the main panel, facing condescending physicians, bureaucrats and upper society gentlemen and ladies on the other side. The importance of social movements to the development of public health policies illustrated by Rivera in 1953 continues to be relevant in Latin America today where increasing millions still lack the benefits of health care and social security.

The Double Burden of Malnutrition: A Systematic Review of Operational Definitions (P22-006-19)

ObjectivesThe double burden of malnutrition (DBM) has received increased attention in research and policy arenas, with wide variation in how DBM is defined. We aimed to systematically identify current operational definitions for DBM (e.g., the coexistence of overnutrition and undernutrition) used in research and evaluate their frequency of use and implications for nutrition surveillance and programs. MethodsWe conducted a structured search for peer-reviewed articles published up to July 2017, using terms describing overnutrition (e.g., overweight, obesity) and undernutrition (e.g., stunting, anemia) in PubMed and Scopus. Additional references were added through snowball searches and online searches for gray literature. We included studies that reported DBM prevalence, including those with primary or secondary data analyses (see Figure 1). Screening of abstracts and full texts for inclusion was conducted in duplicate, with discrepancies resolved by discussion and consensus. Information extracted included the level of DBM assessment (population, household, or individual), measures of overnutrition and undernutrition (BMI, waist circumference, micronutrient status, etc.), and stated definitions of DBM. ResultsWe identified 1920 titles and abstracts for screening through the structured search, and added an additional 66 papers and reports. Of these, 500 full-texts were reviewed and 239 were eligible for data extraction. Frequently-occurring DBM definitions included the coexistence of: 1) overweight/obesity and underweight within a population (e.g., entire country or region); 2) adult overweight/obesity and child stunting within a population or household; and 3) overweight/obesity and anemia or iron deficiency within an individual. DBM was most frequently measured at the population level, followed by the individual and household levels. ConclusionsThe most common operational definitions of DBM relied on population-level analyses of anthropometric indicators, with many studies leveraging existing data, such as national health surveys. Further research exploring DBM definitions in relation to key health outcomes and country priorities may help select indicators that best inform public health program and policy development. Funding SourcesThis work was supported by the USDA National Institute of Food and Agriculture Hatch Project. Supporting Tables, Images and/or Graphs▪

A Reliable Preclinical Model to Study the Impact of Cigarette Smoke in Development and Disease.

The World Health Organization has estimated that, worldwide, cigarette smoking has caused more than 100 million deaths in the last century, a number that is expected to increase in the future. Understanding cigarette smoke toxicity is key for research and development of proper public health policies. The current challenge is to establish a reliable preclinical model to evaluate the effects of cigarette smoke. In this work, we describe a simple method that allows for quantifying the toxic effects of cigarette smoke using zebrafish. Here, viability of larvae and adult fish, as well as the effects of cigarette smoke extracts on vascular development and tissue regeneration, can be easily assayed. © 2019 by John Wiley & Sons, Inc.