Top Research Priorities Research Articles

Moving forward through consensus: a national Delphi approach to determine the top research priorities in prostate cancer in Uganda

ObjectiveTo identify key areas for research in prostate cancer (PC) in the Ugandan context by establishing the major health system, socioeconomic and clinical barriers to seeking, reaching and receiving high-quality...

Bottom-up approach to set research needs in healthcare

Abstract Clinical research is a pivotal element for the Emilia-Romagna (Italy) healthcare system. Since 2004 the regional government has established “regional health research plans” that define priority research topics for the regional health system (RHS). Research on identified topics has been funded by periodic calls for public grants to support not for profit research carried out in regional public Hospitals and Local Health Trusts (LHTs). Until today, in Emilia-Romagna region, a top-down approach was used with regional decision-makers in identifying research themes to be investigated and funded. The goal of this intervention was to promote a bottom-up approach to identify research needs and survey research expectations from different stakeholders. To widely represent research needs and expectations, the research process involved not only decision-makers but also researchers, healthcare and social professionals, a citizens’ advisory committee. To enable every stakeholder to make a concrete contribution to the regional health research plan, innovative qualitative techniques such as focus group (FG) and Open Space Technology (OST) were used. Then, the material was analyzed by content analysis and a narrative synthesis of results was carried out. From January to December 2022, 160 regional stakeholders participated in 8 FGs and one OST. Research on health and social services emerged as the main ‘orphan’ area. Needs focused on the evaluation of services and factors affecting the quality of care, and on the development of new organizational models and research methods to assess organizational innovations. Research on interventions to improve community healthcare was indicated as an urgent need. The work highlights that the research on the organization of social and health services is one of the topic neglected. In particular the need to deepen the methodology and to study effective interventions to be implemented was expressed. Key messages • Research on health and social services emerged as the main ‘orphan’ area. • The work returns results on research needs from a broad sample of stakeholders to policymakers to direct regional funding for research.

Modelling the impact of renewable energy investment on global carbon dioxide emissions

The adversities of climate change facing the world highlight the importance of reducing the rise of global carbon emissions (CO2E), which is a top priority for policymakers and researchers. Renewable energy is hailed as a remedy to the rise in global CO2E. However, there are persistently low levels of global renewable energy investment (REI). This study, therefore, examines the linear and non-linear effect of REI (measured by solar, wind, small hydropower, geothermal, biomass, marine, and biofuel energy investment) on CO2E using a global dataset from 2004Q1 to 2018Q1. The study also examines the economic growth mechanism through which REI influences CO2E. Using the Ordinarily Least Squares model, the findings show that all the measures of REI significantly increase CO2E from the linear analysis. However, the non-linear analysis showed that solar and wind energy investment have a statistically significant inverted U-shaped relationship with CO2E while small hydropower and biofuel energy investment have a statistically significant U-shaped relationship with CO2E. Thus, solar and wind energy investment reduce CO2E only after attaining a threshold of investment with the threshold value of solar and wind energy investment being 28.125 (representing about $1.64 trillion) and 26.308 (representing about $266.3 billion), respectively. Also, the threshold value of small hydropower and biofuel energy investment beyond which they increase CO2E are 20.071 (representing about $520.9 million) and 22.8 (representing about $7.978 billion), respectively. Finally, solar, wind and geothermal energy investment indirectly reduce CO2E by increasing green economic growth while the reverse exists for biofuel energy investment. Solar and wind energy investment is, therefore, recommended for attaining carbon neutrality targets. Policymakers should incentivize production tax credits, investment tax credits, feed-in-tariffs, subsidies, affordable loans, and research and development to drive solar and wind energy investment.

Using Research to Transform Electronic Health Record Modernization: Advancing a VA Partnered Research Agenda to Increase Research Impacts.

The U.S. Department of Veterans Affairs (VA) is undergoing an enterprise-wide transition from a homegrown electronic health record (EHR) system to a commercial off-the-shelf product. Because of the far-reaching effects of the EHR transformation through all aspects of the healthcare system, VA Health Services Research and Development identified a need to develop a research agenda that aligned with health system priorities so that work may inform evidence-based improvements in implementation processes and outcomes. The purpose of this paper is to report on the development of a research agenda designed to optimize the EHR transition processes and implementation outcomes in a large, national integrated delivery system. We used a sequential mixed-methods approach (portfolio assessment, literature review) combined with multi-level stakeholder engagement approach that included research, informatics, and healthcare operations experts in EHR transitions in and outside the VA. Data from each stage were integrated iteratively to identify and prioritize key research areas within and across all stakeholder groups. VA informatics researchers, regional VA health system leaders, national VA program office leaders, and external informatics experts with EHR transition experience. Through three rounds of stakeholder engagement, priority research topics were identified that focused on operations, user experience, patient safety, clinical outcomes, value realization, and informatics innovations. The resulting EHR-focused research agenda was designed to guide development and conduct of rigorous research evidence aimed at providing actionable results to address the needs of operations partners, clinicians, clinical staff, patients, and other stakeholders. Continued investment in research and evaluation from both research and operations divisions of VA will be critical to executing the research agenda, ensuring its salience and value to the health system and its end users, and ultimately realizing the promise of this EHR transition.

Expression of Cytoskeletal Proteins (GFAP, Vimentin), Proapoptotic Protein (Caspase-3) and Protective Protein (S100) in the Epileptic Focus in Adults and Children with Drug-Resistant Temporal Lobe Epilepsy Associated with Focal Cortical Dysplasia.

The European Commission of the International League Against Epilepsy (ILAE) has identified glial mechanisms of seizures and epileptogenesis as top research priorities. The aim of our study was to conduct a comparative analysis of the expression levels of cytoskeletal proteins (glial fibrillar acidic protein (GFAP) and vimentin), protective protein S100, and proapoptotic caspase-3 protein in patients with drug-resistant epilepsy (DRE) associated with focal cortical dysplasia (FCD). We aimed to investigate how the expression levels of these proteins depend on age (both in children and adults), gender, and disease duration, using immunohistochemistry. Nonparametric statistical methods were employed for data analysis. In the epileptic focus area of the cortex and white matter in patients with FCD-associated temporal lobe DRE, a higher level of expression of these proteins was observed. Age and gender differences were found for vimentin and S100. In the early stages of disease development, there was a compensatory sequential increase in the expression of cytoskeletal and protective proteins. In patients with DRE, depending on the disease duration, patterns of development of neurodegeneration were noted, which is accompanied by apoptosis of gliocytes. These results provide insights into epilepsy mechanisms and may contribute to improving diagnostic and treatment approaches.

Mapping global evidence on injuries/trauma due to sexual and gender-based violence for research prioritisation and development of guidelines to mitigate their impact: a scoping review protocol

BackgroundThe World Health Organization recognises injuries as a growing global public health problem. While there are several causes of injuries and trauma, relevant research is mostly centred on road traffic accidents, burns, and drowning with less focus on violence-related injuries/trauma such as sexual and gender-based violence (SGBV). To identify priority research topics, prioritisation, and development of practice guidelines to mitigate the impact of injuries/trauma resulting from SGBV, this systematic scoping review will aim to map and describe the range of research relating to injuries/trauma due to SGBV in the global context.MethodsA scoping review guided by Arksey and O’Malley’s methodological framework will be conducted. Literature relating to injuries/trauma and SGBV will be searched in PubMed, SCOPUS, and PsycINFO, CINAHL, Web of Science, Google Scholar, Trip, guideline repositories, websites, and reference list of included articles. This study will include evidence sources focused on the epidemiological burden, guidelines for out-of-hospital and in-hospital care of victims, barriers or facilitators to reporting and obtaining healthcare, and approaches for mitigating injuries/trauma due to SGBV. The search will be limited to publications within 10 years (2012 to 2023). Two authors will apply the eligibility criteria to identify potentially relevant citations. The data will be extracted in duplicate and methodological quality assessed using varied tools (Mixed Method Quality Appraisal Tool; and Appraisal of Guidelines, Research and Evaluation instrument). The study will be reported in keeping with the Preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews.DiscussionThe scoping review will highlight existing literature on injuries/trauma due to SGBV and identify gaps to facilitate research prioritisation, development of guidelines, and resource allocation to alleviate the impact of injuries/trauma resulting from SGBV. This study’s findings will be disseminated via a series of meetings with key stakeholders (local and international) in the field of healthcare, policy, social welfare, GBV interest groups, and others. Also, the final scoping review results will be presented at relevant workshops, meetings, and conferences. Moreover, this study’s findings will be disseminated via journal publications and policy briefs.

Priority setting to support a public health research agenda: a modified Delphi study with public health stakeholders in Germany

BackgroundResearch priority setting (RPS) studies are necessary to close the significant gap between the scientific evidence produced and the evidence stakeholders need. Their findings can make resource allocation in research more efficient. However, no general framework for conducting an RPS study among public health stakeholders exists. RPS studies in public health are rare and no such study has been previously conducted and published in Germany. Therefore, we aimed to investigate which research topics in public health are prioritised by relevant stakeholders in Germany.MethodsOur RPS study consisted of a scoping stage and a Delphi stage each split into two rounds. Firstly, we invited members of the German Public Health Association to gather expert insights during two initial workshops. Next, we defined the relevant stakeholder groups and recruited respondents. Thereafter, we collected research topics and assessment criteria with the respondents in the first Delphi round and aggregated the responses through content analysis. Finally, we asked the respondents to rate the research topics with the assessment criteria in the second Delphi round.ResultsIn total, 94 out of the 140 invited public health organisations nominated 230 respondents for the Delphi study of whom almost 90% participated in both Delphi rounds. We compiled a comprehensive list of 76 research topics that were rated and ranked by several assessment criteria. We split the research topics into two types, substantive research topics and methodological-theoretical research topics respectively, to ensure the comparability among the research topics. In both types of research topics—substantive research topics and methodological-theoretical research topics—the respective top five ranked research topics hardly differed between public health researchers and public health practitioners. However, clear differences exist in the priority ranking of many (non-top priority) research topics between the stakeholder groups.ConclusionsThis research demonstrates that it is possible, with limited resources, to prioritise research topics for public health at the national level involving a wide range of pertinent stakeholders. The results can be used by research funding institutions to initiate calls for research projects with an increased relevance for health and/or scientific progress.

Research Priorities in Prehabilitation for Patients Undergoing Cancer Surgery: An International Delphi Study

BackgroundRecently, the number of prehabilitation trials has increased significantly. The identification of key research priorities is vital in guiding future research directions. Thus, the aim of this collaborative study was to define key research priorities in prehabilitation for patients undergoing cancer surgery.MethodsThe Delphi methodology was implemented over three rounds of surveys distributed to prehabilitation experts from across multiple specialties, tumour streams and countries via a secure online platform. In the first round, participants were asked to provide baseline demographics and to identify five top prehabilitation research priorities. In successive rounds, participants were asked to rank research priorities on a 5-point Likert scale. Consensus was considered if > 70% of participants indicated agreement on each research priority.ResultsA total of 165 prehabilitation experts participated, including medical doctors, physiotherapists, dieticians, nurses, and academics across four continents. The first round identified 446 research priorities, collated within 75 unique research questions. Over two successive rounds, a list of 10 research priorities reached international consensus of importance. These included the efficacy of prehabilitation on varied postoperative outcomes, benefit to specific patient groups, ideal programme composition, cost efficacy, enhancing compliance and adherence, effect during neoadjuvant therapies, and modes of delivery.ConclusionsThis collaborative international study identified the top 10 research priorities in prehabilitation for patients undergoing cancer surgery. The identified priorities inform research strategies, provide future directions for prehabilitation research, support resource allocation and enhance the prehabilitation evidence base in cancer patients undergoing surgery.

Tezacaftor/Ivacaftor therapy has negligible effects on the cystic fibrosis gut microbiome.

People with cystic fibrosis (pwCF) experience a range of persistent gastrointestinal symptoms throughout life. There is evidence indicating interaction between the microbiota and gut pathophysiology in CF. However, there is a paucity of knowledge on the potential effects of CF transmembrane conductance regulator (CFTR) modulator therapies on the gut microbiome. In a pilot study, we investigated the impact of Tezacaftor/Ivacaftor dual combination CFTR modulator therapy on the gut microbiota and metabolomic functioning in pwCF. Fecal samples from 12 pwCF taken at baseline and following placebo or Tezacaftor/Ivacaftor administration were subjected to microbiota sequencing and to targeted metabolomics to assess the short-chain fatty acid (SCFA) composition. Ten healthy matched controls were included as a comparison. Inflammatory calprotectin levels and patient symptoms were also investigated. No significant differences were observed in overall gut microbiota characteristics between any of the study stages, extended also across intestinal inflammation, gut symptoms, and SCFA-targeted metabolomics. However, microbiota and SCFA metabolomic compositions, in pwCF, were significantly different from controls in all study treatment stages. CFTR modulator therapy with Tezacaftor/Ivacaftor had negligible effects on both the gut microbiota and SCFA composition across the course of the study and did not alter toward compositions observed in healthy controls. Future longitudinal CFTR modulator studies will investigate more effective CFTR modulators and should use prolonged sampling periods, to determine whether longer-term changes occur in the CF gut microbiome. IMPORTANCE People with cystic fibrosis (pwCF) experience persistent gastrointestinal (GI) symptoms throughout life. The research question "how can we relieve gastrointestinal symptoms, such as stomach pain, bloating, and nausea?" remains a top priority for clinical research in CF. While CF transmembrane conductance regulator (CFTR) modulator therapies are understood to correct underlying issues of CF disease and increasing the numbers of pwCF are now receiving some form of CFTR modulator treatment. It is not known how these therapies affect the gut microbiome or GI system. In this pilot study, we investigated, for the first time, effects of the dual combination CFTR modulator medicine, Tezacaftor/Ivacaftor. We found it had negligible effects on patient GI symptoms, intestinal inflammation, or gut microbiome composition and functioning. Our findings are important as they fill important knowledge gaps on the relative effectiveness of these widely used treatments. We are now investigating triple combination CFTR modulators with prolonged sampling periods.

An Evaluation of the Alignment of Surplus Food Recovery and Redistribution Technologies with the Circular Economy

In Qatar, food security is a top research priority. The National Food Security Strategy (2018–2023) and the Qatar National Vision 2030 show evidence of policy support regarding food security. The United Nations Sustainable Development Goal (S.D.G.) 12.3 frames the basis of food waste reduction efforts. Our study aims to provide basic information for innovative mobile application development that addressed food insecurity and waste in Qatar. Furthermore, we discuss how such a technology and the proposed features align with the circular economy concept. The circular economy aims to prolong the useful life of materials and products to maximize resource value and reduce waste. In addition, we highlight the main potential benefits that various stakeholders in the Qatar economy could derive from the innovative surplus food recovery mobile application. The scope of this work is necessary given the diverse nature of the stakeholders involved in the surplus food recovery and redistribution industry. The innovation demonstrated significant solutions to many problems, and using them in the food sector could provide optimal solutions to manage/reduce food surplus waste and loss. The suggested platform differs from the existing food services application, as it closes the food circle and achieves the sustainable goals for a better environment and society for future generations. We conclude with suggestions concerning how public–private collaboration could help recover surplus food and reduce food loss.

Feasibility of comparing medical management and surgery (with neurosurgery or stereotactic radiosurgery) with medical management alone in people with symptomatic brain cavernoma – protocol for the Cavernomas: A Randomised Effectiveness (CARE) pilot trial

IntroductionThe top research priority for cavernoma, identified by a James Lind Alliance Priority setting partnership was ‘Does treatment (with neurosurgery or stereotactic radiosurgery) or no treatment improve outcome for people...

Serum neurofilament light chain reference database for individual application in paediatric care: a retrospective modelling and validation study

Neurological conditions represent an important driver of paediatric disability burden worldwide. Measurement of serum neurofilament light chain (sNfL) concentrations, a specific marker of neuroaxonal injury, has the potential to contribute to the management of children with such conditions. In this context, the European Medicines Agency recently declared age-adjusted reference values for sNfL a top research priority. We aimed to establish an age-adjusted sNfL reference range database in a population of healthy children and adolescents, and to validate this database in paediatric patients with neurological conditions to affirm its clinical applicability. To generate a paediatric sNfL reference dataset, sNfL values were measured in a population of healthy children and adolescents (aged 0-22 years) from two large cohorts in Europe (the Coronavirus Antibodies in Kids from Bavaria study, Germany) and North America (a US Network of Paediatric Multiple Sclerosis Centers paediatric case-control cohort). Children with active or previous COVID-19 infection or SARS-CoV-2 antibody positivity at the time of sampling, or a history of primary systemic or neurological conditions were excluded. Linear models were used to restrospectively study the effect of age and weight on sNfL concentrations. We modelled the distribution of sNfL concentrations as a function of age-related physiological changes to derive reference percentile and Z score values via a generalised additive model for location, scale, and shape. The clinical utility of the new reference dataset was assessed in children and adolescents (aged 1-19 years) with neurological diseases (epilepsy, traumatic brain injury, bacterial CNS infections, paediatric-onset multiple sclerosis, and myelin oligodendrocyte glycoprotein antibody-associated disease) from the paediatric neuroimmunology clinic at the University of California San Francisco (San Francisco, CA, USA) and the Children's Hospital of the University of Regensburg (Regensburg, Germany). Samples from 2667 healthy children and adolescents (1336 [50·1%] girls and 1331 [49·9%] boys; median age 8·0 years [IQR 4·0-12·0]) were used to generate the reference database covering neonatal age to adolescence (target age range 0-20 years). In the healthy population, sNfL concentrations decreased with age by an estimated 6·8% per year until age 10·3 years (estimated multiplicative effect per 1 year increase 0·93 [95% CI 0·93-0·94], p<0·0001) and was mostly stable thereafter up to age 22 years (1·00 [0·52-1·94], p>0·99). Independent of age, the magnitude of the effect of weight on sNfL concentrations was marginal. Samples from 220 children with neurological conditions (134 [60·9%] girls and 86 [39·1%] boys; median age 14·7 years [IQR 10·8-16·5]) were used to validate the clinical utility of the reference Z scores. In this population, age-adjusted sNfL Z scores were higher than in the reference population of healthy children and adolescents (p<0·0001) with higher effect size metrics (Cohen's d=1·56) compared with the application of raw sNfL concentrations (d=1·28). The established normative sNfL values in children and adolescents provide a foundation for the clinical application of sNfL in the paediatric population. Compared with absolute sNfL values, the use of sNfL Z score was associated with higher effect size metrics and allowed for more accurate estimation of the extent of ongoing neuroaxonal damage in individual patients. Swiss National Science Foundation, US National Institutes of Health, and the National Multiple Sclerosis Society.

Current progress in the targeted therapy of breast cancer: Structure-activity correlation and docking studies (2015-2021).

Despite cancer research and therapy, breast cancer remains a complicated health crisis in women and represents a top biomedical research priority. Nowadays, breast cancer is an extremely heterogeneous disease and is known as the leading cause of death among women worldwide. The incidence and mortality rates of breast cancer have been increasing gradually for the past decades. Nowadays, common treatments for breast cancer are chemotherapy, endocrine therapy, immunotherapy, radiotherapy, and surgery. The most common targets in breast cancer treatment are human epidermal growth factor receptor 2 (HER2) and estrogen receptors. The literature suggests that several targets/pathways are also involved in the development of breast cancer, that is, poly(ADP-ribose) polymerase (PARP), bromodomain-containing protein 4 (BRD4), cyclin-dependent kinase 4/6 (CDK4/6), epidermal growth factor receptor (EGFR), vascular endothelial growth factor receptor (VEGFR), polo-like kinase 1 (PLK1), phosphoinositide 3-kinases/protein kinase B/mammalian target of rapamycin (PI3K/AKT/mTOR), histone deacetylase (HDAC), nuclear factor kappa B (NF-κB), PD-L1, and aromatase inhibitors. Meanwhile, the study of breast cancer is a hot topic in the current scenario of basic/clinical research. This review article provides information on different targets associated with breast cancer and summarizes the progress of current research on synthesized inhibitors as anti-breast cancer agents from 2015 to 2021. The review aims to provide structure-activity relationship and docking studies for designing novel compounds for breast cancer therapy.

Research Priorities in the Management of Hidradenitis Suppurativa.

There is a need for high-quality research to support the management of hidradenitis suppurativa. This letter offers suggestions for priority research topics derived from a stakeholder consensus meeting. Investigation of laser hair removal treatment, potentially in combination with medical treatment, was recognized as an important focus for future hidradenitis suppurativa research.

Stigma on People with Mental Illness

As a minority group, people with mentally illness are not deeply concerned with the society. Information mismatch and incomprehension lead to discrimination and misunderstanding. The purpose of this paper is to reveal this unfair discrimination in order to reduce the misunderstanding. Specifically, it introduces the specific mental illnesses or symptoms are more likely to be misunderstood by others, how discrimination was generated by people because of the inaccurate cognition towards mental illness, and the impact of discrimination on people with mental illness. The stigma not only harms patients in the process of socialization and integration of the society, but also influences patients families and daily life. These harms and disadvantages make patients suffer secondary hurting in addition to the disease. The expectation of treating this unfairness is that with the development of society and time, more and more people will understand the situation of patients with mental illness and be able to get along with them with a normal mind. Plus, it is the top priority of research to intervene such stigma and further reduce the negative impact on patients. However, due to the different implementation measures, the society lacks a real practice template. There is no real data on the effectiveness of the intervention. It is all theoretical, and there is no research based on the actual implementation results, which needs to be further addressed in future research.

Protocol Development for a Qualitative Methodological Study Within a Trial (Qual-SWAT): The KARMA-Dep-2 Trial.

Despite methodological improvements in clinical trial design and conduct more generally, methodological limitations persist in trials concerning mental health care. A qualitative Study Within A Trial (Qual-SWAT), embedded in the KARMA-Dep-2 host trial, will be undertaken to explore and gain an understanding of two methodological questions in randomised trials specific to mental health care: (1) what are the key barriers and enablers of participation in randomised trials in mental health; and (2) how can randomised trials become part of routine mental health care. These issues will be examined from patient-participant and clinician- / researcher-participant perspectives, in alignment with PRioRiTy research themes. A descriptive qualitative study design will be used. Data will be collected via one-to-one semi-structured interviews, conducted via Microsoft Teams. The interview data will be analysed using Braun and Clarke's Thematic Analysis approach. One-to-one interviews will be conducted with three participant groups ( N = 30): 1) host trial patient-participants ( n = 10); 2) potentially eligible host trial patient-participants who refused enrolment in the host trial ( n = 10); and 3) clinician- / researcher-participants who are associated with work on the host trial ( n = 10). Ethical approval has been granted by St. Patrick's Mental Health Services Research Ethics Committee, Ireland (Ref: Protocol 09/20). When the study is completed, a report will be prepared and submitted to the Health Research Board (HRB). Findings will be shared with the host trial team and study participants, and submitted for publication. ClinicalTrials.gov ( NCT04939649); EudraCT ( 2019-003109-92). Official title: Ketamine as an Adjunctive Therapy for Major Depression - A Randomised Controlled Trial: [KARMA-Dep (2)].

Establishing critical care nursing research priorities for three Australian regional public hospitals: A mixed method priority setting study

ObjectiveTo determine key priorities for critical care nursing research in three Australian regional public hospitals, representing the shared priorities of healthcare professionals and patient representatives. MethodsA three phase priority setting study, including consensus methods (nominal group), survey, qualitative interviews and focus groups were conducted between May 2021 and March 2022. Healthcare professionals and patient representatives from critical care units in regional public hospitals in Australia participated. A patient representative contributed to research design and co-authored this paper. ResultsIn phase one, 29 research topics were generated. In phase two, during a nominal group ranking process, the top 5 priority areas for each site were identified. In the final phase, three themes from focus groups and interviews included patient flow through intensive care, patient care through intensive care journey and intensive care patient recovery. ConclusionIdentifying context specific research priorities through a priority setting exercise provides insight into the topics that are important to healthcare professionals and to patients in critical care. The top research priorities for nursing research in critical care in regional Australian hospitals include patient flow, patient recovery, and evidence based patient care through the intensive care journey, such as delirium management, pain and sedation, and mobilisation. These shared priorities will be used to guide future nursing research in critical care over the next 3–5 years. Implications for Clinical PracticeThe method we used in identifying the research priorities can be used by other researchers and clinicians; close collaboration among researchers and clinicians will be beneficial for practice improvement; and how we can be reassured that our practice is evidence based is worthy of attention.

A Methodology for Strategic Selection of Priority Research Topics in Terms of Bibliometric Analysis

A Methodology for Strategic Selection of Priority Research Topics in Terms of Bibliometric Analysis

Prevalence, trends and distribution of lifestyle cancer risk factors in Uganda: a 20-year systematic review

BackgroundCancer is becoming an important public health problem in Uganda. Cancer control requires surveillance of lifestyle risk factors to inform targeted interventions. However, only one national Non-Communicable Disease (NCD) risk factor survey has been conducted in Uganda. This review assessed the prevalence, trends and distribution of lifestyle risk factors in Uganda.MethodsThe review identified studies up to January 2019 by searching Medline, Embase, CINAL and Cochrane databases. Further literature was identified from relevant websites and journals; scanning reference lists of relevant articles; and citation searching using Google Scholar. To be eligible, studies had to have been conducted in Uganda, and report prevalence estimates for at least one lifestyle cancer risk factor. Narrative and systematic synthesis was used to analyse the data.ResultsTwenty-four studies were included in the review. Overall, unhealthy diet (88%) was the most prevalent lifestyle risk factor for both males and females. This was followed by harmful use of alcohol (range of 14.3% to 26%) for men, and being overweight (range of 9% to 24%) for women. Tobacco use (range of 0.8% to 10.1%) and physical inactivity (range of 3.7% to 4.9%) were shown to be relatively less prevalent in Uganda. Tobacco use and harmful use of alcohol were more common in males and more prevalent in Northern region, while being overweight (BMI > 25 kg/m2) and physical inactivity were more common in females and more prevalent in Central region. Tobacco use was more prevalent among the rural populations compared to urban, while physical inactivity and being overweight were more common in urban than in rural settings. Tobacco use has decreased overtime, while being overweight increased in all regions and for both sexes.ConclusionThere is limited data about lifestyle risk factors in Uganda. Apart from tobacco use, other lifestyle risk factors seem to be increasing and there is variation in the prevalence of lifestyle risk factors among the different populations in Uganda. Prevention of lifestyle cancer risk factors requires targeted interventions and a multi-sectoral approach. Most importantly, improving the availability, measurement and comparability of cancer risk factor data should be a top priority for future research in Uganda and other low-resource settings.

Concern about the human health implications of marine biodiversity loss is higher among less educated and poorer citizens: Results from a 14-country study in Europe

IntroductionMarine biodiversity loss has direct and indirect effects on human health and wellbeing. Recent European data suggest that the public is aware of this, identifying marine biodiversity protection as its top research priority in terms of oceans and human health, rated higher than issues such as plastic, chemical, and microbial pollution.MethodsThe current study aimed to better understand key sociodemographic and personality predictors of concern about marine biodiversity loss and the desire for more research into marine biodiversity protection, in an attempt to support communication efforts targeting specific sectors in society. Data were drawn from nationally representative samples of 14 European countries (n = 14,167).ResultsResults show greater concern about marine biodiversity loss and support for more research into marine biodiversity protection by older adults, females, and individuals: (i) without (vs. with) a university degree; (ii) with lower (vs. middle) incomes; (iii) who identified as politically left-wing; (iv) who visited the coast more often; and (v) those with more open, agreeable and conscientious personalities.DiscussionThese results suggest that, although concern and research support are generally high among European citizens, policy makers and communicators need to take into consideration individual-level variation.