Prevention Policies Research Articles

Addressing the Global Challenge: Strategies for Cervical Prevention and Early Detection within WHO's 90-70-90 Framework

Cervical cancer represents a substantial global health issue, standing as the third most prevalent cancer globally and the principal cause of cancer-associated mortality in women, with an uneven burden shouldered by less developed countries. Despite being the most preventable malignancy, with nearly all cases attributed to HPV infection, which has a lifetime cumulative risk of 80% through sexual transmission, cervical cancer remains a pressing issue. National cervical cytology screening programs have been implemented to identify cervical abnormalities, lesions, and early malignancies in eligible women. However, the utilization of screening techniques is declining, and due to resource constraints, screening schemes have not been adopted in less-developed economies. Several nations have embraced alternative screening techniques, such as Visual Inspection with Acetic Acid (VIA), which have shown impacts on mortality and morbidity rates. With the rising accessibility of efficacious HPV screening and self-testing, there will be a necessity to reconfigure existing cervical screening programs. Furthermore, preventative HPV vaccination is an integral part of the World Health Organization’s (WHO) Global Strategy to Expedite the Eradication of Cervical Cancer as a Public Health Issue, necessitating the restructuring of vaccination endeavors. This review article evaluates potential techniques for detecting precancerous lesions within the context of the WHO's 90-70-90 global policy for cervical cancer prevention and early diagnosis. The incidence and mortality rates are examined, highlighting the effectiveness of cervical cancer prevention efforts.

Study on Soil Pollution Control and Land Ecological Restoration Technology

This paper discusses the present situation and development trend of soil pollution control and land ecological restoration technology. Soil pollution mainly comes from industrial emissions, excessive use of pesticides and fertilizers and improper treatment of municipal garbage, which poses a threat to agriculture, human health and ecological balance. Treatment technologies include engineering remediation (such as soil replacement and water washing), physical-chemical remediation (such as solidification-stabilization, leaching, etc.), and biological remediation (using microorganisms, plants and animals). Land ecological restoration emphasizes integrity and sustainability, and adopts various methods such as plant and microbial restoration. In addition, prevention and control strategies and policy suggestions are put forward, including strengthening waste treatment standards, rational use of pesticides and fertilizers, and promoting waste classification. It is also suggested to establish a sound legal system for soil pollution prevention and control and raise public awareness of environmental protection.

Evaluations of storm tide hazard along the coast of China using synthetic dynamic tropical cyclone events

Concurring with high astronomical tides, storm surges have caused devastating damage in low-lying areas along the Chinese coastal regions. However, accurately calculating tropical cyclone (TC) storm tide hazards, especially those with long return periods, has proven challenging due to limited temporal and spatial information on TCs. In this study, we adopt the Synthetic Dynamic TC Method (SDTM), which enables a more robust estimation of storm tide hazards by generating a large number of synthetic TCs based on historical best track data and ocean-atmosphere environmental data. Within the SDTM framework, synthetic TCs corresponding to 10,000 years are validated using several statistical metrics, and the associated storm tides are simulated. For comparison, we employ the Historical Storm Method (HSM) to simulate storm tides for historical TCs from 1950 to 2019. Storm tide hazard curves are calculated and compared using these two methods. Our results demonstrate that the SDTM can robustly estimate storm tide hazards for both short and long return periods, whereas the HSM performs well for short return periods but struggles to reliably assess storm tide hazards for long return periods. Notably, within the SDTM, storm tide height exhibits nonlinear growth with increasing return periods in the Gumbel plot, a phenomenon not observed in the HSM due to the limited time span of TC records. With sufficient TC data, the spatial storm tide hazard maps obtained from the SDTM can serve as a robust foundation for developing disaster prevention and mitigation policies.

Policy brief Belgian EBCP mirror group ‘prevention’ and ‘early detection & screening’ in cancer

The availability and linkage of comprehensive data on cancer mortality, incidence, screening and vaccination (HPV/HB) are essential for monitoring the process and impact of all screening and vaccination programmes, and to generate evidence to improve prevention policies. Linkage of data registries will allow better exploitation of real-world data. Simplification of data sharing for epidemiological research is of utmost importance. Human, as well as technical/technological and legal/regulatory barriers need to be tackled in Belgium to aid actors involved in screening, to facilitate organised linkage of data. Rapid advances in technologies for early detection and screening for a broad range of cancer types provide significant opportunities. Such tests are not yet ready for adoption in screening programmes. Emerging evidence should be monitored to ensure that promising innovations can transition to implementation studies in a timely manner. More and sustained research is needed to generate the necessary scientific relevance for new screening techniques in relevant cancer types.

Assessing the national and subnational firearm violence trends in Mexico from 1990 to 2019: secondary data analysis from the Global Burden of Disease study

BackgroundMexico is among the countries with the highest mortality rates by firearms worldwide. We aimed to analyse the trend in the burden of firearm violence (FV) by age and sex...

Epidemiological profile of polytrauma victims attended in a basic care hospital in the South of Brazil: retrospective cross-sectional study

Background: In the scope of public health, it is fundamental to comprehend the patterns and characteristics of the patients attended in hospitals for the guidance about prevention and intervention policies. In this perspective, the present study aims to evaluate the epidemiological profile of polytrauma victims who were assisted in a basic care hospital, located in the interior of Rio Grande do Sul, Brazil, during the period of January 1st to December 31th of 2022. The importance of studying the mechanism of trauma lies in the fact that it is the main cause of fatality in the population between 1 and 44 years old and represents a total of 5.8 million deaths annually in Brazil. Methods: The methodology consists of a retrospective cross-sectional study based on the analysis of hospital records, identifying patterns of gender, age, type of injury, modes of damage and outcome of the attended patients. Results: Based on the data collected, it was observed a predominance of the male gender among the polytrauma victims, with a significant incidence of assistance resulting from motor vehicle collisions, corroborating with previous epidemiological evidence. Conclusion: The epidemiological profile of polytraumatized patients is male, aged 41 and victims of traffic accidents. Therefore, urges the need to develop preventive and interventionist measures in relation to the causal factors of polytrauma, such as road infrastructure and alcohol use. In addition, the study was limited by the fact that it did not investigate the use of alcohol by the drivers, and the license status.

Learning from place-based flood prevention policies: a realist approach

ABSTRACT Due to the frequency and impact of events, flood prevention is gaining importance on public agendas. Local governments and communities have a role to play, but they often lack resources and models to face these challenges. This paper maintains that a place-based approach could address some of the shortcomings of conventional flood prevention methods, and proposes to adopt a realist methodology to learn from innovations in this field. An application is exemplified through the case of the ‘community road maintenance workers’ intervention. The approach seems promising to foster policies more nuanced and integrated, coupling prevention and development.

Community-based malaria prevention policy model in Rampah Village, Kutambaru District, Langkat Regency, Indonesia

Community-based malaria prevention policy model in Rampah Village, Kutambaru District, Langkat Regency, Indonesia

Risk factors of passive suicidal ideation among outpatients in traditional medicine clinics: The case of Korean medicine in South Korea

Suicide is the leading cause of death worldwide, especially in South Korea. Individuals using Korean medicine (KM) clinics are common in this country, but KM doctor is not yet used in the country's suicide prevention policy. In this study, we investigated the prevalence and risk factors of passive suicidal ideation (SI) among outpatients at KM clinics, and attempted to develop a predictive model of SI through multivariate analysis. The Korea Health Panel Annual Data 2019, a nationally representative survey in South Korea, was analyzed. In this study, 1924 (weighted n:5,958,666) people aged 19 or older who used the KM outpatient service at least once in 2019 were set as study subjects. The authors calculated the weighted prevalence of passive SI and identified significant sociodemographic, physical, and mental factors using the Rao-Scott chi-square test and weighted logistic regression. A suicide risk scorecard was developed using the point to double the odds method to quantify individual risk, resulting in a score range of 0–100. We found high prevalence of passive SI among KM outpatients (7.5 %), and the annual prevalence of passive SI tended to be higher with increasing age (4.6 % in young adults, 6.7 % in middle-aged, and 12.4 % in old age). Also, the prevalence increased as stress worsened (2.0 % in hardly, 3.9 % in a little, 13.7 % in a lot, and 24.8 % in very much). By using multiple logistic regression analysis, SI risk prediction score model was developed, including basic livelihood security recipients, presence of chronic diseases, perceived stress, depression, and low quality of life. According to our findings, passive SI is not uncommon among KM outpatients. Based on current findings, the potential role of KMDs in the country's suicide prevention strategy can be discussed focusing on specific groups such as socioeconomically vulnerable groups, the elderly population, and those with physical illnesses.

Plasma metabolites as potential markers and targets to prevent and treat urolithiasis: a Mendelian randomization study.

Studies on the relationships between diseases of the urinary system and human plasma proteomes have identified several potential biomarkers. However, none of these studies have elucidated the causal relationships between plasma proteins and urolithiasis. The objective of the study was to investigate the potential risks of plasma metabolites in urolithiasis using a two-sample Mendelian randomization (MR) study. A total of 1,400 metabolites were identified in the most comprehensive genome-wide association study (GWAS) of plasma metabolomics in a European population to date, and single-nucleotide polymorphisms (SNPs) were used as the instrumental variables for the plasma metabolites. The European GWAS data for urinary calculi included 482,123 case samples and 6,223 control samples (ebi-a-GCST90018935). The associations between the plasma metabolites and risk of urolithiasis were evaluated by inverse variance weighting (IVW) and supplemented by sensitivity analyses of the MR-Egger and MR-PRESSO tests. For the first time, we found a causal relationship between two plasma metabolites (p < 1.03 × 10-4) and urolithiasis (p < 0.05). The chemical 4-hydroxychlorothalonil, which is an intermediate product of the pesticide hydroxychlorothalonil, could promote urolithiasis (odds ratio (OR) = 1.12) as a risk factor. Moreover, 1-stearoyl-2-arachidonoyl-GPC, which is an important component of phospholipid metabolism in the human body, can inhibit urolithiasis (OR = 0.94). Our results suggest that blood metabolites can be used as blood markers and drug targets in the prevention, diagnosis, and treatment of urolithiasis; furthermore, our results can provide a basis for policy makers to formulate prevention and treatment policies for urolithiasis.

Does knowledge matter? How a target's knowledge of their COVID‐19 infection during a violation of preventive policies affects perceived immorality and dehumanization

AbstractDuring the COVID‐19 pandemic, behaviours that violated various precautionary policies were recurring. The present research examined how Chinese participants' perception of targets in terms of immorality and dehumanization depends on the target's knowledge of their COVID‐19 infection. In Study 1 (N = 223), we manipulated the presentation of the target's knowledge of their COVID‐19 infection before violating policies and observed that a target who knew they were infected was perceived as more immoral and less human than a target who knew they were not infected. In Study 2 (N = 267), we replicated this effect and further observed that a target was perceived as less moral and human even when they did not acquire knowledge of their COVID‐19 infection until after having violated the policies. Moreover, perceived immorality played a mediating role between the target's knowledge of their COVID‐19 infection and dehumanization, which was moderated by risk perception of COVID‐19 in Study 2, but not by fear of COVID‐19 in Study 1. These findings increase our understanding of the phenomenon of moralization in the context of a pandemic.

Two Decades of Fatal Workplace Accidents in Milan and Monza, Italy: Trends, Work Sectors, and Causes From Autoptic Data.

Work-related fatalities represent an important global public health threat, accounting for over 300,000 deaths annually. Despite preventive strategies, fatalities persist, necessitating comprehensive investigations. Autoptic investigations, when ordered, offer comprehensive data on fatal accidents, in particular with detailed information about the type of accident, lesions, and type of work, enabling a thorough analysis of various factors contributing to workplace deaths. This study investigates work-related fatalities in Milan and Monza Brianza, Lombardy, analyzing patterns, industries, and factors leading to death among workers. This retrospective study analyzed all fatal work accident data from the Autopsy Database of the Legal Medicine Institute of Milan from January 2000 to December 2022. We also estimated the risk of fatal accidents per 1.00.000 workers using ISTAT data for the different work sectors. Of the 17,841 violent deaths in Milan and Monza Brianza, 308 resulted from work-related accidents. The majority were male (95.1%). The secondary sector showed the higher estimated risk (27 /106 vs. 19/106 in primary and 2.3/106 in tertiary sector) accounted for 78.5% of fatalities, with specialized workers (35.1%) and construction workers (25%) being the most affected. Falls from above were the leading cause of death (36.7%). A decreasing trend in fatal accidents over the study period was observed, with July having the greatest frequency. The most common causes of death were polytrauma (36.4%) and head injuries (19.2%). Non-Italian workers constitute a noteworthy percentage of fatal cases (24%). The secondary sector has the most fatal accidents at work despite a decrease in accidents over the observed time period. There is a need for rigorous analysis and interventions, using forensic autopsy case data to help understand causes, and collaboration between institutions is encouraged to develop effective preventive policies.

Patterns and outcomes of Emergency Pediatric Unit admissions in Usmanu Danfodiyo University Teaching Hospital in Sokoto State, Nigeria: a five-year review

Children are susceptible to illnesses that often require urgent medical attention, with attendant high mortality rates, especially in resource-constrained settings. Periodic audits in tertiary care facilities can guide preventive and therapeutic policies. The aim was to determine the admissions pattern and outcome over five years in the Emergency Paediatric Unit (EPU) of Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto, a major tertiary facility in North Western Nigeria. This was a retrospective study between January 2017 and December 2021. The admission records of children aged &gt;1 month to 15 years were retrieved, relevant information extracted, and entered into a study proforma. Data was analyzed using SPSS version 23. There were 6088 admissions. Under-fives constituted 4448 (73.1%), and males were 3558 (58.4%). The median age was 24.0 months (Interquartile Range, IQR, 12, 60). Top admissions were severe malaria (1100; 18.1%), acute diarrhoeal disease (631; 10.4%), Sickle Cell Disease (SCD) (624; 10.2%), pneumonia (547;9.0%), Severe Acute Malnutrition (SAM) (438;7.2%), febrile convulsions (421;6.9%), pharyngotonsillitis (402;6.6%) and sepsis (398;6.5%). Total discharges were 2483 (40.8%), 2635 (43.3%) were transferred, and mortalities were 679 (11.2%). Case fatality rates of the top admissions were sepsis (19.6%), SAM (19.4%), severe malaria (13.7%), pneumonia (10.6%), febrile convulsions (5.0%), acute diarrhoeal disease (4.9%), pharyngotonsillitis (2.5%) and SCD (2.1%). SCD was the most common non-infectious morbidity and responsible for most re-admissions. Malaria was the top cause of mortality in all age groups except infancy, where sepsis and pneumonia predominated. In conclusion, malaria and other infectious diseases accounted for most admissions. Non-communicable diseases, like SCD, also constitute significant morbidity. Hence, policymakers need to scale up targeted preventive measures.

Government funded suicide prevention in Australia – an environmental scan

BackgroundSuicide is a worldwide public health problem. In response to this problem, Australia was one of the first countries to develop national suicide prevention policy. Guided by the National Suicide Prevention Office (NSPO), which was established in 2021, suicide prevention in Australia is in a period of reform. The NSPO is driving a nationally consistent and integrated approach to suicide prevention including leading the development of a new National Suicide Prevention Strategy. This article summarises findings from an environmental scan of government-led suicide prevention in Australia, conducted as an input for the development of the new Strategy.MethodsThe scan was conducted from August 2022 to January 2023. We searched relevant government websites and Google to identify policy documents and programs and services. We undertook a desktop review of documents and programs/services using coding templates developed to address the objectives of the scan. Qualitative information was extracted in a systematic manner using these templates.ResultsAustralia’s suicide prevention efforts are significant as demonstrated by activities ranging from policy documents intended to guide and plan activity, the National Mental Health and Suicide Prevention Agreement committing the Federal Government and jurisdictions to work together, and the availability of national, state, local area based, and digital services and programs. Suicide prevention approaches in Australia are mostly selective or indicated. There is less emphasis on universal approaches, wellbeing promotion, strengthening protective factors and mitigating the impact of known drivers of distress. In addition, there is limited evidence to demonstrate a whole-of-government or whole-of-system approach is operating in Australia. Findings should be interpreted in the context that suicide prevention in Australia is currently in a period of transition.ConclusionsCurrent government emphasis on and investment in suicide prevention activity, together with strong commitment to lived experience and cross sectorial collaboration, are substantial and appropriate. There are also many opportunities to further progress cross-portfolio and cross-jurisdiction suicide prevention and response efforts. This requires urgently adopting a shared understanding of suicide, which includes the diverse drivers of suicidal distress, and improving protective factors and social wellbeing.

Food Manufacturing Workers and Structural Causality among Work Environment, Work–Family Conflict, Musculoskeletal Pain, Sleep-Related Problems, and Burnout

This study analyzes the association and structural causality among work environment, work–family conflict, musculoskeletal pain, sleep-related problems, and burnout in the food manufacturing industry. This study used the 6th Korean Working Environment Survey data, and 523 food production workers were selected as research subjects. Structural equation modeling showed that work environment and work–family conflict significantly affected musculoskeletal pain. In addition, work–family conflict and musculoskeletal pain affected sleep-related problems, and musculoskeletal pain and sleep-related problems impacted burnout. Furthermore, this research provides practical strategies to deal with musculoskeletal pain, sleep-related issues, and burnout. Burnout is more affected by sleep-related problems than by musculoskeletal pain. Additionally, sleep-related problems seem to be more affected by musculoskeletal pain than by work–family conflict. Meanwhile, musculoskeletal pain is influenced by the work environment rather than by work–family conflict. This result can be used to establish preventive policies for the safety and health of food manufacturing production workers.

Indonesian Education Policy and Management in Resolving Social Disaster

Indonesia, an archipelagic nation rich in natural resources, religious variety, and ethnic diversity, faces social complexities due to these diversities. Social disputes often arise from racial, religious, and social justice disparities, as well as resource competition. This research employs a descriptive qualitative approach to explore how education can prevent and resolve conflicts by promoting diversity, tolerance, and peace. By analyzing community dynamics through literature studies and theories such as the Explanatory Theory and Peace Education Theory, the study aims to provide new insights into educational management techniques and policies for conflict prevention and resolution. Findings indicate that politics, religion, and ethnicity often lead to social strife in Indonesia. Peace education, through inclusive curricula and teacher training, is recommended as an effective solution. Effective educational management requires community involvement, continual assessment, cross-sector cooperation, and adaptability to regional challenges. Thus, education is posited as a primary tool for fostering a just and peaceful society in Indonesia.

Environmental and economic impact analysis of levying VOCs environmental protection tax in China

China is one of the largest volatile organic compounds (VOCs) emitters worldwide. The emission levels of and harm caused by VOCs have attracted much attention. China has implemented multiple policies for VOCs prevention and control but lacks economic control measures for VOCs In this study, the input-output (IO) price model was used to simulate and analyze the emission reduction and economic effects resulting from the imposition of a VOCs environmental protection tax (EPT) in 31 provinces in China. The results show that, first, the collection of a VOCs-EPT can achieve not only VOCs emission reductions but also the synergistic emission reductions of other major pollutants. Second, the collection of a VOCs-EPT could have a negative impact on the macroeconomy, i.e., the greater the tax scope and the higher the tax rate are, the greater the negative economic impact. Third, differences in the level of economic development, the structure of pollution emissions and the stringency of tax policies among regions would cause the emission reduction effect and related negative economic impact to vary across regions. Finally, the collection of a VOCs-EPT could have heterogeneous impacts on various industries, as high-emission industries would suffer greater negative impacts. Therefore, each region should set tax rates that match its provincial economic and environmental development levels. Furthermore, a VOCs-EPT can be levied on key industries, and reasonable preferential tax policies can be formulated to reduce negative macroeconomic benefits.

Dynamic patterns of COVID stress syndrome among university students during an outbreak: a time-series network analysis

Objective Assessing the progression of COVID stress syndrome (CSS) and understanding how cognitive and emotional factors play a role in the dynamic system is critical for prevention and intervention during the COVID-19 pandemic. We investigated the dynamic relationship between self-reported COVID stress syndrome, cognitive factors, and emotional factors through time-series network analysis. Methods and Measures Participants were 188 university students involved in an experience sampling method study that lasted 14 days, three times a day, during the COVID-19 pandemic period following a shift in pandemic prevention and control policy. Results CSS symptoms are usually present simultaneously, and xenophobia is the most central node of the network. There is a complex mutual predictive relationship between CSS symptoms, in which traumatic stress symptoms are crucial in developing and maintaining the CSS symptom network. Negative affect was associated with CSS symptoms at the same time, and subjective health cognition was a significant predictor of CSS symptoms the next time. Conclusions Traumatic stress symptoms are essential nodes in the CSS symptom network, and negative emotions and subjective health influence the occurrence and development of CSS symptoms.

Identification of protein biomarkers in wastewater linked to the incidence of COVID-19

Wastewater-based epidemiological (WBE) surveillance is a viable disease surveillance technique capable of monitoring the spread of infectious disease agents in sewershed communities. In addition to detecting viral genomes in wastewater, WBE surveillance can identify other endogenous biomarkers that are significantly elevated and excreted in the saliva, urine, and/or stool of infected individuals. Human protein biomarkers allow the realization of real-time WBE surveillance using highly sensitive biosensors. In this study, we analyzed endogenous protein biomarkers present in wastewater influent through liquid chromatography–tandem mass spectrophotometry and scaffold data-independent acquisition to identify candidate target protein biomarkers for WBE surveillance of SARS-CoV-2. We found that out of the 1382 proteins observed in the wastewater samples, 44 were human proteins associated with infectious diseases. These included immune response substances such as immunoglobulins, cytokine–chemokines, and complements, as well as proteins belonging to antimicrobial and antiviral groups. A significant correlation was observed between the intensity of human infectious disease-related protein biomarkers in wastewater and COVID-19 case numbers. Real-time WBE surveillance using biosensors targeting immune response proteins, such as antibodies or immunoglobulins, in wastewater holds promise for expediting the implementation of relevant policies for the effective prevention of infectious diseases in the near future.

COVID-19 mortality: educational inequalities and socio-spatial context in two provinces of Argentina.

Motivation for the study. There are very few studies on the educational inequalities in COVID-19 mortality, taking into account social contextual factors. Main findings. We found educational inequalities of COVID-19 mortality during both the 2020 and 2021 waves, regardless of the level of poverty and urbanization in the departments of Mendoza and San Juan provinces (Argentina). Implications. Preventive policies should focus not only in areas with high levels of poverty, but also in areas with adults of low educational level. With the aim of describing the association between sociodemographic characteristics and contextual factors with COVID-19 mortality during 2020-2021 in the provinces of Mendoza and San Juan in Argentina, we conducted an ecological study, which included the sociodemographic factors: age, sex and educational level, and the contextual factors: poverty and urbanization at the departmental level. The analyses were estimated using negative binomial Bayesian hierarchical models. Educational inequalities existed regardless of socioeconomic context and level of urbanization. The exception was the age group 65 years and older during 2021, which, regardless of educational level, showed a higher risk of death by COVID-19 in departments with high levels of structural poverty. In conclusion, educational inequality is an indicator of social inequality that increases vulnerability to COVID-19 mortality.