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Do sugar taxes work?

Do sugar taxes work?

Characterizing opioid-involved overdose risk in local communities: An opioid overdose vulnerability assessment across Indiana, 2017

The objective of this initiative was to conduct a comprehensive opioid overdose vulnerability assessment in Indiana and evaluate spatial accessibility to opioid use disorder treatment, harm reduction services, and opioid response programs. We compiled 2017 county-level (n = 92) data on opioid-related and socioeconomic indicators from publicly available state and federal sources. First, we assessed the spatial distribution of opioid-related indicators in a geographic information system (GIS). Next, we used a novel regression-weighted ranking approach with mean standardized covariates and an opioid-involved overdose mortality outcome to calculate county-level vulnerability scores. Finally, we examined accessibility to opioid use disorder treatment services and opioid response programs at the census tract-level (n = 1511) using two-step floating catchment area analysis. Opioid-related emergency department visit rate, opioid-related arrest rate, chronic hepatitis C virus infection rate, opioid prescription rate, unemployment rate, and percent of female-led households were independently and positively associated with opioid-involved overdose mortality (p < 0.05). We identified high-risk counties across the rural–urban continuum and primarily in east central Indiana. We found that only one of the 19 most vulnerable counties was in the top quintile for treatment services and had naloxone provider accessibility in all of its census tracts. Findings from our vulnerability assessment provide local-level context and evidence to support and inform future public health policies and targeted interventions in Indiana in areas with high opioid overdose vulnerability and low service accessibility. Our approach can be replicated in other state and local public health jurisdictions to assess opioid-involved public health vulnerabilities.

Quantifying the effect of Wakefield et al. (1998) on skepticism about MMR vaccine safety in the U.S.

Efforts to trace the rise of childhood vaccine safety concerns in the US often suggest Andrew Wakefield and colleagues' retracted 1998 Lancet study (AW98)-which alleged that the MMR vaccine can cause children to develop autism-as a primary cause of US vaccine skepticism. However, a lack of public opinion data on MMR safety collected before/after AW98's publication obscures whether anecdotal accounts are indicative of a potentially-causal effect. We address this problem using a regression discontinuity framework to study change in monthly MMR injury claims (N = 74,850; from 1990-2019) from the Vaccine Adverse Events Reporting System (VAERS) to proxy concern about vaccine safety. Additionally, we suggest a potential mechanism for the effect of AW98 on vaccine skepticism, via automated sentiment analyses of MMR-related news stories (N = 674; from 1996-2000) in major television and newspaper outlets. AW98 led to an immediate increase of about 70 MMR injury claims cases per month, averaging across six estimation strategies (meta-analytic effect = 70.44 [52.19, 88.75], p < 0.01). Preliminary evidence suggests that the volume of negative media attention to MMR increased in the weeks following AW98's publication, across four estimation strategies (meta-analytic effect = 9.59% [3.66, 15.51], p < 0.01). Vaccine skepticism increased following the publication of AW98, which was potentially made possible by increased negative media coverage of MMR. Childhood vaccine skepticism presents an important challenge to widespread vaccine uptake, and undermines support for pro-vaccine health policies. In addition to advancing our understanding of the previously-obscured origins of US vaccine skepticism, our work cautions that high-profile media attention to inaccurate scientific studies can undermine public confidence in vaccines. We conclude by offering several recommendations that researchers and health communicators might consider to detect and address future threats to vaccine confidence.

Black–white racial disparities in COVID-19: Awareness and framing of decision-making rationales.

Black–White racial disparities in COVID-19 have received much media attention. Yet the degree to which laypeople are aware of these disparities and support equitable ventilator allocation remains unclear. This mixed methods study investigated laypeople’s awareness and the rationales they provided for ventilator allocation. Adults from the United States (N = 249) participated in the study in April 2020. They selected between photos of two people in four comparisons, indicating who they believed was more likely to be affected by COVID-19, to whom they would allocate a ventilator, and their rationale for allocation. Black individuals were more frequently rated as affected by COVID-19 and selected to receive a ventilator. Participants who selected the Black individual to receive a ventilator cited COVID-19 statistics and structural-level need, while participants who selected the White individual cited physical appearance (weight and age) as their rationale. Public support for equitable COVID-19 health policies (e.g., finances for production of ventilators, lock-down and mask-wearing policies) can potentially be harnessed by underscoring differential rates of infection, hospitalization, death, and highlighting structural need. (PsycInfo Database Record (c) 2021 APA, all rights reserved) © 2021 American Psychological Association

The role of race and scientific trust on support for COVID-19 social distancing measures in the United States.

Pundits and academics across disciplines note that the human toll brought forth by the novel coronavirus (COVID-19) pandemic in the United States (U.S.) is fundamentally unequal for communities of color. Standing literature on public health posits that one of the chief predictors of racial disparity in health outcomes is a lack of institutional trust among minority communities. Furthermore, in our own county-level analysis from the U.S., we find that counties with higher percentages of Black and Hispanic residents have had vastly higher cumulative deaths from COVID-19. In light of this standing literature and our own analysis, it is critical to better understand how to mitigate or prevent these unequal outcomes for any future pandemic or public health emergency. Therefore, we assess the claim that raising institutional trust, primarily scientific trust, is key to mitigating these racial inequities. Leveraging a new, pre-pandemic measure of scientific trust, we find that trust in science, unlike trust in politicians or the media, significantly raises support for COVID-19 social distancing policies across racial lines. Our findings suggest that increasing scientific trust is essential to garnering support for public health policies that lessen the severity of the current, and potentially a future, pandemic.

Iodine deficiency in women of childbearing age in Brazil: systematic review and meta-analysis

Background: Despite current policies of salt iodination, iodine deficiency is still a global public health problem, especially in women. So far, conflicting evidence has been suggested for the prevalence of iodine deficiency in Brazil. Objective: To estimate the prevalence of iodine deficiency and associated factors in women of childbearing age in Brazil. Methods: A systematic review was conducted using databases (PubMed, LILACS, WHO, Scopus, and Capes’ dissertation and thesis), from inception to May 2020. Meta-analyses of proportions were performed using the variance inverse for the fixed model. Reporting and methodological quality were assessed using the Joanna Briggs Institute tool to prevalence studies. Results: Our review identified seven studies published between 2002 e 2017, including 1354 participants, especially pregnant women. All studies presented at least one quality limitation, mainly regarding the sampling method (i.e., convenience) and small sample size. The prevalence of iodine deficiency ranged among studies from 16% to 62%. In contrast, the meta-analysis identified a mean prevalence of 40% (95% confidence interval, CI 37%-43%) for pregnant women and 13% (95% CI 4%-24%) for non-pregnant women. Cumulative meta-analysis suggests a tendency of higher iodine deficiency prevalence from 2018 in pregnant women. Conclusions: Although this systematic review identified studies with poor methodological and reporting quality, a high prevalence of iodine deficiency was identified in pregnant women, reinforcing the importance of national nutritional policies for monitoring iodine status in this population. Future studies should consider random probabilistic sampling, appropriate sample size, and pre-defined subgroup analysis to adequately inform the prevalence of iodine deficiency and associated factors in women of childbearing age and support health policies.

Effect of COVID-19 on management of type 1 diabetes: Pushing the boundaries of telemedical healthcare.

The new coronavirus disease 2019 (COVID-19) pandemic posed a great burden on health care systems worldwide and is an enormous and real obstacle in providing needed health care to patients with chronic diseases such as diabetes. Parallel to COVID-19, there have been great advances in technology used for management of type 1 diabetes, primarily insulin pumps, sensors, integrated and closed loop systems, ambulatory glucose profile software, and smart phone apps providing necessary essentials for telemedicine implementation right at the beginning of the COVID-19 pandemic. The results of these remote interventions are reassuring in terms of glycemic management and hemoglobin A1c reductions. However, data on long-term outcomes and cost reductions are missing as well as proper technical infrastructure and government health policy support.

Mapping health vulnerabilities: exploring territorial profiles to support health policies.

Vulnerability processes and effects, albeit of great importance to cohesion and territorial policies, are nonetheless still underexplored and narrowly operationalized in scientific research. In particular, most assessments rely on economic indicators and a limited territorial scale, which do not have the same analytic potential of a broader view at a national level with regional/municipal similarities, specificities, and inter-connections. This gap also applies to health-related vulnerabilities, which, stemming from a lack of socioeconomic and environmental resources, has increased during and after the economic crisis of the past decade. This paper aims to analyze the health vulnerability phenomena in Portugal from a spatial perspective. Following a Multiple Correspondence Analysis, different territorial profiles of social vulnerability associated with the population health condition and access to and use of "health services" are identified. We conclude by outlining the importance of adding the spatial context to health policies addressing vulnerabilities and suggest avenues for future research.

Comparative Analysis of State Level Health Policy Support for Opioid Abuse Mitigation in Rural America

In rural America, opioid use disorder (OUD) continues to adversely impacted familial, public, and economic systems, creating extraordinary societal and financial burden. This comparative analysis of state-level public health policy and practices in rural opioid use abatement promotes the development and implementation of contextualized evidence-based comprehensive policy initiatives. Policy analysis across select highly affected states (Indiana, Kansas, Kentucky, and West Virginia) and exemplar OUD policy response states (Colorado, Massachusetts, Ohio, and Vermont) was performed using a systematic review of literature, legislation, plans, and policies. Findings included close alignment between states’ OUD policies and public health best practice standards; minimized differences between exemplar and highly affected states policy responses; and resource driven gaps in opioid epidemic legislation, regulation, guidelines, strategic plans, and initiatives. Furthermore, it is advocated that public and private stakeholders committed to health equity must seek reductions in opioid related disease and mortality through increased resource allocation.

Weight bias and support of public health policies

Public health policies have been proposed to help address prevalent Canadian obesity rates. Along with the increase in obesity prevalence, explicit weight bias is also rampant in Western society. This paper aimed to assess the association between explicit weight bias attitudes and Canadian public support of these policy recommendations. Canadian adults (N = 903; 51% female; BMI = 27.3 ± 7.0kg/m2) completed an online survey measuring explicit weight bias, using the three subscales of the Anti-Fat Attitudes Questionnaire: Willpower (belief in weight controllability), Fear of fat (fear of gaining weight), and Dislike (antipathy towards people with obesity). Whether these subscales were associated with policy support was assessed with logistic regression. Analyses were adjusted for age, race, gender, and income. Public support of policy recommendations ranged from 53% to 90%. Explicit weight bias was primarily expressed through a fear of weight gain and the belief that weight gain was within the individual's control based on willpower. Although the Dislike subscale was associated with lower support for several policies that enable or guide individual choice in behaviour change, the Willpower and Fear of fat subscales were associated with greater support for similar policies. This study contributes to evidence-informed public health action by describing public support of public health policies and demonstrating an association between explicit weight bias and public support. A higher total explicit weight bias score increased the odds of supporting primarily less intrusive policies. However, dislike of individuals with obesity was associated with decreased odds of supporting many policies.

Heidelberg Milestones Communication (HeiMeKOM) - Experiences, Best Practice Examples and Recommendations from the Final Symposium on January 30 and 31 in 2020

The National Cancer Plan emphasises the importance of medical communication and calls for its integration into medical education and training. In this context, the Milestone Communication Approach meets the communicative challenges in dealing with lung cancer patients. Interprofessional tandems, consisting of doctors and nurses, conduct structured conversations at defined moments with patients and their relatives. The concept aims at shared decision making, continuity in the care of lung cancer patients and the early integration of palliative care. During the symposium on the Heidelberg Milestone Communication in January 2020, recommendations on the care situation of lung cancer patients in advanced stages were developed. In addition, the further adaptability of HeiMeKOM to other settings and hospitals and to other diseases was discussed as well as the possibility of implementing such a concept in standard care. This article presents the experiences, best practice examples and recommendations discussed during the symposium in order to enable their extrapolation to other similarly oriented projects. The long-term goal is to transfer the milestone concept to other hospital, primarily certified lung cancer centers, and to ensure permanent funding. For further dissemination of the concept and, above all, to have it established in standard care, health policy awareness and support are required in addition to the integration of the concept in competence catalogues of continuing medical and nursing education.

ALTERING THE HUMAN GENOME: MAPPING THE GENOME EDITING REGULATORY SYSTEM IN SOUTH AFRICA

Novel therapeutic strategies using genome editing technologies, such as CRISPR-Cas9, are revolutionising the way in which diseases can be prevented and treated in the future. Consequently, a global debate has emerged around the ethical and legal implications relating to the use of such technology in research, therapy, and human reproduction. This has brought to the forefront questions regarding the extent to which current policies respond to these issues. In this paper, we provide a “map” of South African policy relating to genome editing, and illustrate how current ethical guidelines and law regulate its use. We find that the South African policy framework is marred with inconsistencies and incompleteness, and that an opportunity exists for the normative and regulatory framework governing this field of research and therapeutic application in South Africa, to be reviewed and reformed. In this paper we present certain recommendations – with the goal of informing and supporting health policy and decision-making regarding the regulation of genome editing in South Africa. We suggest that by adopting a pragmatic regulatory approach, such recommendations serve to address public concern, reflect appropriate international perspectives, and provide a firm foundation for the development of genome editing regulation in South Africa.

Impact of a New SARS-CoV-2 Variant on the Population: A Mathematical Modeling Approach

Several SARS-CoV-2 variants have emerged around the world, and the appearance of other variants depends on many factors. These new variants might have different characteristics that can affect the transmissibility and death rate. The administration of vaccines against the coronavirus disease 2019 (COVID-19) started in early December of 2020 and in some countries the vaccines will not soon be widely available. For this article, we studied the impact of a new more transmissible SARS-CoV-2 strain on prevalence, hospitalizations, and deaths related to the SARS-CoV-2 virus. We studied different scenarios regarding the transmissibility in order to provide a scientific support for public health policies and bring awareness of potential future situations related to the COVID-19 pandemic. We constructed a compartmental mathematical model based on differential equations to study these different scenarios. In this way, we are able to understand how a new, more infectious strain of the virus can impact the dynamics of the COVID-19 pandemic. We studied several metrics related to the possible outcomes of the COVID-19 pandemic in order to assess the impact of a higher transmissibility of a new SARS-CoV-2 strain on these metrics. We found that, even if the new variant has the same death rate, its high transmissibility can increase the number of infected people, those hospitalized, and deaths. The simulation results show that health institutions need to focus on increasing non-pharmaceutical interventions and the pace of vaccine inoculation since a new variant with higher transmissibility, such as, for example, VOC-202012/01 of lineage B.1.1.7, may cause more devastating outcomes in the population.

COVID-19 deaths among nurses: a cross-sectional study.

BackgroundNurses who are one of the pivotal elements of countries’ strategic responses to COVID-19 are being exposed to COVID-19.AimsTo investigate the underlying characteristics of nurses who died due to COVID-19.MethodsOn 1 September 2020, a grey literature search was conducted. Data obtained through Medscape, Google, PubMed, government and non-government websites. The search strategy was carried out using variants and combinations of keywords related to ‘nurse’ and ‘COVID-19’ in English. ed data included age, gender, type of nurse, department of nursing, country, date of death and publication characteristics.ResultsOut of reported 1518 COVID-19-related nurse deaths, details of age, gender and department of nursing were available for 766 (50%), 945 (62%) and 153 (10%) of nurses, respectively. The median age of the nurses was 56 years. The majority of deaths were reported in the 46- to 65 (32%)-year age range. While the registered nurses had the highest number of deaths according to types of nurses (680/957; 71%), they are mental health nurses (42/153; 28%) in the department of nursing. The countries with the most reported nurse deaths were USA, South Africa, Mexico and Russia.ConclusionsThe predominance of deceased mental health nurses among nursing departments can be examined in future studies. Supportive health policies can be developed to increase the motivation of nurses.

A review of constituents identified in e-cigarette liquids and aerosols.

INTRODUCTIONIdentification of chemicals present in e-liquids and aerosols is a vital first step in assessing the human health effects of e-cigarettes. We aim to identify the qualitative and quantitative constituents present in e-cigarette liquids and aerosols.METHODSA comprehensive search of scientific databases included literature up to July 2020. A total of 28 articles met inclusion criteria; 18 articles assessed e-liquid constituents and 15 articles assessed aerosol constituents. Of these, 5 assessed constituents present in both mediums. We included English-language publications that examine qualitative and/or quantitative constituents in e-cigarette liquids and aerosols.RESULTSIn total, articles identified 60 compounds in e-liquids and 47 compounds in aerosols. A total of 22 compounds were identified in both e-liquids and aerosols. These are: acenaphthylene, acetaldehyde, acetol, antimony, benzaldehyde, benzene, chromium, copper, diacetyl, formaldehyde, glycerol, lead, limonene, naphthalene, nickel, nicotine, nicotine-N'-oxides, 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK), N-Nitrosonornicotine (NNN), propylene glycol, toluene, and vegetable glycerin. Some of the identified chemicals have been labeled as harmful, toxic, or cancerous through human, animal, and cell line studies. A variety of laboratory methods were used for analyses, which made reported levels less consistent.CONCLUSIONSE-liquids and aerosols contain a variety of chemicals with potential health effects from inhaling them. Further, secondhand health effects are unknown because of limited understanding of the dose of exposure by non-users. Identification of constituents in e-cigarettes is the first step to determine their risks to humans and support evidence-based regulations and health policies.

Blood Work: Managing Menstruation, Menopause and Gynaecological Health Conditions in the Workplace.

The menstrual cycle remains neglected in explorations of public health, and entirely remiss in occupational health literature, despite being a problematic source of gendered inequalities at work. This paper proposes the new concept of blood work to explain the relationship between menstruation (and associated gynaecological health conditions) and employment for women and trans/non-binary people. We build on and extend health and organisational literature on managing bodies at work by arguing that those who experience menstruation face additional work or labour in the management of their own bodies through the menstrual cycle. We discuss how this additional labour replicates problematic elements that are identifiable in public health initiatives, in that it is individualised, requiring individual women and trans/non-binary people to navigate unsupportive workplaces. We present findings from an analysis of qualitative survey data that were completed by 627 participants working in higher education, revealing that employees’ blood work comprises distinct difficulties that are related to the management of painful, leaking bodies, access to facilities, stigma, and balancing workload. We suggest developing supportive workplaces and public health policies, which refocus the responsibility for accessible, equal workplaces that accommodate menstruating employees, and those with gynaecological health conditions.

Multimorbidity epidemiology and health care utilization through combined healthcare administrative databases.

multimorbidity analysis provides essential information to support health policy in the field of prevention, clinical management, and resources allocation in order to guarantee personalized and adequate strategies for patients with multiple chronic pathologies. to present the application of a methodology based upon data retrieved in healthcare administrative databases to investigate the extent of multimorbidity (coexistence of two or more chronic condition), evaluating its epidemiology, its impact on healthcare resources, and identifying patterns of associative multimorbidity, based on non-random association among chronic diseases.DESIGN: observational study based on regional healthcare data record linkage. all people aged 18 years or older permanently or temporarily resident in Emilia-Romagna Region (Northern Italy) during 2017 (amounting to 3,901,252 persons) were included. period prevalence and incidence of 32 chronic diseases; identification of patients affected by two or more concurrent chronic diseases (multimorbid patients), and evaluation of their period prevalence, incidence, healthcare resources use, and costs. Factorial analysis was applied to assess association among chronic diseases and to estimate groups of chronic conditions non-randomly coexisting (patterns of multimorbidity) among the elderly (people aged 65+ years). the multimorbidity incidence rate in 2017 was 2.7% (4.9% in the elderly) and the multimorbidity period prevalence, evaluated on the 3,901,252 adult residents, was 25.2%, ranging from 2.8% in people aged <40 years to 72.5% in octogenarians, with no major difference by gender. Sixty one percent of the elderly suffered from two or more concurrent chronic diseases and, among these, four groups of chronic condition non-randomly coexisting were recognized (cardiovascular, neuropsychiatric, metabolic, and pain pattern). These four multimorbidity patterns affected 39.6% of over 65. The impact on healthcare resources use was considerable: about 70% of all provided healthcare services and 72% of the costs incurred by Regional Health Service was allocated to multimorbid patients (81% and 86.7%, respectively, among the elderly). healthcare administrative databases are a valuable tool to assess the frequency of multimorbidity and its impact on healthcare resources. Patients belonging to the four common patterns of multimorbidity identified in this study explained a high proportion of multimorbidity prevalence and healthcare resources use.

COVID-19 Pandemic and Global Corporate CDS Spreads

We examine the impact of the COVID-19 pandemic on CDS spreads of companies around the world. We find that the pandemic-induced increases in corporate CDS spreads are concentrated in firms with higher leverage, non-investment-grade rating, lower profitability, and higher stock volatility. Further analysis shows that increases in CDS spreads are smaller for firms with employee health policies in place, better corporate social responsibility performance, stronger corporate governance, and operating in industries less affected by social distancing. Lastly, our results reveal that the successful vaccine trials and national policies including income support packages, lockdown policies and health policies help to reduce corporate CDS spreads.

An analysis of Sri Lankan government policies for prevention and control of non-communicable diseases and its risk factors

Non-communicable diseases (NCDs) are the leading causes of mortality, morbidity, and disability in Sri Lanka. The Government of Sri Lanka is committed to address the NCD burden of the country. This report presents an analysis of the Sri Lankan government policies of health sector as well as all other related sectors in relation to prevention and control of NCD and its risk factors in the country. Collection of policies and selection, the relevant policies to be included in the analysis were based on a systematic approach and the analysis was based on a framework which included aspects of prevention and control of NCD/NCD risk factors that are supported by the policy; and the main policy directives/strategies proposed. The selected policies were also mapped against the four strategic areas of the multisectoral action plan for the prevention and control of NCD of Sri Lanka. The analysis showed that a great majority of health and non-health policies have explicitly specified its support to the relevant areas of NCD or NCD risk factor prevention or control. The main aspects that were not explicitly specified by the health sector policies were prevention and control of psychological stress, obtaining the support of media in inculcating healthy lifestyles and targeted interventions to the marginalized or vulnerable population groups and people with special needs. Almost all the policy documents analyzed were well aligned with the four strategic action areas of the National Multisectoral Action Plan for the prevention and control of NCD 2016–2020. The Government of Sri Lanka has adequate health and non-health policy support to prevent and control NCD and NCD risk factors.

Postlaunch evidence-generation studies for medical devices in Spain: the RedETS approach to integrate real-world evidence into decision making.

The Monitoring Studies (MS) program, the approach developed by RedETS to generate postlaunch real-world evidence (RWE), is intended to complement and enhance the conventional health technology assessment process to support health policy decision making in Spain, besides informing other interested stakeholders, including clinicians and patients. The MS program is focused on specific uncertainties about the real effect, safety, costs, and routine use of new and insufficiently assessed relevant medical devices carefully selected to ensure the value of the additional research needed, by means of structured, controlled, participative, and transparent procedures. However, despite a clear political commitment and economic support from national and regional health authorities, several difficulties were identified along the development and implementation of the first wave of MS, delaying its execution and final reporting. Resolution of these difficulties at the regional and national levels and a greater collaborative impulse in the European Union, given the availability of an appropriate methodological framework already provided by EUnetHTA, might provide a faster and more efficient comparative RWE of improved quality and reliability at the national and international levels.