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Akselrod S, Collins T, Berlina D, Collins A, Allen L. Integrated health reporting within the UN architecture: learning from maternal, newborn and child health. Glob Health Res Policy 2024; 9:1. [PMID: 38163917 PMCID: PMC10759695 DOI: 10.1186/s41256-023-00342-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 12/11/2023] [Indexed: 01/03/2024] Open
Abstract
Despite a proliferation of the United Nations General Assembly high-level meetings on a range of health issues and developmental challenges, global funding continues to flow disproportionately to HIV and maternal, newborn and child health (MNCH). Using the experience of MNCH, this short article argues that successful human rights framing and the development of robust and regular reporting mechanisms in the international development architecture has contributed to these areas receiving attention. Taking non-communicable diseases (NCDs) as an example of a relatively neglected health area, we propose mechanisms that would improve integrated reporting of health issues in a way that aligns with the move toward cross-cutting themes and matching political and financial commitments with impact. As new frameworks are being developed to support multi-agency approaches to achieving SDG 3-including reporting and accountability-there are opportunities to ensure MNCH and NCDs jointly seek data collection measures that can support specific targets and indicators that link NCDs with early childhood development.
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Akselrod S, Banerjee A, Collins TE, Acharya S, Artykova N, Askew I, Berdzuli N, Diorditsa S, Eggers R, Farrington J, Jakab Z, Ferreira-Borges C, Mikkelsen B, Azzopardi-Muscat N, Olsavszky V, Park K, Sobel H, Tran H, Vujnovic M, Weber M, Were W, Yaqub N, Berlina D, Dunlop CL, Allen LN. Integrating maternal, newborn, child health and non-communicable disease care in the sustainable development goal era. Front Public Health 2023; 11:1183712. [PMID: 37483915 PMCID: PMC10362386 DOI: 10.3389/fpubh.2023.1183712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 06/06/2023] [Indexed: 07/25/2023] Open
Abstract
Noncommunicable diseases (NCDs) and maternal newborn and child health (MNCH) are two deeply intertwined health areas that have been artificially separated by global health policies, resource allocations and programming. Optimal MNCH care can provide a unique opportunity to screen for, prevent and manage early signs of NCDs developing in both the woman and the neonate. This paper considers how NCDs, NCD modifiable risk factors, and NCD metabolic risk factors impact MNCH. We argue that integrated management is essential, but this faces challenges that manifest across all levels of domestic health systems. Progress toward Sustainable Development targets requires joined-up action.
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Affiliation(s)
| | - Anshu Banerjee
- Maternal, Newborn, Child and Adolescent Health, and Ageing, World Health Organization, Geneva, Switzerland
| | - Téa E. Collins
- Global NCD Platform, World Health Organization, Geneva, Switzerland
| | - Shambhu Acharya
- Country Strategy and Support, World Health Organization, Geneva, Switzerland
| | - Nazira Artykova
- WHO European Region Country Office in Kyrgyzstan, Bishkek, Kyrgyzstan
| | - Ian Askew
- Sexual and Reproductive Health, World Health Organization, Geneva, Switzerland
| | - Nino Berdzuli
- Division of Country Health Programmes, World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Sergey Diorditsa
- WHO Representative's Office, WHO European Region Country Office in Belarus, Minsk, City of Minsk, Belarus
| | - Rudolf Eggers
- Integrated Health Services, World Health Organization, Geneva, Switzerland
| | - Jill Farrington
- Deputy Director-General Office, World Health Organization, Geneva, Switzerland
| | - Zsuzsanna Jakab
- Deputy Director-General Office, World Health Organization, Geneva, Switzerland
| | - Carina Ferreira-Borges
- Division of Country Health Programmes, World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Bente Mikkelsen
- NCD Department, World Health Organization, Geneva, Switzerland
| | - Natasha Azzopardi-Muscat
- Division of Country Health Policies and Systems, World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Victor Olsavszky
- WHO European Region Tajikistan Country Office, Dushanbe, Tajikistan
| | - Kidong Park
- Data, Strategy and Innovation Group, World Health Organization Regional Office for the Western Pacific, Manila, Philippines
| | - Howard Sobel
- WHO Regional Office for the Western Pacific Country Office in the Solomon Islands, Manila, Philippines
| | - Huong Tran
- Division of Programmes for Disease Control, World Health Organization Regional Office for the Western Pacific, Manila, Philippines
| | - Melita Vujnovic
- WHO European Region Office for the Russian Federation, Moscow, Russia
| | - Martin Weber
- Division of Country Health Policies and Systems, World Health Organization Regional Office for Europe Country Office in Greece, Copenhagen, Denmark
| | - Wilson Were
- Child Health and Development, World Health Organization, Geneva, Switzerland
| | - Nuhu Yaqub
- Child Health and Development, World Health Organization, Geneva, Switzerland
| | - Daria Berlina
- Global NCD Platform, World Health Organization, Geneva, Switzerland
| | - Catherine L. Dunlop
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, United Kingdom
| | - Luke N. Allen
- Global NCD Platform, World Health Organization, Geneva, Switzerland
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Akselrod S, Collins TE, Hoe C, Seyer J, Tulenko K, Ortenzi F, Berlina D, Sobel H. Building an interdisciplinary workforce for prevention and control of non-communicable diseases: the role of e-learning. BMJ 2023; 381:e071071. [PMID: 37220940 PMCID: PMC10203826 DOI: 10.1136/bmj-2022-071071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Affiliation(s)
| | - Téa E Collins
- Global NCD Platform, World Health Organization, Geneva, Switzerland
| | - Connie Hoe
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Julia Seyer
- World Medical Association, Ferney-Voltaire, France
| | - Kate Tulenko
- Global NCD Platform, World Health Organization, Geneva, Switzerland
| | - Flaminia Ortenzi
- Global NCD Platform, World Health Organization, Geneva, Switzerland
| | - Daria Berlina
- Global NCD Platform, World Health Organization, Geneva, Switzerland
| | - Howard Sobel
- Maternal Child Health and Quality Safety, World Health Organization Regional Office for the Western Pacific, Manila, Philippines
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Jardim SR, de Souza LMP, de Souza HSP. The Rise of Gastrointestinal Cancers as a Global Phenomenon: Unhealthy Behavior or Progress? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3640. [PMID: 36834334 PMCID: PMC9962127 DOI: 10.3390/ijerph20043640] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 02/09/2023] [Accepted: 02/13/2023] [Indexed: 06/18/2023]
Abstract
The overall burden of cancer is rapidly increasing worldwide, reflecting not only population growth and aging, but also the prevalence and spread of risk factors. Gastrointestinal (GI) cancers, including stomach, liver, esophageal, pancreatic, and colorectal cancers, represent more than a quarter of all cancers. While smoking and alcohol use are the risk factors most commonly associated with cancer development, a growing consensus also includes dietary habits as relevant risk factors for GI cancers. Current evidence suggests that socioeconomic development results in several lifestyle modifications, including shifts in dietary habits from local traditional diets to less-healthy Western diets. Moreover, recent data indicate that increased production and consumption of processed foods underlies the current pandemics of obesity and related metabolic disorders, which are directly or indirectly associated with the emergence of various chronic noncommunicable conditions and GI cancers. However, environmental changes are not restricted to dietary patterns, and unhealthy behavioral features should be analyzed with a holistic view of lifestyle. In this review, we discussed the epidemiological aspects, gut dysbiosis, and cellular and molecular characteristics of GI cancers and explored the impact of unhealthy behaviors, diet, and physical activity on developing GI cancers in the context of progressive societal changes.
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Affiliation(s)
- Silvia Rodrigues Jardim
- Division of Worker’s Health, Universidade Federal do Rio de Janeiro, Rio de Janeiro 22290-140, RJ, Brazil
| | - Lucila Marieta Perrotta de Souza
- Departamento de Clínica Médica, Hospital Universitário, Universidade Federal do Rio de Janeiro, Rua Prof. Rodolpho Paulo Rocco 255, Ilha do Fundão, Rio de Janeiro 21941-913, RJ, Brazil
| | - Heitor Siffert Pereira de Souza
- Departamento de Clínica Médica, Hospital Universitário, Universidade Federal do Rio de Janeiro, Rua Prof. Rodolpho Paulo Rocco 255, Ilha do Fundão, Rio de Janeiro 21941-913, RJ, Brazil
- D’Or Institute for Research and Education (IDOR), Rua Diniz Cordeiro 30, Botafogo, Rio de Janeiro 22281-100, RJ, Brazil
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5
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Lucini D, Pagani E, Capria F, Galiano M, Marchese M, Cribellati S, Parati G. Age Influences on Lifestyle and Stress Perception in the Working Population. Nutrients 2023; 15:nu15020399. [PMID: 36678269 PMCID: PMC9865201 DOI: 10.3390/nu15020399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 01/10/2023] [Accepted: 01/11/2023] [Indexed: 01/15/2023] Open
Abstract
Workplace health promotion programs and services offered by insurers may play a fundamental role to foster health/well-being and to prevent chronic diseases. To this end, they should be tailored to companies/employees’ requirements and characteristics. In particular, age needs to be taken into account, considering both that young age workers are generally healthy, and that young age is the best period in lifespan to address prevention and instilling healthy behaviors. We employed an anonymous, simple web-based questionnaire (filled out by 1305 employees) which furnishes data regarding lifestyle (nutrition, exercise, smoking, stress, sleep, etc.), some of which were used to build a unique descriptor (Lifestyle Index; 0−100 higher scores being healthier). We considered three subgroups accordingly to age: ≤30; between 30 and 50; >50 years. This study showed age influences lifestyle and stress perception in the working population: the youngest employees (both men and women) presented the worst lifestyle index, particularly in its stress component. This observation may potentially be useful to tailor workplace health promotion programs and to personalize insurance protocols and services offered to employees. The practical message of our study is that in healthy young people focusing only on medical parameters (frequently within normal ranges in this cohort), albeit important, may be not sufficient to foster proactive actions to prevent chronic non-communicable diseases in adult life. Vice versa, driving their attention on current behaviors might elicit their proactive role to improve lifestyle, getting immediate advantages such as well-being improvement and the possibility to best manage stress.
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Affiliation(s)
- Daniela Lucini
- BIOMETRA Department, University of Milan, 20129 Milan, Italy
- Exercise Medicine Unit, Istituto Auxologico Italiano, IRCCS, 20135 Milan, Italy
- Correspondence: ; Tel.: +39-02-619112808
| | - Eleonora Pagani
- Department of Psychology, Catholic University of the Sacred Hearth, 20123 Milan, Italy
| | | | | | | | | | - Gianfranco Parati
- Department of Medicine and Surgery, University of Milano-Bicocca, 20126 Milan, Italy
- Department of Cardiology, Istituto Auxologico Italiano, IRCCS, 20149 Milan, Italy
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Trapani D, Sandoval J, Aliaga PT, Ascione L, Maria Berton Giachetti PP, Curigliano G, Ginsburg O. Screening Programs for Breast Cancer: Toward Individualized, Risk-Adapted Strategies of Early Detection. Cancer Treat Res 2023; 188:63-88. [PMID: 38175342 DOI: 10.1007/978-3-031-33602-7_3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
Early detection of breast cancer (BC) comprises two approaches: screening of asymptomatic women in a specified target population at risk (usually a target age range for women at average risk), and early diagnosis for women with BC signs and symptoms. Screening for BC is a key health intervention for early detection. While population-based screening programs have been implemented for age-selected women, the pivotal clinical trials have not addressed the global utility nor the improvement of screening performance by utilizing more refined parameters for patient eligibility, such as individualized risk stratification. In addition, with the exception of the subset of women known to carry germline pathogenetic mutations in (high- or moderately-penetrant) cancer predisposition genes, such as BRCA1 and BRCA2, there has been less success in outreach and service provision for the unaffected relatives of women found to carry a high-risk mutation (i.e., "cascade testing") as it is in these individuals for whom such actionable information can result in cancers (and/or cancer deaths) being averted. Moreover, even in the absence of clinical cancer genetics services, as is the case for the immediate and at least near-term in most countries globally, the capacity to stratify the risk of an individual to develop BC has existed for many years, is available for free online at various sites/platforms, and is increasingly being validated for non-Caucasian populations. Ultimately, a precision approach to BC screening is largely missing. In the present chapter, we aim to address the concept of risk-adapted screening of BC, in multiple facets, and understand if there is a value in the implementation of adapted screening strategies in selected women, outside the established screening prescriptions, in the terms of age-range, screening modality and schedules of imaging.
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Affiliation(s)
- Dario Trapani
- Division of New Drug Development for Innovative Therapies, European Institute of Oncology IRCCS, Milan, Italy.
| | - Josè Sandoval
- Department of Oncology, Geneva University Hospitals, Geneva, Switzerland
- Unit of Population Epidemiology, Division and Department of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Pamela Trillo Aliaga
- Division of New Drug Development for Innovative Therapies, European Institute of Oncology IRCCS, Milan, Italy
- Department of Oncology and Hematology, University of Milan, Milan, Italy
| | - Liliana Ascione
- Division of New Drug Development for Innovative Therapies, European Institute of Oncology IRCCS, Milan, Italy
- Department of Oncology and Hematology, University of Milan, Milan, Italy
| | - Pier Paolo Maria Berton Giachetti
- Division of New Drug Development for Innovative Therapies, European Institute of Oncology IRCCS, Milan, Italy
- Department of Oncology and Hematology, University of Milan, Milan, Italy
| | - Giuseppe Curigliano
- Division of New Drug Development for Innovative Therapies, European Institute of Oncology IRCCS, Milan, Italy
- Department of Oncology and Hematology, University of Milan, Milan, Italy
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Wildman JM, Morris S, Pollard T, Gibson K, Moffatt S. " I wouldn't survive it, as simple as that": Syndemic vulnerability among people living with chronic non-communicable disease during the COVID-19 pandemic. SSM. QUALITATIVE RESEARCH IN HEALTH 2022; 2:100032. [PMID: 34909754 PMCID: PMC8654704 DOI: 10.1016/j.ssmqr.2021.100032] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 11/23/2021] [Accepted: 12/07/2021] [Indexed: 12/03/2022]
Abstract
The co-occurrence of COVID-19, non-communicable diseases and socioeconomic disadvantage has been identified as creating a syndemic: a state of synergistic epidemics, occurring when co-occurring health conditions interact with social conditions to amplify the burden of disease. In this study, we use the concept of illness management work to explore the impact of the COVID-19 pandemic on the lives of people living with, often multiple, chronic health conditions in a range of social circumstances. In-depth interviews were conducted between May and July 2020 with 29 participants living in a city in North East England. Qualitative data provide unique insights for those seeking to better understand the consequences for human life and wellbeing of the interacting social, physical and psychological factors that create syndemic risks in people's lives. Among this group of people at increased vulnerability to harm from COVID-19, we find that the pandemic public health response increased the work required for condition management. Mental distress was amplified by fear of infection and by the requirements of social isolation and distancing that removed participants' usual sources of support. Social conditions, such as poor housing, low incomes and the requirement to earn a living, further amplified the work of managing everyday life and risked worsening existing mental ill health. As evidenced by the experiences reported here, the era of pandemics will require a renewed focus on the connection between health and social justice if stubborn, and worsening health and social inequalities are to be addressed or, at the very least, not increased.
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Affiliation(s)
- Josephine M. Wildman
- Population Health Sciences Institute, Newcastle University, Ridley 1 Building, 5th Floor, Queen Victoria Road, Newcastle Upon Tyne, NE1 4LP, United Kingdom
| | - Stephanie Morris
- Department of Anthropology, Durham University, Dawson Building, South Road, Durham, DH1 3LE, United Kingdom
| | - Tessa Pollard
- Department of Anthropology, Durham University, Dawson Building, South Road, Durham, DH1 3LE, United Kingdom
| | - Kate Gibson
- Population Health Sciences Institute, Newcastle University, Ridley 1 Building, 5th Floor, Queen Victoria Road, Newcastle Upon Tyne, NE1 4LP, United Kingdom
| | - Suzanne Moffatt
- Population Health Sciences Institute, Newcastle University, Ridley 1 Building, 5th Floor, Queen Victoria Road, Newcastle Upon Tyne, NE1 4LP, United Kingdom
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Allen LN, Aghilla M, Kak M, Loffreda G, Wild CEK, Hatefi A, Herbst CH, El Saeh H. Conflict as a macrodeterminant of non-communicable diseases: the experience of Libya. BMJ Glob Health 2022; 7:bmjgh-2021-007549. [PMID: 36210068 PMCID: PMC9540835 DOI: 10.1136/bmjgh-2021-007549] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 01/20/2022] [Indexed: 11/15/2022] Open
Affiliation(s)
- Luke N Allen
- Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK
| | | | | | - Giulia Loffreda
- Institute for Global Health and Development, Queen Margaret University, Edinburgh, Scotland
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County Health Leadership Practices and Readiness for Noncommunicable Disease Services in Kenya. Ann Glob Health 2022; 88:58. [PMID: 35936230 PMCID: PMC9306762 DOI: 10.5334/aogh.2673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 06/15/2022] [Indexed: 11/20/2022] Open
Abstract
Background: Premature mortality from noncommunicable diseases (NCDs) is a contemporary development challenge. Low-income and lower-middle-income countries are disproportionately affected, with the poorest in society considered the most vulnerable. A paucity of literature exists on how leadership practices at the implementation level relate to ensuring readiness for NCD services. Objective: This study investigated any relationship between leadership practices and readiness for NCD services. Methods: This correlational study investigated any relationship between leadership practices at the county level and readiness for NCD services in Kenya using secondary data from a 2013 Service Availability and Readiness Assessment survey. Correlation and multiple linear regression tests were used to determine the strength and direction of any relationship between leadership practices (annual work planning, therapeutic committees, and supportive supervision), and NCD readiness (county readiness score). Findings: The findings indicated a statistically significant relationship between therapeutic committee (p = .002) and supportive supervision practices (p = .023) and NCD readiness. Leadership practices also had a statistically significant predictive relationship with NCD readiness (p = .009). Conclusion: Health leaders should ensure that leadership practices that have a predictive relationship with NCD readiness, such as therapeutic committee activities and supportive supervision visits, are implemented appropriately. Further, county health leaders should pay particular attention to the implementation of these leadership practices at nonpublic and Tiers 2, 3, and 4 health facilities that had lower NCD readiness scores.
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Vineis P, Barouki R. The exposome as the science of social-to-biological transitions. ENVIRONMENT INTERNATIONAL 2022; 165:107312. [PMID: 35635963 DOI: 10.1016/j.envint.2022.107312] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 04/19/2022] [Accepted: 05/17/2022] [Indexed: 06/15/2023]
Abstract
The understanding of disease etiology and pathogenesis has radically changed as a consequence of the new challenges posed by climate change, environmental degradation and emerging infectious diseases. The awareness of the influence of distal causes (e.g. planetary changes at the roots of new pandemics), of the social environment and of early life exposures calls for innovative models of disease onset. Here we propose a scheme for the practice of epidemiology and toxicology that incorporates new recent advancements in both disciplines, under the general umbrella of the "exposome". The exposome approach to disease encompasses a lifecourse perspective from conception onwards, and the investigation of the role played by all exposures individuals undergo in their lives. These include social inequalities and psychosocial influences, in addition to chemical, biological and physical exposures. We stress the role played by social differences and inequalities in the course of life as an overarching factor that influences downstream layers (including behaviours). We show that the idea of "lifecourse exposome" is compatible with the current interpretation of Adverse Outcome Pathways in toxicology, and in fact we propose an extension of the concept towards "lifecourse Adverse Outcome Pathways". We propose to merge different research perspectives and promote an encounter between the sociological perspective of "biography" (using Pierre Bourdieu's conceptual framework) and biology, according to the idea of accumulated biological capital of individuals. We also propose to treat social capital (including inequalities) no longer as a confounding factor but as an overarching determinant, perhaps the most important of all because it is the one that influences all other exposures downstream. The importance of early exposures in a lifecourse perspective leads to policy implications, i.e. investing more in the various forms of capital (social, economic, cultural) in early life.
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Affiliation(s)
- Paolo Vineis
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, United Kingdom.
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11
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Global challenges and policy solutions in breast cancer control. Cancer Treat Rev 2022; 104:102339. [DOI: 10.1016/j.ctrv.2022.102339] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 01/12/2022] [Accepted: 01/14/2022] [Indexed: 02/08/2023]
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Castro-Bedriñana J, Chirinos-Peinado D, De La Cruz-Calderón G. Predictive model of stunting in the Central Andean region of Peru based on socioeconomic and agri-food determinants. PUBLIC HEALTH IN PRACTICE 2021; 2:100112. [PMID: 36101621 PMCID: PMC9461592 DOI: 10.1016/j.puhip.2021.100112] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 03/16/2021] [Accepted: 03/17/2021] [Indexed: 11/22/2022] Open
Abstract
Objectives A limitation in the design and monitoring of public health policies is the lack of conceptual models to explain their results. The objective of this study was to develop a predictive model of stunting in children under 5 years of age in the central Andean region of Peru, using socioeconomic and agro-productive predictors. Study design Cross-sectional data of 380 families in 15 districts of the central region of Peru. WHO criteria were used to define stunting prediction model. Methods An explanatory and predictive study of stunting in children was carried out considering causality criteria through Chi-square tests and bivariate logistic regression. Family food production, maternal education, breastfeeding practices and others determinant related to rural zone conditions were considered as explanatory variables in stunting of children under 5 years old. Three exhaustive models for predicted the presence of stunting was developed. Results Stunting percentage was 40.3. To Hosmer and Lemeshow test, the best fit was the model that considered the level of maternal education, timely consumption of colostrum, birth weight and guinea pig rearing, having high reliability (P < 0.05). Conclusions A predictive model for early detection of stunting risk in rural areas of the Andean region was developed based on simple and easily applied indicators. Effective policies are required to improve the feeding practices of pregnant women, increase breastfeeding and promote guinea pig raising for self-consumption and improve the nutritional status of children.
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Affiliation(s)
- Jorge Castro-Bedriñana
- Specialized Research Center in Nutritional Food Security, Universidad Nacional del Centro del Perú, Huancayo, Peru
| | - Doris Chirinos-Peinado
- Specialized Research Center in Nutritional Food Security, Universidad Nacional del Centro del Perú, Huancayo, Peru
| | - Gina De La Cruz-Calderón
- Professional School of Agroindustrial Engineering, Universidad Nacional Autónoma de Chota, Cajamarca, Peru
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Bispo Júnior JP, Santos DBD. [COVID-19 as a syndemic: a theoretical model and foundations for a comprehensive approach in health]. CAD SAUDE PUBLICA 2021; 37:e00119021. [PMID: 34644754 DOI: 10.1590/0102-311x00119021] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 08/13/2021] [Indexed: 01/22/2023] Open
Abstract
This essay aims to present and discuss the theoretical framework for the COVID-19 syndemic. The first part presents the foundations and principles of syndemic theory. For the purposes of this essay, syndemic was defined as a process of synergic interaction between two or more diseases, in which the effects are mutually enhanced. We discussed the three principal typologies of syndemic interaction: mutually causal epidemics; epidemics interacting synergically; and serial causal epidemics. In the second part, COVID-19 is analyzed as a syndemic resulting from the interaction between various groups of diseases and the socioeconomic context. The theoretical model considered the interaction between COVID-19 and chronic noncommunicable diseases, infectious and parasitic diseases, and mental health problems. The essay addressed how social iniquities and conditions of vulnerability act at various levels to increase the effect of COVID-19 and other pandemics. The last section discusses the need for comprehensive, multisector, and integrated responses to COVID-19. A model for intervention was presented that involves the patient care and socioeconomic dimensions. In the sphere of patient care, the authors defend the structuring of strong and responsive health systems, accessible to the entire population. The economic and social dimension addressed the issue of reclaiming the ideals of solidarity, the health promotion strategy, and emphasis on social determinants of health. In conclusion, the lessons learned from the syndemic approach to COVID-19 call on government and society to develop policies that link clinical, sanitary, socioeconomic, and environmental interventions.
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Courtin E, Vineis P. COVID-19 as a Syndemic. Front Public Health 2021; 9:763830. [PMID: 34568273 PMCID: PMC8459739 DOI: 10.3389/fpubh.2021.763830] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 08/27/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- Emilie Courtin
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Paolo Vineis
- MRC Centre for Environment and Health, Imperial College London, London, United Kingdom
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Chigangaidze RK, Chinyenze P. Is It "Aging" or Immunosenescence? The COVID-19 Biopsychosocial Risk Factors Aggravating Immunosenescence as Another Risk Factor of the Morbus. A Developmental-clinical Social Work Perspective. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2021; 64:676-691. [PMID: 33975529 DOI: 10.1080/01634372.2021.1923604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 04/23/2021] [Accepted: 04/26/2021] [Indexed: 06/12/2023]
Abstract
COVID-19 has proliferated ageism. The impetus of this article is to show that immunosenescence is a risk factor to COVID-19 and not aging per se. Based on the idea that some older people are also healthier than younger ones, the emphasis of this article is on immunosenescence and not aging as a risk factor of COVID-19 complications. The paper utilizes a biopsychosocial approach to expound on the link between immunosenescence and COVID-19 risk factors. The article explores biological factors such as malnutrition, comorbidities, substance abuse, and sex. It also expands on psychosocial factors such as mental health disorders, homelessness, unemployment, lack of physical exercises, stigma, and discrimination. The article calls for gerontological social work to assume a developmental-clinical social work perspective to prevent the early onset and progression of immunosenescence. It calls for gerontological social work to prevent factors that promote unhealthy aging. The article promotes a preventative stance to practice and not just curative approaches. Treatment involves primary prevention which emphasizes on avoiding the onset of unhealthy aging. It is this approach that gerontological social work should aim also to address in building resilience in the face of pandemics.
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Affiliation(s)
- Robert K Chigangaidze
- Faculty of Social Sciences, School of Social Work, Midlands State University, Gweru, Zimbabwe
| | - Patience Chinyenze
- Faculty of Social Sciences, School of Social Work, Midlands State University, Gweru, Zimbabwe
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Interaction between Autonomic Regulation, Adiposity Indexes and Metabolic Profile in Children and Adolescents with Overweight and Obesity. CHILDREN-BASEL 2021; 8:children8080686. [PMID: 34438577 PMCID: PMC8394084 DOI: 10.3390/children8080686] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 07/31/2021] [Accepted: 08/04/2021] [Indexed: 01/22/2023]
Abstract
Early obesity predicts initial modifications in cardiac and vascular autonomic regulation. The aim of this study was to assess the possible interaction between non-invasive measures of autonomic cardiovascular control and peripheral endothelium regulation in children with overweight and obesity. We involved 114 young subjects (77M/37F, 12.7 ± 2.2 years) with normal weight (NW, n = 46) to overweight or obesity (OB, n = 68). Multivariate statistical techniques utilizing a collection of modern indices of autonomic regulation, adiposity indexes and metabolic profile were employed. Resting values show substantial equivalence of data. Conversely, blood pressure variance is greater in NW/OB groups. The correlation matrix between major autonomic and metabolic/hemodynamic variables shows a clustered significant correlation between homogeneous indices. A significant correlation between metabolic indices and endothelial and autonomic control, mostly in its vascular end, was recorded. Particularly, the alpha index is significantly correlated with triglycerides (r = −0.261) and endothelial indices (RHI, r = 0.276). Children with obesity show a link between indices of autonomic and endothelial function, fat distribution and metabolic profile. The optimization of autonomic control, for instance by exercise/nutrition interventions, could potentially prevent/delay the occurrence of structural vascular damage leading to reduced cardiovascular health.
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Pan XF, Yang J, Wen Y, Li N, Chen S, Pan A. Non-Communicable Diseases During the COVID-19 Pandemic and Beyond. ENGINEERING (BEIJING, CHINA) 2021; 7:899-902. [PMID: 33898076 PMCID: PMC8056943 DOI: 10.1016/j.eng.2021.02.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Affiliation(s)
- Xiong-Fei Pan
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN 37203, USA
- The George Institute for Global Health, University of New South Wales, Sydney, NSW 2042, Australia
| | - Juan Yang
- Ministry of Education Key Laboratory of Public Health Safety, School of Public Health, Fudan University, Shanghai 200032, China
| | - Ying Wen
- Department of Communicable Diseases Control and Prevention, Shenzhen Center for Disease Control and Prevention, Shenzhen 518055, China
| | - Naishi Li
- National Health Commission Key Laboratory of Endocrinology, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Simiao Chen
- Heidelberg Institute of Global Health, Heidelberg Medical School, Heidelberg University, Heidelberg 69120, Germany
- Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - An Pan
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
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Jaramillo AM, Montes F, Sarmiento OL, Ríos AP, Rosas LG, Hunter R, Rodríguez AL, King AC. Social cohesion emerging from a community-based physical activity program: A temporal network analysis. NETWORK SCIENCE (CAMBRIDGE UNIVERSITY PRESS) 2021; 9:35-48. [PMID: 34322275 PMCID: PMC8315584 DOI: 10.1017/nws.2020.31] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Community-based physical activity programs, such as the Recreovía, are effective in promoting healthy behaviors in Latin America. To understand Recreovías' challenges and scalability, we characterized its social network longitudinally while studying its participants' social cohesion and interactions. First, we constructed the Main network of the program's Facebook profile in 2013 to determine the main stakeholders and communities of participants. Second, we studied the Temporal network growth of the Facebook profiles of three Recreovía locations from 2008 to 2016. We implemented a Time Windows in Networks algorithm to determine observation periods and a scaling model of cities' growth to measure social cohesion over time. Our results show physical activity instructors as the main stakeholders (20.84% nodes of the network). As emerging cohesion, we found: (1) incremental growth of Facebook users (43-272 nodes), friendships (55-2565 edges), clustering coefficient (0.19-0.21), and density (0.04-0.07); (2) no preferential attachment behavior; and (3) a social cohesion super-linear growth with 1.73 new friendships per joined user. Our results underscore the physical activity instructors' influence and the emergent cohesion in innovation periods as a co-benefit of the program. This analysis associates the social and healthy behavior dimensions of a program occurring in natural environments under a systemic approach.
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Affiliation(s)
- Ana María Jaramillo
- Department of Industrial Engineering, Social and Health Complexity Center, Universidad de Los Andes, Bogotá, Colombia
- Department of Computer Science, University of Exeter, Exeter, UK
| | - Felipe Montes
- Department of Industrial Engineering, Social and Health Complexity Center, Universidad de Los Andes, Bogotá, Colombia
| | | | - Ana Paola Ríos
- School of Medicine, Universidad de Los Andes, Bogotá, Colombia
- Grupo de Cuidado Cardiorrespiratorio, Universidad Manuela Beltrán, Bogotá
| | - Lisa G. Rosas
- Palo Alto Medical Foundation Research Institute, Palo Alto, CA, USA and Stanford University, Palo Alto, CA, USA
| | - Ruth Hunter
- United Kingdom Clinical Research Collaboration Centre of Excellence for Public Health/Centre for Public Health, Queen’s University Belfast, Belfast, UK
| | - Ana Lucía Rodríguez
- Department of Psychology, Health Disparities and Cultural Identities Research Lab, Florida International University, Miami, FL, USA
| | - Abby C. King
- Stanford Prevention Research Center, Department of Medicine, School of Medicine at Stanford University, 1070 Arrastradero Road, Suite 100, Palo Alto, CA, USA and Department of Health Research and Policy, School of Medicine at Stanford University, Palo Alto, CA, USA
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Lucini D, Pagani M. Exercise Prescription to Foster Health and Well-Being: A Behavioral Approach to Transform Barriers into Opportunities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:968. [PMID: 33499284 PMCID: PMC7908585 DOI: 10.3390/ijerph18030968] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 01/15/2021] [Accepted: 01/16/2021] [Indexed: 12/12/2022]
Abstract
The current literature contains multiple examples of exercise interventions to foster health and to prevent/treat many chronic non-communicable diseases; stress and functional syndromes. On the other hand, sedentariness is increasing and to transform a sedentary subject into a regular exerciser is not only very difficult but considered by some unrealistic in current clinical practice. Ideally a physical activity intervention may be considered actually efficacious when it outgrows the research setting and becomes embedded in a system, ensuring maintenance and sustainability of its health benefits. Physicians need specific skills to improve patients' exercise habits. These range from traditional clinical competencies, to technical competencies to correctly prescribe exercise, to competencies in behavioral medicine to motivate the subject. From a behavioral and medical point of view, an exercise prescription may be considered correct only if the subject actually performs the prescribed exercise and this results in an improvement of physiological mechanisms such as endocrine, immunological and autonomic controls. Here we describe a model of intervention intended to nurture exercise prescription in everyday clinical setting. It aims to a tailored prescription, starts from the subject's assessment, continues defining clinical goals/possible limitations and ends when the subject is performing exercise obtaining results.
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Affiliation(s)
- Daniela Lucini
- BIOMETRA Department, University of Milan, 20122 Milano, Italy;
- Exercise Medicine Unit, Humanitas Clinical and Research Center, 20089 Rozzano, Italy
| | - Massimo Pagani
- BIOMETRA Department, University of Milan, 20122 Milano, Italy;
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20
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Tan MMJ, Han E, Shrestha P, Wu S, Shiraz F, Koh GCH, McKee M, Legido-Quigley H. Framing global discourses on non-communicable diseases: a scoping review. BMC Health Serv Res 2021; 21:20. [PMID: 33407447 PMCID: PMC7786870 DOI: 10.1186/s12913-020-05958-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 11/23/2020] [Indexed: 11/19/2022] Open
Abstract
Background The choices that policymakers make are shaped by how their problems are framed. At last, non-communicable diseases (NCDs) have risen high on the global policy agenda, but there are many disputed issues. First, what are they? Their name refers not to what they are but what they are not. Second, where do their boundaries lie? What diseases are included? Third, should we view their causes as mainly biomedical, behavioural, or social, or a combination? Our failure to resolve these issues has been invoked as a reason for our limited progress in developing and implementing effective remedies. In this scoping review, we ask “What is known from the existing literature about how NCDs are framed in the global policy discourses?” We answer it by reviewing the frames employed in policy and academic discourses. Methods We searched nine electronic databases for articles published since inception to 31 May 2019. We also reviewed websites of eight international organisations to identify global NCDs policies. We extracted data and synthesised findings to identify key thematic frames. Results We included 36 articles and nine policy documents on global NCDs policies. We identified five discursive domains that have been used and where there are differing perspectives. These are: “Expanding the NCDs frame to include mental health and air pollution”; “NCDs and their determinants”; “A rights-based approach to NCDs”; “Approaches to achieving policy coherence in NCDs globally”; and “NCDs as part of Sustainable Socio-economic Development”. We further identified 12 frames within the five discursive domains. Conclusions This scoping review identifies issues that remain unresolved and points to a need for alignment of perspectives among global health policy actors, as well as synergies with those working on mental health, maternal health, and child health. The current COVID-19 pandemic warrants greater consideration of its impact on global NCDs policies. Future global strategies for NCDs need to consider explicitly how NCDs are framed in a changing global health discourse and ensure adequate alignment with implementation and global health issues. There is a need for global strategies to recognise the pertinent role of actors in shaping policy discourses. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-020-05958-0.
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Affiliation(s)
- Melisa Mei Jin Tan
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2 #10-01, Tahir Foundation Building, Singapore, 117549, Singapore.
| | - Emeline Han
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2 #10-01, Tahir Foundation Building, Singapore, 117549, Singapore
| | - Pami Shrestha
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2 #10-01, Tahir Foundation Building, Singapore, 117549, Singapore
| | - Shishi Wu
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2 #10-01, Tahir Foundation Building, Singapore, 117549, Singapore
| | - Farah Shiraz
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2 #10-01, Tahir Foundation Building, Singapore, 117549, Singapore
| | - Gerald Choon-Huat Koh
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2 #10-01, Tahir Foundation Building, Singapore, 117549, Singapore
| | - Martin McKee
- London School of Hygiene and Tropical Medicine, London, WC1H 9SH, UK
| | - Helena Legido-Quigley
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2 #10-01, Tahir Foundation Building, Singapore, 117549, Singapore.,London School of Hygiene and Tropical Medicine, London, WC1H 9SH, UK
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Affiliation(s)
- Robert C Van de Graaf
- Addiction Care Northern Netherlands, Leonard Springerlaan 27, 9727 KB Groningen, Netherlands
| | - Leonard Hofstra
- Department of Cardiology, VU University Medical Center, Amsterdam University Medical Center, Amsterdam, Netherlands
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Affiliation(s)
- Trevor A Sheldon
- Institute of Population Health Sciences, Barts and the London School of Medicine and Dentistry, Queen Mary University, London, UK
| | - John Wright
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford
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Herrick C. The optics of noncommunicable diseases: from lifestyle to environmental toxicity. SOCIOLOGY OF HEALTH & ILLNESS 2020; 42:1041-1059. [PMID: 32162326 DOI: 10.1111/1467-9566.13078] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Until recently, the noncommunicable disease (NCD) category was composed of four chronic diseases (cancer, cardiovascular disease, diabetes and chronic respiratory disease) and four shared, 'modifiable' behavioural risk factors (smoking, diet, physical activity and alcohol). In late 2018, the NCD category was expanded to include mental health as an additional disease outcome and air pollution as an explicit environmental risk factor. The newly-expanded NCD category connects behavioural and environmental readings of risk and shifts attention from individual acts of consumption to unequal and inescapable conditions of environmental exposure. It thus renders the increasing 'toxicity' of everyday life amid ubiquitous environmental contamination a new conceptual and empirical concern for NCD research. It also, as this paper explores, signals a new 'optics' of a much-maligned disease category. This is particularly significant as chronic disease research has long been siloed between public and environmental health, with each discipline operationalising the notion of the 'environment' as a source of disease causation in contrasting ways. Given this, this paper is positioned as a significant contribution to both research on NCDs and environmental risk, bringing these interdisciplinary domains into a new critical conversation around the concept of toxicity.
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Affiliation(s)
- Clare Herrick
- Department of Geography, Kings College London, London, UK
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24
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Pop TL, Namazova-Baranova L, Mestrovic J, Nigri L, Vural M, Sacco M, Giardino I, Ferrara P, Pettoello-Mantovani M. The Role of Healthy Lifestyle Promotion, Counseling, and Follow-up in Noncommunicable Diseases Prevention. J Pediatr 2020; 217:221-223.e1. [PMID: 31740143 DOI: 10.1016/j.jpeds.2019.10.061] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 10/24/2019] [Indexed: 02/08/2023]
Affiliation(s)
- Tudor Lucian Pop
- European Paediatric Association/Union of National European Paediatric Societies and Associations (EPA/UNEPSA), Berlin, Germany; 2nd Pediatric Clinic, University of Medicine and Pharmacy Iuliu Hatieganu, Cluj-Napoca, Romania
| | - Leyla Namazova-Baranova
- European Paediatric Association/Union of National European Paediatric Societies and Associations (EPA/UNEPSA), Berlin, Germany; Russian Medical Research and Scientific Medical University of Moscow, Russian Federation, Moscow, Russia
| | - Julije Mestrovic
- European Paediatric Association/Union of National European Paediatric Societies and Associations (EPA/UNEPSA), Berlin, Germany; Medical School of Split, University Hospital of Split, Split, Croatia
| | - Luigi Nigri
- European Paediatric Association/Union of National European Paediatric Societies and Associations (EPA/UNEPSA), Berlin, Germany; Italian Federation of Pediatricians, Rome, Italy
| | - Mehmet Vural
- European Paediatric Association/Union of National European Paediatric Societies and Associations (EPA/UNEPSA), Berlin, Germany; University of Istanbul, Istanbul University Cerrahpaşa, Medical Faculty, Istanbul, Turkey
| | - Michele Sacco
- European Paediatric Association/Union of National European Paediatric Societies and Associations (EPA/UNEPSA), Berlin, Germany; Department of Pediatrics, Scientific Institute "Casa Sollievo della Sofferenza" SCV, University of Foggia, Foggia, Italy
| | - Ida Giardino
- Department of Biomedical Sciences, University of Foggia, Foggia, Italy
| | - Pietro Ferrara
- Institute of Pediatrics, Catholic University Medical School, Rome, Italy; Service of Pediatrics, Campus Bio-Medico University, Rome, Italy
| | - Massimo Pettoello-Mantovani
- European Paediatric Association/Union of National European Paediatric Societies and Associations (EPA/UNEPSA), Berlin, Germany; Department of Pediatrics, Scientific Institute "Casa Sollievo della Sofferenza" SCV, University of Foggia, Foggia, Italy.
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25
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Introducing 24-Hour Movement Guidelines for the Early Years: A New Paradigm Gaining Momentum. J Phys Act Health 2020; 17:92-95. [DOI: 10.1123/jpah.2019-0401] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 09/22/2019] [Indexed: 11/18/2022]
Abstract
Background: Emerging research shows that the composition of movement behaviors throughout the day (physical activities, sedentary behaviors, sleep) is related to indicators of health, suggesting previous research that isolated single movement behaviors maybe incomplete, misleading, and/or unnecessarily constrained. Methods: This brief report summarizes evidence to support a 24-hour movement behavior paradigm and efforts to date by a variety of jurisdictions to consult, develop, release, promote, and study 24-hour movement guidelines. It also introduces and summarizes the accompanying series of articles related specifically to 24-hour movement guidelines for the early years. Results: Using robust and transparent processes, Canada, Australia, New Zealand, South Africa, and the World Health Organization have developed and released 24-hour movement guidelines for the early years: an integration of physical activity, sedentary behavior, and sleep. Other countries are exploring a similar approach and related research is expanding rapidly. Articles related to guideline development in South Africa, the United Kingdom, Australia, and by the World Health Organization are a part of this special series. Conclusions: A new paradigm employing 24-hour movement guidelines for the early years that combines recommendations for movement behaviors across the whole day is gaining momentum across the globe.
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Pais SC, Menezes I. How do we live with chronic disease? A rights-based approach promoting the wellbeing of children with chronic disease. CIENCIA & SAUDE COLETIVA 2019; 24:3663-3672. [PMID: 31576996 DOI: 10.1590/1413-812320182410.17932019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 07/01/2019] [Indexed: 11/22/2022] Open
Abstract
This paper focuses on the life experiences of children with chronic disease, a group whose invisibility involves particular challenges in their relationship with professionals in important life contexts, such as family, school and hospital. The study includes two complementary phases: i) Phase 1, composed of 15 interviews with parents, education and health professionals and two focus group discussions with children, and children and their mothers; and ii) Phase 2, which included self-report questionnaires administered to parents (n = 152) and children with chronic disease (n = 176). Based on a mixed methodology, this study combines quantitative and qualitative methods assuming that plural approaches allow for a deeper understanding of the life conditions of children with chronic disease and their families. The results reinforce the reproduction of social stereotypes and the tendency to focus on the individual ability to solve problems, which still remain to be circumscribed to the people's chronic disease sphere. Moreover, this paper reveals the central role that inclusive contexts have on children's wellbeing.
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Affiliation(s)
- Sofia Castanheira Pais
- Centre for Research and Intervention in Education, Faculty of Psychology and Education Sciences, University of Porto. R. Alfredo Allen. 4200-135. Porto, Portugal.
| | - Isabel Menezes
- Centre for Research and Intervention in Education, Faculty of Psychology and Education Sciences, University of Porto. R. Alfredo Allen. 4200-135. Porto, Portugal.
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Hunter RF, de la Haye K, Murray JM, Badham J, Valente TW, Clarke M, Kee F. Social network interventions for health behaviours and outcomes: A systematic review and meta-analysis. PLoS Med 2019; 16:e1002890. [PMID: 31479454 PMCID: PMC6719831 DOI: 10.1371/journal.pmed.1002890] [Citation(s) in RCA: 141] [Impact Index Per Article: 28.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Accepted: 07/30/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND There has been a growing interest in understanding the effects of social networks on health-related behaviour, with a particular backdrop being the emerging prominence of complexity or systems science in public health. Social network interventions specifically use or alter the characteristics of social networks to generate, accelerate, or maintain health behaviours. We conducted a systematic review and meta-analysis to investigate health behaviour outcomes of social network interventions. METHODS AND FINDINGS We searched eight databases and two trial registries from 1990 to May 28, 2019, for English-language reports of randomised controlled trials (RCTs) and before-and-after studies investigating social network interventions for health behaviours and outcomes. Trials that did not specifically use social networks or that did not include a comparator group were excluded. We screened studies and extracted data from published reports independently. The primary outcome of health behaviours or outcomes at ≤6 months was assessed by random-effects meta-analysis. Secondary outcomes included those measures at >6-12 months and >12 months. This study is registered with the International Prospective Register of Systematic Reviews, PROSPERO: CRD42015023541. We identified 26,503 reports; after exclusion, 37 studies, conducted between 1996 and 2018 from 11 countries, were eligible for analysis, with a total of 53,891 participants (mean age 32.4 years [SD 12.7]; 45.5% females). A range of study designs were included: 27 used RCT/cluster RCT designs, and 10 used other study designs. Eligible studies addressed a variety of health outcomes, in particular sexual health and substance use. Social network interventions showed a significant intervention effect compared with comparator groups for sexual health outcomes. The pooled odds ratio (OR) was 1.46 (95% confidence interval [CI] 1.01-2.11; I2 = 76%) for sexual health outcomes at ≤6 months and OR 1.51 (95% CI 1.27-1.81; I2 = 40%) for sexual health outcomes at >6-12 months. Intervention effects for drug risk outcomes at each time point were not significant. There were also significant intervention effects for some other health outcomes including alcohol misuse, well-being, change in haemoglobin A1c (HbA1c), and smoking cessation. Because of clinical and measurement heterogeneity, it was not appropriate to pool data on these other behaviours in a meta-analysis. For sexual health outcomes, prespecified subgroup analyses were significant for intervention approach (p < 0.001), mean age of participants (p = 0.002), and intervention length (p = 0.05). Overall, 22 of the 37 studies demonstrated a high risk of bias, as measured by the Cochrane Risk of Bias tool. The main study limitations identified were the inclusion of studies of variable quality; difficulty in isolating the effects of specific social network intervention components on health outcomes, as interventions included other active components; and reliance on self-reported outcomes, which have inherent recall and desirability biases. CONCLUSIONS Our findings suggest that social network interventions can be effective in the short term (<6 months) and longer term (>6 months) for sexual health outcomes. Intervention effects for drug risk outcomes at each time point were not significant. There were also significant intervention effects for some other health outcomes including alcohol misuse, well-being, change in HbA1c, and smoking cessation.
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Affiliation(s)
- Ruth F. Hunter
- UKCRC Centre of Excellence for Public Health (NI)/Centre for Public Health, Queen’s University Belfast, Belfast, United Kingdom
| | - Kayla de la Haye
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, United States of America
| | - Jennifer M. Murray
- UKCRC Centre of Excellence for Public Health (NI)/Centre for Public Health, Queen’s University Belfast, Belfast, United Kingdom
| | - Jennifer Badham
- UKCRC Centre of Excellence for Public Health (NI)/Centre for Public Health, Queen’s University Belfast, Belfast, United Kingdom
| | - Thomas W. Valente
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, United States of America
| | - Mike Clarke
- Northern Ireland Methodology Hub, Centre for Public Health, Queen’s University Belfast, Belfast, United Kingdom
| | - Frank Kee
- UKCRC Centre of Excellence for Public Health (NI)/Centre for Public Health, Queen’s University Belfast, Belfast, United Kingdom
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Logan AC, Prescott SL, Katz DL. Golden Age of Medicine 2.0: Lifestyle Medicine and Planetary Health Prioritized. J Lifestyle Med 2019; 9:75-91. [PMID: 31828026 PMCID: PMC6894443 DOI: 10.15280/jlm.2019.9.2.75] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Accepted: 02/22/2019] [Indexed: 12/16/2022] Open
Abstract
The 'golden age of medicine' - the first half of the 20th century, reaching its zenith with Jonas Salk's 1955 polio vaccine - was a time of profound advances in surgical techniques, immunization, drug discovery, and the control of infectious disease; however, when the burden of disease shifted to lifestyle-driven, chronic, non-communicable diseases, the golden era slipped away. Although modifiable lifestyle practices now account for some 80% of premature mortality, medicine remains loathe to embrace lifestyle interventions as medicine Here, we argue that a 21st century golden age of medicine can be realized; the path to this era requires a transformation of medical school recruitment and training in ways that prioritize a broad view of lifestyle medicine. Moving beyond the basic principles of modifiable lifestyle practices as therapeutic interventions, each person/community should be viewed as a biological manifestation of accumulated experiences (and choices) made within the dynamic social, political, economic and cultural ecosystems that comprise their total life history. This requires an understanding that powerful forces operate within these ecosystems; marketing and neoliberal forces push an exclusive 'personal responsibility' view of health - blaming the individual, and deflecting from the large-scale influences that maintain health inequalities and threaten planetary health. The latter term denotes the interconnections between the sustainable vitality of person and place at all scales. We emphasize that barriers to planetary health and the clinical application of lifestyle medicine - including authoritarianism and social dominance orientation - are maintaining an unhealthy status quo.
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Affiliation(s)
- Alan C Logan
- in-VIVO Planetary Health, West New York, NJ, USA
| | - Susan L Prescott
- in-VIVO Planetary Health, West New York, NJ, USA.,School of Medicine, University of Western Australia, Perth, WA, Australia
| | - David L Katz
- Yale University, Prevention Research Center, Griffin Hospital, Derby, CT, USA
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29
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Sumriddetchkajorn K, Shimazaki K, Ono T, Kusaba T, Sato K, Kobayashi N. Universal health coverage and primary care, Thailand. Bull World Health Organ 2019; 97:415-422. [PMID: 31210679 PMCID: PMC6560367 DOI: 10.2471/blt.18.223693] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 02/07/2019] [Accepted: 03/18/2019] [Indexed: 11/27/2022] Open
Abstract
Thailand’s policy on universal health coverage (UHC) has made good progress since its inception in 2002. Every Thai citizen is now entitled to essential preventive, curative and palliative health services at all life stages. Like its counterparts elsewhere, however, the policy faces challenges. A predominantly tax-financed system in a nation with a high proportion of people living in poverty will always strive to contain rising costs. Disparities exist among the different health insurance schemes that provide coverage for Thai citizens. National health expenditure is heavily borne by the government, primarily to reduce financial barriers to access for the poor. The population is ageing and the disease profiles of the population are changing alongside the modernization of Thai people’s lifestyles. Thailand is now aiming to enhance and sustain its UHC policy. We examine the merits of different policy options and aim to identify the most promising and feasible way to enhance and sustain UHC. We argue that developing the existing primary care system in Thailand has the greatest potential to provide more self-sustaining, efficient, equitable and effective UHC. Primary care needs to move from its traditional role of providing basic disease-based care, to being the first point of contact in an integrated, coordinated, community-oriented and person-focused care system, for which the national health budget should be prioritized.
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Affiliation(s)
- Kanitsorn Sumriddetchkajorn
- National Health Security Office, 4th Floor, Government Complex Building B, Chaengwattana Road, Laksi, Bangkok, 10210 Thailand
| | - Kenji Shimazaki
- National Graduate Institute for Policy Studies, Tokyo, Japan
| | - Taichi Ono
- National Graduate Institute for Policy Studies, Tokyo, Japan
| | | | - Kotaro Sato
- Hokkaido Centre for Family Medicine, Sapporo, Japan
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Adjaye-Gbewonyo K, Vaughan M. Reframing NCDs? An analysis of current debates. Glob Health Action 2019; 12:1641043. [PMID: 31362599 PMCID: PMC6711186 DOI: 10.1080/16549716.2019.1641043] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 07/03/2019] [Indexed: 12/22/2022] Open
Abstract
There have been many debates in recent years as to whether the communicable disease versus non-communicable disease (NCD) division is a meaningful one in disease classification. Several critiques have been raised about the framing of NCDs, regarding not only the prominent role that infections play in the aetiology of NCDs, but also the communicability of many social determinants of NCDs and the individualistic, 'lifestyle' framing of NCDs that tends to focus on health behaviours to the neglect of socio-political, environmental, and structural determinants of health. In this paper, we give a historical overview of the usage of the NCD terminology and analyse some of the recent debates regarding the naming and framing of NCDs. We argue that a lack of reflection on the assumptions underlying the naming and framing of NCDs may lead to the collection of insufficient epidemiological data, the development of inappropriate interventions and the provision of inadequate care. Work in social epidemiology, health promotion, medical anthropology, demography, and other fields may provide insights into the ways in which efforts targeting NCDs may be reframed to improve impact and efficacy. In addition, concepts such as multimorbidity and syndemics, frameworks such as ecosocial theory and approaches based in the social sciences may provide a way forward in the conceptualization of disease.
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Affiliation(s)
| | - Megan Vaughan
- Institute of Advanced Studies, University College London, London, UK
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Pérez W, Contreras M, Peña R, Zelaya E, Persson LÅ, Källestål C. Food insecurity and self-rated health in rural Nicaraguan women of reproductive age: a cross-sectional study. Int J Equity Health 2018; 17:146. [PMID: 30227875 PMCID: PMC6145199 DOI: 10.1186/s12939-018-0854-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 08/31/2018] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Access to food is a basic necessity, and food insecurity may impair the individual's well-being and health. Self-rated health measurements have frequently been used to assess population health. Little is known, however, as to whether food security is associated with self-rated health in low- and middle-income settings. This study aims at analyzing the association between food security and self-rated health among non-pregnant women of reproductive age in a rural Nicaraguan setting. METHODS Data was taken from the 2014 update of a health and demographic surveillance system in the municipalities of Los Cuatro Santos in northwestern Nicaragua. Fieldworkers interviewed women about their self-rated health using a 5-point Likert scale. Food insecurity was assessed by the household food insecurity access (HFIAS) scale. A multilevel Poisson random-intercept model was used to calculate the prevalence ratio. RESULTS The survey included 5866 women. In total, 89% were food insecure, and 48% had poor self-rated health. Food insecurity was associated with poor self-rated health, and remained so after adjustment for potential confounders and accounting for community dependency. CONCLUSION In this Nicaraguan resource-limited setting, there was an association between food insecurity and poor self-rated health. Food insecurity is a facet of poverty and measures an important missing capability directly related to health.
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Affiliation(s)
- Wilton Pérez
- International Maternal and Child Health (IMCH), Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Mariela Contreras
- International Maternal and Child Health (IMCH), Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Rodolfo Peña
- International Maternal and Child Health (IMCH), Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
- Pan American Health Organization, Tegucigalpa, Honduras
| | - Elmer Zelaya
- Asociación para el Desarrollo Económico y Social de El Espino (APRODESE), Cinco Pinos, Nicaragua
| | - Lars-Åke Persson
- International Maternal and Child Health (IMCH), Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
- Department of Disease Control, London School of Hygiene & Tropical Medicine, London, UK
| | - Carina Källestål
- International Maternal and Child Health (IMCH), Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
- Department of Disease Control, London School of Hygiene & Tropical Medicine, London, UK
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Improving health through diet and exercise in children. Eur J Clin Nutr 2018; 72:1251-1254. [PMID: 30185856 DOI: 10.1038/s41430-018-0209-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2018] [Revised: 05/03/2018] [Accepted: 05/08/2018] [Indexed: 11/09/2022]
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Moine S, Murray SA, Boyd K, Engels Y, Mitchell G. Palliative care and the endless cycle of serious health-related suffering. Lancet 2018; 392:471-472. [PMID: 30129451 DOI: 10.1016/s0140-6736(18)31195-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 05/17/2018] [Indexed: 11/17/2022]
Affiliation(s)
- Sébastien Moine
- Health Education and Practices Laboratory, University of Paris 13, Bobigny 93017, France; SimUSanté, Amiens University Hospital, Amiens, France.
| | - Scott A Murray
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - Kirsty Boyd
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - Yvonne Engels
- Department of Anaesthesiology, Pain, Palliative Medicine, Radboud University Medical Center, Nijmegen, Netherlands
| | - Geoff Mitchell
- Faculty of Medicine and Biomedical Science, University of Queensland, Brisbane, Australia
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Knaul FM, Gómez-Dantés O, Bhadelia A, Frenk J. Beyond divisive dichotomies in disease classification. LANCET GLOBAL HEALTH 2018; 5:e1073-e1074. [PMID: 29025628 DOI: 10.1016/s2214-109x(17)30376-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Accepted: 08/29/2017] [Indexed: 11/26/2022]
Affiliation(s)
| | | | - Afsan Bhadelia
- Harvard TH Chan School of Public Health, Boston, MA, USA
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Firoz T, McCaw‐Binns A, Filippi V, Magee LA, Costa ML, Cecatti JG, Barreix M, Adanu R, Chou D, Say L. A framework for healthcare interventions to address maternal morbidity. Int J Gynaecol Obstet 2018; 141 Suppl 1:61-68. [PMID: 29851114 PMCID: PMC6001624 DOI: 10.1002/ijgo.12469] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
The maternal health agenda is undergoing a paradigm shift from preventing maternal deaths to promoting women's health and wellness. A critical focus of this trajectory includes addressing maternal morbidity and the increasing burden of chronic and noncommunicable diseases (NCD) among pregnant women. The WHO convened the Maternal Morbidity Working Group (MMWG) to improve the scientific basis for defining, measuring, and monitoring maternal morbidity. Based on the MMWG's work, we propose paradigms for conceptualizing maternal health and related interventions, and call for greater integration between maternal health and NCD programs. This integration can be synergistic, given the links between chronic conditions, morbidity in pregnancy, and long-term health. Pregnancy should be viewed as a window of opportunity into the current and future health of women, and offers critical entry points for women who may otherwise not seek or have access to care for chronic conditions. Maternal health services should move beyond the focus on emergency obstetric care, to a broader approach that encompasses preventive and early interventions, and integration with existing services. Health systems need to respond by prioritizing funding for developing integrated health programs, and workforce strengthening. The MMWG's efforts have highlighted the changing landscape of maternal health, and the need to expand the narrow focus of maternal health, moving beyond surviving to thriving.
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Affiliation(s)
| | - Affette McCaw‐Binns
- Department of Community Health and PsychiatryUniversity of the West IndiesMona, KingstonJamaica
| | - Veronique Filippi
- Department of Infectious Disease EpidemiologyLondon School of Hygiene and Tropical MedicineLondonUK
| | - Laura A. Magee
- Department of Women's HealthKing's College LondonLondonUK
| | - Maria L. Costa
- Department of Obstetrics and GynecologyUniversity of CampinasSão PauloBrazil
| | - Jose G. Cecatti
- Department of Obstetrics and GynecologyUniversity of CampinasSão PauloBrazil
| | - Maria Barreix
- UNDP–UNFPA–UNICEF–WHO–World Bank Special Programme of ResearchDevelopment and Research Training in Human Reproduction (HRP)Department of Reproductive Health and ResearchWHOGenevaSwitzerland
| | - Richard Adanu
- School of Public HealthDepartment of Population, Family and Reproductive HealthUniversity of GhanaAccraGhana
| | - Doris Chou
- UNDP–UNFPA–UNICEF–WHO–World Bank Special Programme of ResearchDevelopment and Research Training in Human Reproduction (HRP)Department of Reproductive Health and ResearchWHOGenevaSwitzerland
| | - Lale Say
- UNDP–UNFPA–UNICEF–WHO–World Bank Special Programme of ResearchDevelopment and Research Training in Human Reproduction (HRP)Department of Reproductive Health and ResearchWHOGenevaSwitzerland
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Vijayasingham L, Allotey P. Reframing non-communicable diseases. LANCET GLOBAL HEALTH 2018; 5:e1070. [PMID: 29025625 DOI: 10.1016/s2214-109x(17)30326-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Accepted: 07/19/2017] [Indexed: 11/27/2022]
Affiliation(s)
- Lavanya Vijayasingham
- Jeffrey Cheah School of Medicine, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway, Selangor 47500, Malaysia.
| | - Pascale Allotey
- Jeffrey Cheah School of Medicine, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway, Selangor 47500, Malaysia
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Cavalin C, Lescoat A. Reframing non-communicable diseases. LANCET GLOBAL HEALTH 2018; 5:e1071. [PMID: 29025626 DOI: 10.1016/s2214-109x(17)30327-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2017] [Accepted: 07/19/2017] [Indexed: 11/16/2022]
Affiliation(s)
- Catherine Cavalin
- Centre for European Studies, Sciences Po, 75 337 Paris CEDEX 07, France; Laboratory of Interdisciplinary Evaluation of Public Policies, Sciences Po, 75 337 Paris CEDEX 07, France; Centre for Employment and Labour Studies, Paris, France.
| | - Alain Lescoat
- UMR INSERM U1085, Research Institute in Health, Environment and Occupation, University of Rennes 1, Rennes, France; Department of Internal Medicine, University Hospital of Rennes, University of Rennes 1, Rennes, France
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Vineis P. From John Snow to omics: the long journey of environmental epidemiology. Eur J Epidemiol 2018; 33:355-363. [PMID: 29680996 PMCID: PMC5945800 DOI: 10.1007/s10654-018-0398-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 04/08/2018] [Indexed: 12/18/2022]
Abstract
A major difference between infectious and non-communicable diseases is that infectious diseases typically have unique necessary causes whereas noncommunicable diseases have multiple causes which by themselves are usually neither necessary nor sufficient. Epidemiology seems to have reached a limit in disentangling the role of single components in causal complexes, particularly at low doses. To overcome limitations the discipline can take advantage of technical developments including the science of the exposome. By referring to the interpretation of the exposome as put forward in the work of Wild and Rappaport, I show examples of how the science of multi-causality can build upon the developments of omic technologies. Finally, I broaden the picture by advocating a more holistic approach to causality that also encompasses social sciences and the concept of embodiment. To tackle NCDs effectively on one side we can invest in various omic approaches, to identify new external causes of non-communicable diseases (that we can use to develop preventive strategies), and the corresponding mechanistic pathways. On the other side, we need to focus on the social and societal determinants which are suggested to be the root causes of many non-communicable diseases.
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Affiliation(s)
- Paolo Vineis
- MRC-PHE Centre for Environment and Health, Imperial College London, Norfolk Place, London, W21PG, UK. .,Italian Institute for Genomic Medicine, Turin, Italy.
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Socially awkward: how can we better promote walking as a social behaviour? Br J Sports Med 2018; 52:757-758. [DOI: 10.1136/bjsports-2017-098564] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/16/2017] [Indexed: 11/03/2022]
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Hatefi A. The costs of reaching the health-related SDGs. THE LANCET GLOBAL HEALTH 2017; 5:e1183. [DOI: 10.1016/s2214-109x(17)30415-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Accepted: 09/13/2017] [Indexed: 11/25/2022] Open
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Cavalin C, Lescoat A. From (re-)framing NCDs to shaping public health policies on NCDs and communicable diseases. Lancet 2017; 390:1830-1831. [PMID: 29082874 DOI: 10.1016/s0140-6736(17)32419-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 08/18/2017] [Indexed: 11/26/2022]
Affiliation(s)
- Catherine Cavalin
- Centre for European Studies and Laboratory of Interdisciplinary Evaluation of Public Policies, Sciences Po, 75 337 Paris CEDEX 07, France; Centre for Employment and Labour Studies, Cnam Centre, Noisy-le-Grand, France.
| | - Alain Lescoat
- UMR Inserm U1085, Research Institute in Health, Environment and Occupation/Institut de Recherche sur la Santé, l'Environnement et le Travail, and Department of Internal Medicine, University of Rennes 1, Rennes, France
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