1
|
Lee JN, Wang J, Kurash L, Teel J. Utilizing a Flex Clinician to Manage Absences and Support Wellness. Fam Pract Manag 2024; 31:15-18. [PMID: 38743794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
|
2
|
Olasehinde O, Aderounmu A, Wuraola F, Omisore A, Akinkuolie A, Towoju A, Mohammed T, Mango V, Kingham PT, Adisa A, Alatise O. Breast Cancer Stage at Diagnosis in a Nigerian Hospital: Trend over a Decade. West Afr J Med 2023; 40:1298-1303. [PMID: 38261017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
BACKGROUND Breast cancer outcomes are poor in Nigeria, partly due to late-stage diagnosis. To assess the impact of past and present interventions, a review of an institutional data base was performed to determine the trend with respect to stage at diagnosis over a decade. METHODS A retrospective analysis of an institutional data base was performed over a decade. The review period was divided into segments (2013-2015, 2016-2018 and 2019-2022). The latter period (2019-2022), corresponds to a time of more intense community interventions aimed at promoting early diagnosis and treatment around the locality of the teaching hospital. The stage at diagnosis within these periods were compared. The relationship between stage and sociodemographic variables (age, religion, marital status, menopausal status, and level of education) was assessed. RESULTS There were 910 patients, 144 within the first period (2013-2015), 318 in the second (2016-2018) and 454 in the third period (2019-2022). The majority presented with stage 3 disease (73.8%). There was a significant decline in the proportion of metastatic cases and a concomitant increase in early cases in the latter part of the review. The proportion of metastatic cases reduced from 23.6% (2013-2015), to 15.7% (2016-2018) and 9.3% (2019-2022) (p=0.001). Level of education was significantly associated with stage (p=0.001). CONCLUSION This study shows a trend towards downstaging of breast cancer in our locality. This trend corresponds to the period of more intense community interventions, justifying the need to further interrogate the direct impact of each of the interventions. This will provide a firm basis for sustaining or improving on current efforts to achieve more robust gains.
Collapse
Affiliation(s)
- O Olasehinde
- Department of Surgery, Obafemi Awolowo University, Ile-Ife, Nigeria.
| | - A Aderounmu
- Department of Surgery, Obafemi Awolowo University, Ile-Ife, Nigeria.
| | - F Wuraola
- Department of Surgery, Obafemi Awolowo University, Ile-Ife, Nigeria.
| | - A Omisore
- Department of Radiology, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - A Akinkuolie
- Department of Surgery, Obafemi Awolowo University, Ile-Ife, Nigeria.
| | - A Towoju
- Department of Radiology, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - T Mohammed
- Department of Surgery, Obafemi Awolowo University, Ile-Ife, Nigeria.
| | - V Mango
- Memorial Sloan-Kettering Cancer Center, New York, U. S. A
| | - P T Kingham
- Memorial Sloan-Kettering Cancer Center, New York, U. S. A
| | - A Adisa
- Department of Surgery, Obafemi Awolowo University, Ile-Ife, Nigeria.
| | - O Alatise
- Department of Surgery, Obafemi Awolowo University, Ile-Ife, Nigeria.
| |
Collapse
|
3
|
|
4
|
Rosa WE, Burnett C, Butler C, Rolle P, Salvage J, Wignall A, Mason DJ. The ICN Global Nursing Leadership Institute: Integrating the SDGs into Leadership and Policy Development. Am J Nurs 2021; 121:54-58. [PMID: 34792506 PMCID: PMC8768889 DOI: 10.1097/01.naj.0000803204.19511.8a] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This article is one in a series in which contributing authors discuss how the United Nations (UN) Sustainable Development Goals (SDGs) are linked to everyday clinical issues; national public health emergencies; and other nursing issues, such as leadership, shared governance, and advocacy. The 2030 Agenda for Sustainable Development, a 15-year plan of action to achieve the goals, was unanimously adopted by all UN member states in September 2015 and took effect on January 1, 2016. The Agenda consists of 17 SDGs addressing social, economic, and environmental determinants of health and 169 associated targets focused on five themes: people, planet, peace, prosperity, and partnership. The SDGs build on the work of the UN Millennium Development Goals, which were in effect from 2000 to 2015. The current article discusses the International Council of Nurses Global Nursing Leadership Institute and its integration of the SDGs into a global leadership and policy development program.
Collapse
Affiliation(s)
- William E Rosa
- William E. Rosa is the psycho-oncology chief research fellow at Memorial Sloan Kettering Cancer Center in New York City; Camille Burnett is an associate professor and chair of the Dean's Workgroup for Health Equity and Racial Justice at the University of Kentucky College of Nursing in Lexington; Chesanny Butler is assistant professor of nursing at the University of South Carolina Beaufort in Bluffton, SC; Prescola Rolle is a nursing officer and medical area deputy supervisor at Princess Margaret Hospital in Nassau, Bahamas; Jane Salvage is program director and training facilitator at the International Council of Nurses, Global Nursing Leadership Institute in London; Angela Wignall is director, learning and performance support and library services at the Vancouver Island Health Authority in Victoria, British Columbia, Canada; and Diana J. Mason is program director at the International Council of Nurses, Global Nursing Leadership Institute in Geneva. Contact author: William E. Rosa, . The authors have disclosed no potential conflicts of interest, financial or otherwise
| | | | | | | | | | | | | |
Collapse
|
5
|
Melariri HI, Kalinda C, Chimbari MJ. Training, Attitudes, and Practice (TAP) among healthcare professionals in the Nelson Mandela Bay municipality, South Africa: A health promotion and disease prevention perspective. PLoS One 2021; 16:e0259884. [PMID: 34818364 PMCID: PMC8612580 DOI: 10.1371/journal.pone.0259884] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 10/28/2021] [Indexed: 12/20/2022] Open
Abstract
Background Healthcare professionals (HCPs) play a pivotal role in ensuring access to quality healthcare of patients. However, their role in health promotion (HP) and disease prevention (DP) has not been fully explored. This study aimed at determining how training, attitude, and practice (TAP) of HCPs influence their practice of HP and DP. Methods Data on TAP regarding HP and DP were collected from 495 HCPs from twenty-three hospitals in the study area using a standardized questionnaire. Bivariate, univariate, and multivariate analyses were conducted to describe how the TAP of HCPs influence their HP and DP practices. The analysis was further desegregated at the three levels of healthcare (primary, secondary and tertiary levels). Results Most of the medical doctors 36.12% (n = 173), registered nurses 28.39% (n = 136), and allied health professionals (AHPs) 11.27% (n = 54) indicated the absence of coordinated HP training for staff in their facilities. Similarly, 32.93% (n = 193) of the HCPs, indicated having participated in HP or DP training. Among those that had participated in HP and DP training, benefits of training were positive behaviour, attributions, and emotional responses. When compared at the different levels of healthcare, enhanced staff satisfaction and continuing professional development for HP were statistically significant only at the tertiary healthcare level. Multivariate analysis showed a likelihood of reduced coordinated HP training for staff among medical doctors (Coef 0.15; 95% CI 0.07–0.32) and AHPs (Coef 0.24; 95% CI 0.10–0.59) compared to nurses. Furthermore, medical doctors (Coeff: 0.66; 95% CI: 0.46–0.94) were less likely to agree that HCPs should model good health behavior to render HP services as compared to nurses. Conclusion Training in HP and DP empowers HCPs with the requisite knowledge and attitude necessary for effective practice. Several HCPs at different levels of care had limited knowledge of HP and DP because of inadequate training. We recommend a strategy aimed at addressing the knowledge and attitudinal gaps of HCPs to ensure effective HP and DP services to patients.
Collapse
Affiliation(s)
- Herbert I. Melariri
- College of Health Sciences, University of KwaZulu Natal, Howard College Campus, Durban, South Africa
- Eastern Cape Department of Health, Port Elizabeth Provincial Hospital, Gqeberha, South Africa
- * E-mail:
| | - Chester Kalinda
- College of Health Sciences, University of KwaZulu Natal, Howard College Campus, Durban, South Africa
- University of Global Health Equity (UGHE), Bill and Joyce Cummings Institute of Global Health, Kigali, Rwanda
| | - Moses J. Chimbari
- College of Health Sciences, University of KwaZulu Natal, Howard College Campus, Durban, South Africa
- Great Zimbabwe University, Masvingo, Zimbabwe
| |
Collapse
|
6
|
Harper KJ. The Future of Nursing Report Set the Stage for Healthier Hoosiers. Nurs Adm Q 2021; 45:46-51. [PMID: 33259370 DOI: 10.1097/naq.0000000000000450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Since the introduction of the Future of Nursing report in 2011, Indiana nursing has successfully implemented many of the recommendations. This article describes these accomplishments. Notable examples include increasing the diversity of the workforce, placement of nurses on community boards and governmental appointments, promoting the advancement of nursing education, and increasing the number of nurses with baccalaureate degrees. Furthermore, Indiana supports the proliferation of new doctoral programs with a scholarship fundraising program to assist nurses with the cost of their education.
Collapse
Affiliation(s)
- Kimberly J Harper
- Indiana Action Coalition-Future of Nursing Campaign for Action, Indiana Center for Nursing, Indianapolis; and Nurses on Boards Coalition, Indianapolis, Indiana
| |
Collapse
|
7
|
Zolnierek C, Watson JJ, Ruiz D. Texas Team Action Coalition Advancing Health Through Nursing: Past, Present, and Future. Nurs Adm Q 2021; 45:35-45. [PMID: 33259369 DOI: 10.1097/naq.0000000000000451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
When the Institute of Medicine released its report, commonly known as the Future of Nursing report, every state was challenged to take on the work of implementing the 8 recommendations. The Texas Team Action Coalition achieved measurable results in many areas; however, sustainability of efforts was challenging due to the volunteer nature of the work. As Robert Wood Johnson Foundation's focus shifted from Advancing Health Through Nursing to Building a Culture of Health for All, the Texas Team sought to realign its work accordingly. This article details initiatives of the Texas Team over the past 10 years and describes current efforts to position itself to champion anticipated recommendations from the 2020-2030 Future of Nursing report from the National Academy of Medicine.
Collapse
Affiliation(s)
- Cindy Zolnierek
- Texas Nurses Association, Austin (Dr Zolnierek); Texas Tech University Health Sciences Center School of Nursing, Lubbock (Dr Watson); and University of Texas of the Permian Basin College of Nursing, Odessa (Dr Ruiz)
| | | | | |
Collapse
|
8
|
Affiliation(s)
- Diane L Spatz
- Dr. Diane L. Spatz is a Professor of Perinatal Nursing & the Helen M. Shearer Professor of Nutrition at the University of Pennsylvania. She holds a joint appointment with the Children's Hospital of Philadelphia (CHOP) where she is a nurse scientist for the lactation program & founder of CHOP's Mothers' Milk Bank. Dr. Spatz can be reached via email at
| |
Collapse
|
9
|
Popkin BM, Barquera S, Corvalan C, Hofman KJ, Monteiro C, Ng SW, Swart EC, Taillie LS. Towards unified and impactful policies to reduce ultra-processed food consumption and promote healthier eating. Lancet Diabetes Endocrinol 2021; 9:462-470. [PMID: 33865500 PMCID: PMC8217149 DOI: 10.1016/s2213-8587(21)00078-4] [Citation(s) in RCA: 108] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 03/08/2021] [Accepted: 03/09/2021] [Indexed: 02/07/2023]
Abstract
The global surges in obesity and nutrition-related non-communicable diseases (NCDs) have created a need for decisive new food policy initiatives. A major concern has been the impact of ultra-processed foods (UPFs) and ultra-processed drinks on weight gain and on the risk of several NCDs. These foods, generally high in calories, added sugar, sodium, and unhealthy fats, and poor in fibre, protein, and micronutrients, have extensive negative effects on human health and on the environment (due to their associated carbon emission and water use). There is a growing tendency worldwide, and especially in South America, for food companies to add micronutrients to UPFs to make health claims regarding these products, to which food-regulating authorities refer to fake foods. Although more than 45 countries and smaller subregional or urban entities have created taxes on ultra-processed drinks, such as sugar-sweetened beverages, only a few have adopted taxes on snacks and other UPFs, and none have added major subsidies for truly healthy, fresh or minimally processed food for people from lower socioeconomic backgrounds. Another major focus has been on developing effective package labelling. A smaller number of countries have selected the most impactful warning labels and linked them with other measures to create a mutually reinforcing set of policies; a few other countries have developed effective school food policies. We herein present in-depth results from key countries involved in all these actions and in comprehensive marketing controls, and conclude with our recommendations for the future. This field is quite new; progress to date is substantial, but much more is left to learn.
Collapse
Affiliation(s)
- Barry M Popkin
- Department of Nutrition, Gillings School of Global Public Health, and Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Simon Barquera
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Camila Corvalan
- Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile
| | - Karen J Hofman
- South African Medical Research Council Centre for Health Economics and Decision Science (PRICELESS SA), Faculty of Health Sciences School of Public Health, University of Witwatersrand, Johannesburg, South Africa
| | - Carlos Monteiro
- Center for Epidemiological Studies in Health and Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Shu Wen Ng
- Department of Nutrition, Gillings School of Global Public Health, and Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Elizabeth C Swart
- Department of Science and Innovation-National Research Foundation Centre of Excellence in Food Security, University of the Western Cape, Cape Town, South Africa
| | - Lindsey Smith Taillie
- Department of Nutrition, Gillings School of Global Public Health, and Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| |
Collapse
|
10
|
Harding JF, Knab J, Zief S, Kelly K, McCallum D. A Systematic Review of Programs to Promote Aspects of Teen Parents' Self-sufficiency: Supporting Educational Outcomes and Healthy Birth Spacing. Matern Child Health J 2021; 24:84-104. [PMID: 31965469 PMCID: PMC7497377 DOI: 10.1007/s10995-019-02854-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Introduction Expectant and parenting teens experience many challenges to achieving self-sufficiency and promoting their children’s healthy development. Teen parents need support to help them address these challenges, and many different types of programs aim to support them. In this systematic review, we examine the research about programs that aim to support aspects of teen parents’ self-sufficiency by promoting their educational outcomes and healthy birth spacing. Methods We conducted a comprehensive literature search of published and unpublished literature to identify studies of programs to support teen parents that met this review’s eligibility criteria. The quality and execution of the eligible study research designs were assessed to determine whether studies’ findings were at risk of bias. We then extracted information about study characteristics, outcomes, and program characteristics for studies considered to provide rigorous evidence. Results We identified 58 eligible studies. Twenty-three studies were considered to provide rigorous evidence about either education, contraceptive use, or repeat pregnancy or birth. Seventeen of these studies showed at least one favorable effect on an outcome in one of these domains, whereas the other six did not show any significant or substantial effects in these domains. These 17 studies represent 14 effective programs. Discussion Effective programs to support expectant and parenting teens have diverse characteristics, indicating there is no single approach for promoting teens’ education and healthy birth spacing. More rigorous studies of programs to support teen parents are needed to understand more about how to support teen fathers and the program characteristics associated with effectiveness. Electronic supplementary material The online version of this article (10.1007/s10995-019-02854-w) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
| | - Jean Knab
- Mathematica, P.O. Box 2393, Princeton, NJ, 08543-2393, USA
| | - Susan Zief
- Mathematica, P.O. Box 2393, Princeton, NJ, 08543-2393, USA
| | - Kevin Kelly
- Mathematica, P.O. Box 2393, Princeton, NJ, 08543-2393, USA
| | - Diana McCallum
- Mathematica, P.O. Box 2393, Princeton, NJ, 08543-2393, USA
| |
Collapse
|
11
|
Backholer K, Baum F, Finlay SM, Friel S, Giles-Corti B, Jones A, Patrick R, Shill J, Townsend B, Armstrong F, Baker P, Bowen K, Browne J, Büsst C, Butt A, Canuto K, Canuto K, Capon A, Corben K, Daube M, Goldfeld S, Grenfell R, Gunn L, Harris P, Horton K, Keane L, Lacy-Nichols J, Lo SN, Lovett RW, Lowe M, Martin JE, Neal N, Peeters A, Pettman T, Thoms A, Thow AMT, Timperio A, Williams C, Wright A, Zapata-Diomedi B, Demaio S. Australia in 2030: what is our path to health for all? Med J Aust 2021; 214 Suppl 8:S5-S40. [PMID: 33934362 DOI: 10.5694/mja2.51020] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 02/17/2021] [Accepted: 02/17/2021] [Indexed: 12/11/2022]
Abstract
CHAPTER 1: HOW AUSTRALIA IMPROVED HEALTH EQUITY THROUGH ACTION ON THE SOCIAL DETERMINANTS OF HEALTH: Do not think that the social determinants of health equity are old hat. In reality, Australia is very far away from addressing the societal level drivers of health inequity. There is little progressive policy that touches on the conditions of daily life that matter for health, and action to redress inequities in power, money and resources is almost non-existent. In this chapter we ask you to pause this reality and come on a fantastic journey where we envisage how COVID-19 was a great disruptor and accelerator of positive progressive action. We offer glimmers of what life could be like if there was committed and real policy action on the social determinants of health equity. It is vital that the health sector assists in convening the multisectoral stakeholders necessary to turn this fantasy into reality. CHAPTER 2: ABORIGINAL AND TORRES STRAIT ISLANDER CONNECTION TO CULTURE: BUILDING STRONGER INDIVIDUAL AND COLLECTIVE WELLBEING: Aboriginal and Torres Strait Islander peoples have long maintained that culture (ie, practising, maintaining and reclaiming it) is vital to good health and wellbeing. However, this knowledge and understanding has been dismissed or described as anecdotal or intangible by Western research methods and science. As a result, Aboriginal and Torres Strait Islander culture is a poorly acknowledged determinant of health and wellbeing, despite its significant role in shaping individuals, communities and societies. By extension, the cultural determinants of health have been poorly defined until recently. However, an increasing amount of scientific evidence supports what Aboriginal and Torres Strait Islander people have always said - that strong culture plays a significant and positive role in improved health and wellbeing. Owing to known gaps in knowledge, we aim to define the cultural determinants of health and describe their relationship with the social determinants of health, to provide a full understanding of Aboriginal and Torres Strait Islander wellbeing. We provide examples of evidence on cultural determinants of health and links to improved Aboriginal and Torres Strait Islander health and wellbeing. We also discuss future research directions that will enable a deeper understanding of the cultural determinants of health for Aboriginal and Torres Strait Islander people. CHAPTER 3: PHYSICAL DETERMINANTS OF HEALTH: HEALTHY, LIVEABLE AND SUSTAINABLE COMMUNITIES: Good city planning is essential for protecting and improving human and planetary health. Until recently, however, collaboration between city planners and the public health sector has languished. We review the evidence on the health benefits of good city planning and propose an agenda for public health advocacy relating to health-promoting city planning for all by 2030. Over the next 10 years, there is an urgent need for public health leaders to collaborate with city planners - to advocate for evidence-informed policy, and to evaluate the health effects of city planning efforts. Importantly, we need integrated planning across and between all levels of government and sectors, to create healthy, liveable and sustainable cities for all. CHAPTER 4: HEALTH PROMOTION IN THE ANTHROPOCENE: THE ECOLOGICAL DETERMINANTS OF HEALTH: Human health is inextricably linked to the health of the natural environment. In this chapter, we focus on ecological determinants of health, including the urgent and critical threats to the natural environment, and opportunities for health promotion arising from the human health co-benefits of actions to protect the health of the planet. We characterise ecological determinants in the Anthropocene and provide a sobering snapshot of planetary health science, particularly the momentous climate change health impacts in Australia. We highlight Australia's position as a major fossil fuel producer and exporter, and a country lacking cohesive and timely emissions reduction policy. We offer a roadmap for action, with four priority directions, and point to a scaffold of guiding approaches - planetary health, Indigenous people's knowledge systems, ecological economics, health co-benefits and climate-resilient development. Our situation requires a paradigm shift, and this demands a recalibration of health promotion education, research and practice in Australia over the coming decade. CHAPTER 5: DISRUPTING THE COMMERCIAL DETERMINANTS OF HEALTH: Our vision for 2030 is an Australian economy that promotes optimal human and planetary health for current and future generations. To achieve this, current patterns of corporate practice and consumption of harmful commodities and services need to change. In this chapter, we suggest ways forward for Australia, focusing on pragmatic actions that can be taken now to redress the power imbalances between corporations and Australian governments and citizens. We begin by exploring how the terms of health policy making must change to protect it from conflicted commercial interests. We also examine how marketing unhealthy products and services can be more effectively regulated, and how healthier business practices can be incentivised. Finally, we make recommendations on how various public health stakeholders can hold corporations to account, to ensure that people come before profits in a healthy and prosperous future Australia. CHAPTER 6: DIGITAL DETERMINANTS OF HEALTH: THE DIGITAL TRANSFORMATION: We live in an age of rapid and exponential technological change. Extraordinary digital advancements and the fusion of technologies, such as artificial intelligence, robotics, the Internet of Things and quantum computing constitute what is often referred to as the digital revolution or the Fourth Industrial Revolution (Industry 4.0). Reflections on the future of public health and health promotion require thorough consideration of the role of digital technologies and the systems they influence. Just how the digital revolution will unfold is unknown, but it is clear that advancements and integrations of technologies will fundamentally influence our health and wellbeing in the future. The public health response must be proactive, involving many stakeholders, and thoughtfully considered to ensure equitable and ethical applications and use. CHAPTER 7: GOVERNANCE FOR HEALTH AND EQUITY: A VISION FOR OUR FUTURE: Coronavirus disease 2019 has caused many people and communities to take stock on Australia's direction in relation to health, community, jobs, environmental sustainability, income and wealth. A desire for change is in the air. This chapter imagines how changes in the way we govern our lives and what we value as a society could solve many of the issues Australia is facing - most pressingly, the climate crisis and growing economic and health inequities. We present an imagined future for 2030 where governance structures are designed to ensure transparent and fair behaviour from those in power and to increase the involvement of citizens in these decisions, including a constitutional voice for Indigenous peoples. We imagine that these changes were made by measuring social progress in new ways, ensuring taxation for public good, enshrining human rights (including to health) in legislation, and protecting and encouraging an independent media. Measures to overcome the climate crisis were adopted and democratic processes introduced in the provision of housing, education and community development.
Collapse
|
12
|
Caicedo C, Anselmi M, Prandi R, Márquez M, Buonfrate BD, Gobbi F, Bisoffi Z, Tognoni G. [I promotori di salute come attori-protagonisti delle cure primarie nel controllo delle malattie comunicabili e non comunicabili e nell' empowerment delle comunità. Esperienza e risultati di lungo periodo in aree marginali in Ecuador dal 1980 al 2018.]. Assist Inferm Ric 2021; 39:47-56. [PMID: 32458830 DOI: 10.1702/3371.33476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
. INTRODUCTION Against the increasing recognition of the critical importance of a direct participation of community members to assure effective health care in peripheral areas of Middle and Low Income Countries (MLIC), representative field experiences of their essential role are only occasionally available. AIMS AND METHODS We report a narrative, factual documentation of a spectrum of projects covering the basic and specific health needs of the disperse communities in Ecuador, a model MLIC, and discuss the broader implications of the role and performance of HPs over a long period, 1980-2018, in the project activation, implementation and monitoring. RESULTS The role of 60 HPs, with the coordination of a small core group of professionals of the Centro de Epidemiologia Comunitaria y Medicina Tropical (CECOMET) is documented through their main achievements which include: infectious diseases and in particular Neglected Tropical Diseases (eradication of onchocerciasis and yaws; virtual elimination of malaria and of strongyloidiasis; identification and control of a new focus of Chagas Disease; control of tuberculosis), mother and child health, reproductive health, hypertension (as model of the emergence of non-transmissible, chronic diseases). The most effective and sustainable strategies and methods are discussed also in terms of their more general transferability, already partially tested in programs in Bolivia, Burkina Faso, undeserved areas of Argentina. CONCLUSIONS The systematic availability of non-professional, trained HPs should be recommended as a sustainable and reliable component of health care strategies and interventions targeted to marginalized settings, to assure a concrete accessibility to the fundamental human right to life.
Collapse
|
13
|
Peighambardoust SH, Karami Z, Pateiro M, Lorenzo JM. A Review on Health-Promoting, Biological, and Functional Aspects of Bioactive Peptides in Food Applications. Biomolecules 2021; 11:631. [PMID: 33922830 PMCID: PMC8145060 DOI: 10.3390/biom11050631] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 04/20/2021] [Accepted: 04/21/2021] [Indexed: 02/07/2023] Open
Abstract
Food-derived bioactive peptides are being used as important functional ingredients for health-promoting foods and nutraceuticals in recent times in order to prevent and manage several diseases thanks to their biological activities. Bioactive peptides are specific protein fractions, which show broad applications in cosmetics, food additives, nutraceuticals, and pharmaceuticals as antimicrobial, antioxidant, antithrombotic, and angiotensin-I-converting enzyme (ACE)-inhibitory ingredients. These peptides can preserve consumer health by retarding chronic diseases owing to modulation or improvement of the physiological functions of human body. They can also affect functional characteristics of different foods such as dairy products, fermented beverages, and plant and marine proteins. This manuscript reviews different aspects of bioactive peptides concerning their biological (antihypertensive, antioxidative, antiobesity, and hypocholesterolemic) and functional (water holding capacity, solubility, emulsifying, and foaming) properties. Moreover, the properties of several bioactive peptides extracted from different foods as potential ingredients to formulate health promoting foods are described. Thus, multifunctional properties of bioactive peptides provide the possibility to formulate or develop novel healthy food products.
Collapse
Affiliation(s)
| | - Zohreh Karami
- Department of Food Science, College of Agriculture, University of Tabriz, Tabriz 5166616471, Iran
| | - Mirian Pateiro
- Centro Tecnológico de la Carne de Galicia, Rúa Galicia No. 4, Parque Tecnológico de Galicia, San Cibrao das Viñas, 32900 Ourense, Spain
| | - José M Lorenzo
- Centro Tecnológico de la Carne de Galicia, Rúa Galicia No. 4, Parque Tecnológico de Galicia, San Cibrao das Viñas, 32900 Ourense, Spain
- Área de Tecnología de los Alimentos, Facultad de Ciencias de Ourense, Universidad de Vigo, 32004 Ourense, Spain
| |
Collapse
|
14
|
Rani Elwy A, Dusek J, Taylor SL. Call for Special Issue Papers: Effectiveness, Implementation, and Dissemination Research in Integrative Health. J Altern Complement Med 2021; 26:655-657. [PMID: 32757961 DOI: 10.1089/acm.2019.29080.cfp8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
15
|
Abstract
BACKGROUND Demanding working conditions in medical practice pressurise the well-being of physicians across all career stages, likely harming patients and healthcare systems. Structural solutions to harmful working conditions are necessary as well as interventions to support physicians in contemporary practice. We report on developing and piloting a team-based program for physicians to improve their working conditions and well-being. APPROACH Program development steps involved: a preparatory phase, needs assessment, and program design. The program consisted of (1) a feedback tool addressing working conditions and well-being, and an intervention including (2a) a facilitated team dialogue and (2b) a team training on communication and collaborative job crafting. In the program's pilot, 377 physicians from 48 teams in 14 Dutch hospitals used the feedback tool. Four teams participated in the team dialogue. Two teams performed the team training. EVALUATION Physicians indicated that the program was a useful format to gain insight into their working conditions and well-being, and possibly to improve their well-being collaboratively. REFLECTION We provide seven critical reflections on developing and piloting our program, accompanied by recommendations for developing well-being interventions. Our development approach, program components, and recommendations may support physicians and other healthcare professionals in demanding work environments.
Collapse
Affiliation(s)
- Maarten P M Debets
- Research Group Professional Performance and Compassionate Care, Department of Medical Psychology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
| | - Kiki M J M H Lombarts
- Research Group Professional Performance and Compassionate Care, Department of Medical Psychology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Renée A Scheepers
- Research Group Professional Performance and Compassionate Care, Department of Medical Psychology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Research Group Socio-Medical Sciences, Erasmus School of Health Policy and Management, Erasmus University of Rotterdam, Rotterdam, The Netherlands
| |
Collapse
|
16
|
Panagiotakos DB, Kouvari M, Souliotis K. Towards a Better Primary Healthcare in Europe: Shifts in Public Health Nutrition Policies. Nutrients 2020; 12:nu12113308. [PMID: 33137959 PMCID: PMC7693260 DOI: 10.3390/nu12113308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 10/27/2020] [Indexed: 11/20/2022] Open
Affiliation(s)
- Demosthenes B. Panagiotakos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 17671 Athens, Greece;
- Faculty of Health, University of Canberra, Bruce ACT 2617, Australia
- Correspondence:
| | - Matina Kouvari
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 17671 Athens, Greece;
| | - Kyriakos Souliotis
- Faculty of Social and Political Sciences, University of Peloponnese, 20100 Korinthos, Greece;
| |
Collapse
|
17
|
Affiliation(s)
- Yuesong Pan
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Hao Li
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Joanna M Wardlaw
- Centre for Clinical Brain Sciences and UK Dementia Research Institute, University of Edinburgh, Edinburgh, UK
| | - Yongjun Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
| |
Collapse
|
18
|
Sadovsky Y, Mesiano S, Burton GJ, Lampl M, Murray JC, Freathy RM, Mahadevan-Jansen A, Moffett A, Price ND, Wise PH, Wildman DE, Snyderman R, Paneth N, Capra JA, Nobrega MA, Barak Y, Muglia LJ. Advancing human health in the decade ahead: pregnancy as a key window for discovery: A Burroughs Wellcome Fund Pregnancy Think Tank. Am J Obstet Gynecol 2020; 223:312-321. [PMID: 32565236 PMCID: PMC7303037 DOI: 10.1016/j.ajog.2020.06.031] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 06/07/2020] [Accepted: 06/10/2020] [Indexed: 12/16/2022]
Abstract
Recent revolutionary advances at the intersection of medicine, omics, data sciences, computing, epidemiology, and related technologies inspire us to ponder their impact on health. Their potential impact is particularly germane to the biology of pregnancy and perinatal medicine, where limited improvement in health outcomes for women and children has remained a global challenge. We assembled a group of experts to establish a Pregnancy Think Tank to discuss a broad spectrum of major gestational disorders and adverse pregnancy outcomes that affect maternal-infant lifelong health and should serve as targets for leveraging the many recent advances. This report reflects avenues for future effects that hold great potential in 3 major areas: developmental genomics, including the application of methodologies designed to bridge genotypes, physiology, and diseases, addressing vexing questions in early human development; gestational physiology, from immune tolerance to growth and the timing of parturition; and personalized and population medicine, focusing on amalgamating health record data and deep phenotypes to create broad knowledge that can be integrated into healthcare systems and drive discovery to address pregnancy-related disease and promote general health. We propose a series of questions reflecting development, systems biology, diseases, clinical approaches and tools, and population health, and a call for scientific action. Clearly, transdisciplinary science must advance and accelerate to address adverse pregnancy outcomes. Disciplines not traditionally involved in the reproductive sciences, such as computer science, engineering, mathematics, and pharmacology, should be engaged at the study design phase to optimize the information gathered and to identify and further evaluate potentially actionable therapeutic targets. Information sources should include noninvasive personalized sensors and monitors, alongside instructive "liquid biopsies" for noninvasive pregnancy assessment. Future research should also address the diversity of human cohorts in terms of geography, racial and ethnic distributions, and social and health disparities. Modern technologies, for both data-gathering and data-analyzing, make this possible at a scale that was previously unachievable. Finally, the psychosocial and economic environment in which pregnancy takes place must be considered to promote the health and wellness of communities worldwide.
Collapse
Affiliation(s)
- Yoel Sadovsky
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Magee-Womens Research Institute, University of Pittsburgh, Pittsburgh, PA
| | - Sam Mesiano
- Department of Reproductive Biology, Case Western Reserve University, and Department of Obstetrics and Gynecology, University Hospitals of Cleveland, Cleveland, OH
| | - Graham J Burton
- Centre for Trophoblast Research; University of Cambridge, Cambridge, United Kingdom
| | - Michelle Lampl
- Center for the Study of Human Health, Emory University, Atlanta, GA
| | | | | | - Anita Mahadevan-Jansen
- Vanderbilt Biophotonics Center and Department of Biomedical Engineering, Vanderbilt University, Nashville, TN
| | - Ashley Moffett
- Department of Pathology; Centre for Trophoblast Research
| | | | - Paul H Wise
- Department of Pediatrics, Stanford University School of Medicine, Stanford University, Stanford, CA
| | - Derek E Wildman
- Genomics Program, College of Public Health, University of South Florida, Tampa, FL
| | - Ralph Snyderman
- Duke Center for Personalized Health Care, Duke University Medical Center, Durham, NC
| | - Nigel Paneth
- Departments of Epidemiology and Biostatistics and of Pediatrics and Human Development, College of Human Medicine, Michigan State University, East Lansing, MI
| | | | | | - Yaacov Barak
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Magee-Womens Research Institute, University of Pittsburgh, Pittsburgh, PA
| | - Louis J Muglia
- Office of the President, Burroughs Wellcome Fund, Research Triangle Park, NC.
| |
Collapse
|
19
|
|
20
|
Abstract
OBJECTIVES This study sought to determine the impact of Healthy Families Healthy Futures (HFHF) enhanced with Steps to Success (STS). HFHF is a structured home visiting program for teen parents in Houston that focuses on improving parenting skills and preventing child abuse. HFHF enhanced with STS includes content and activities aimed to reduce repeat pregnancies within 24 months after the first child's birth. METHODS The study team recruited 248 young mothers for the study, primarily through local health clinics and schools, and then randomly assigned them to either a treatment group that was eligible to participate in HFHF enhanced with STS or to a control group. The control group was not offered any other program through the study. Outcomes were measured by a survey administered 12 months after program intake, in five domains aligned with the program's logic model: (1) exposure to information related to program content, (2) contraception knowledge, (3) contraception use, (4) enhanced family functioning, and (5) child health and development. To estimate program impacts, we used ordinary least squares regression, controlling for demographics and baseline measures of the outcome variables, if available. We use both frequentist approaches (calculations of statistical significance) and Bayesian posterior probabilities to interpret the findings. RESULTS HFHF enhanced with STS significantly (p < .05) impacted exposure to information on parenting and birth control, with effects of 20.8 and 15.4 percentage points, respectively. Using Bayesian posterior probabilities, there is an 85% chance that the program had a favorable effect on these outcomes. We also calculate a probability of 77% that the program had a favorable impact on long-acting reversible contraceptive (LARC) use, but a probability of 89% that the program reduced knowledge of birth control pills; these two results were not statistically significant (p = .17 and .10, respectively). CONCLUSIONS FOR PRACTICE These findings are primarily favorable and consistent with the program content and goals. Smaller than anticipated sample sizes due to recruitment challenges increased the chances for random error to affect the ability to detect statistically significant differences on many of our other outcomes; Bayesian posterior probabilities can therefore aid in interpreting the impact estimates. More research of this promising model is warranted.
Collapse
Affiliation(s)
- Susan Zief
- Mathematica, P.O. Box 2393, Princeton, NJ, 08543, USA.
| | - John Deke
- Mathematica, P.O. Box 2393, Princeton, NJ, 08543, USA
| | | | - Andrew Langan
- Mathematica, P.O. Box 2393, Princeton, NJ, 08543, USA
| | - Subuhi Asheer
- Mathematica, P.O. Box 2393, Princeton, NJ, 08543, USA
| |
Collapse
|
21
|
López-Valenciano A, Mayo X, Liguori G, Copeland RJ, Lamb M, Jimenez A. Changes in sedentary behaviour in European Union adults between 2002 and 2017. BMC Public Health 2020; 20:1206. [PMID: 32843022 PMCID: PMC7448983 DOI: 10.1186/s12889-020-09293-1] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 07/23/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Sedentary behaviour (SB) has been identified as an important mortality risk factor. Health organizations have recognised SB as a public health challenge with major health, social, and economic consequences. Researchers have alerted the need to develop specific strategies, to monitor, prevent, and reduce SB. However, there is no systematic analysis of the SB changes in European Union adults. We aimed to examine SB changes between 2002 and 2017 in the European Union (EU) adult population. METHODS SB prevalence (>4h30mins of sitting time/day) of 96,004 adults as a whole sample and country-by-country was analysed in 2002, 2005, 2013, and 2017 of the Sport and Physical Activity EU Special Eurobarometers' data. The SB question of a modified version of the International Physical Activity Questionnaire was considered. SB prevalence between countries and within years was analysed with a χ2 test, and SB between genders was analysed with the Z-Score test for two population proportions. RESULTS An association between the SB prevalence and the years was found (p < 0.001), with increases for the whole sample (2002: 49.3%, 48.5-50.0 95% confidence interval (CI); 2017: 54.5%, 53.9-55.0 95% CI) and men (2002: 51.2%, 50.0-52.4 95% CI; 2017: 55.8%, 55.0-56.7 95% CI) and women (2002: 47.6%, 46.6-48.7 95% CI; 2017: 53.4%, 52.6-54.1 95% CI) separately. The adjusted standardised residuals showed an increase in the observed prevalence versus the expected during 2013 and 2017 for the whole sample and women and during 2017 for men. For all years, differences were observed in the SB prevalence between countries for the whole sample, and men and women separately (p < 0.001). Besides, the SB prevalence was always higher in men versus women in the overall EU sample (p < 0.001). CONCLUSIONS SB prevalence increased between 2002 and 2017 for the EU as a whole and for both sexes separately. Additionally, differences in SB prevalence were observed for all years between EU countries in the whole sample and both sexes separately. Lastly, SB was consistently higher in men than women. These findings reveal a limited impact of current policies and interventions to tackle SB at the EU population level.
Collapse
Affiliation(s)
- A. López-Valenciano
- Observatory of Healthy & Active Living of Spain Active Foundation, Centre for Sport Studies, King Juan Carlos University, Madrid, Spain
- GO fit LAB, Ingesport, Madrid, Spain
| | - X. Mayo
- Observatory of Healthy & Active Living of Spain Active Foundation, Centre for Sport Studies, King Juan Carlos University, Madrid, Spain
| | - G. Liguori
- University of Rhode Island, Kingston, RI USA
| | - R. J. Copeland
- Advanced Wellbeing Research Centre, College of Health, Wellbeing, and Life Sciences, Sheffield Hallam University, Sheffield, UK
- The National Centre for Sport and Exercise Medicine, Sheffield, UK
| | - M. Lamb
- Advanced Wellbeing Research Centre, College of Health, Wellbeing, and Life Sciences, Sheffield Hallam University, Sheffield, UK
- Centre for Behavioural Science and Applied Psychology, Sheffield Hallam University, Sheffield, UK
| | - A. Jimenez
- Observatory of Healthy & Active Living of Spain Active Foundation, Centre for Sport Studies, King Juan Carlos University, Madrid, Spain
- GO fit LAB, Ingesport, Madrid, Spain
- Advanced Wellbeing Research Centre, College of Health, Wellbeing, and Life Sciences, Sheffield Hallam University, Sheffield, UK
| |
Collapse
|
22
|
Tareg AC, Reichhardt ML. Lessons from the Field: Going Local-Everybody Wins. Hawaii J Health Soc Welf 2020; 79:13-18. [PMID: 32596672 PMCID: PMC7311945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Pacific Islanders suffer from chronic diseases attributed largely to an overconsumption of processed foods. As a response, the CDC-funded Racial and Ethnic Approaches to Community Health (REACH) Go Local Project in Yap, Federated States of Micronesia (population: 12,000) sought to create a food intervention that would not only increase access to fresh, local foods, but benefit food vendors as well for a sustainable effect. For this program, a number of markets were chosen for selling any fresh local produce, meat, and catch. These markets agreed to allow purchasers of healthy local food of a minimum amount to be entered into a monthly raffle. Monthly winners received fresh food gift certificates while participating markets received a gift upon certificate redemption. REACH and partners distributed healthy island recipes and nutrition information at these partner markets. Formative evaluation examined customer and vendor satisfaction through interviews and surveys, and tracking of healthy food purchases and customer demographics were garnered via raffle information. Brief interviews with customers and vendors revealed favorable reactions to the Go Local Project. People enjoyed winning and vendors found satisfaction in promoting health through their businesses.
Collapse
Affiliation(s)
- Aileen C. Tareg
- Yap State Department of Health Services, Yap, Federated States of Micronesia
| | | |
Collapse
|
23
|
Ikerdeu E, Lyman A, Koshiba C, Tutii I, Whipps V, Ngirmang K, Osarch S. Lessons from the Field: Interventions to Improve Health and Quality of Life to Address the NCD Crisis in Palau - Fostering Collaboration Across Sectors within the Government and Civil Society. Hawaii J Health Soc Welf 2020; 79:19-23. [PMID: 32596673 PMCID: PMC7311937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The Republic of Palau is a small island nation in the North Pacific with a population of 17,501. The islands of Palau are geographically isolated, considered rural, and medically underserved. The prevalence of non-communicable diseases (NCDs) and risk factors are very high and account for more than 75% of all deaths and disabilities. Recognizing that the high rates of NCDs are undermining health and sustainable development of the nation, Palau declared a state of health emergency due to the epidemic of NCDs. It was recognized during the development of the NCD Prevention and Control Strategic Plan of Action 2015-2020 (Palau NCD Plan) that improved collaboration between government agencies, civil society, and the private sector was needed to address this epidemic. A multi-sectoral solution was needed to address a multi-sectoral problem. Through Presidential Executive Order, the National Coordinating Mechanism for Non-Communicable Diseases (CM) was established to mobilize sufficient resources and coordinate actions to prevent and control NCDs, ensure successful implementation of the Palau NCD Plan, the World Health Organization Framework Convention on Tobacco Control, and other related plans and commitments, align such plans to national policies, ensure a health-in-all-policy approach to address health inequities, and bridge the gap between health and quality of life. Though the CM is young, improved coordination between agencies and accelerated action has taken place. Legislation was enacted that mandates 10% of alcohol and tobacco taxes be directed to NCD prevention through the Coordinating Mechanism, thus ensuring sustainability.
Collapse
Affiliation(s)
- Edolem Ikerdeu
- Republic of Palau Ministry of Health, Koror, Palau (EI, CK, IT, KN, SO)
| | - Annabel Lyman
- Coalition for a Tobacco Free Palau, Koror, Palau (AL, VW)
| | - Candace Koshiba
- Republic of Palau Ministry of Health, Koror, Palau (EI, CK, IT, KN, SO)
| | - Irish Tutii
- Republic of Palau Ministry of Health, Koror, Palau (EI, CK, IT, KN, SO)
| | - Valerie Whipps
- Coalition for a Tobacco Free Palau, Koror, Palau (AL, VW)
| | - Komtil Ngirmang
- Republic of Palau Ministry of Health, Koror, Palau (EI, CK, IT, KN, SO)
| | - Sylvia Osarch
- Republic of Palau Ministry of Health, Koror, Palau (EI, CK, IT, KN, SO)
| |
Collapse
|
24
|
Gonzales R, Alam L, Silverio A, Navasca D. Lessons from the Field: Guam Salt Reduction Campaign. Hawaii J Health Soc Welf 2020; 79:30-32. [PMID: 32596675 PMCID: PMC7311934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
To lessen the salt-intake of people in Guam for the prevention of non-communicable diseases (NCD) associated with a high sodium diet, the Racial and Ethnic Approach to Community Health (REACH) program and NCD Consortium of the Guam Bureau of Community Health Services (BCHS) formed strategies that encourage healthier eating behavior. Project stakeholders, like restaurants, food services establishments, and vendors, removed salt products from dine-in tables, including saltshakers, soy sauce, and finadene. Combined programmatic efforts resulted in support by 47 restaurants out of 140 restaurants that were approached for the salt reduction initiative: the removal of saltshakers and other high sodium-containing condiments from tables, made available only upon a customer's request.
Collapse
Affiliation(s)
- Ruby Gonzales
- Department of Family Medicine and Community Health, John A. Burns School of Medicine, University of Hawai‘i at Manoa, Honolulu, HI (RG, DN)
- Guam Comprehensive Cancer Control Program, Guam Department of Public Health and Social Services, Mangilao, GU (RG, LA)
| | - Lawrence Alam
- Guam Comprehensive Cancer Control Program, Guam Department of Public Health and Social Services, Mangilao, GU (RG, LA)
| | - Al Silverio
- Guam Office of Minority Health, Guam Department of Public Health and Social Services, Mangilao, GU (AS)
| | - Dioreme Navasca
- Department of Family Medicine and Community Health, John A. Burns School of Medicine, University of Hawai‘i at Manoa, Honolulu, HI (RG, DN)
| |
Collapse
|
25
|
Abstract
BACKGROUND Identifying social innovation in health initiatives, promoting quality of life through them, and transforming current health conditions demand the knowledge, comprehension and appropriation of the theoretical and methodological developments of this concept. Academic developments in social innovation have mainly occurred in and been documented for English-speaking countries, although relevant experiences have been implemented in Latin America. In this article, we describe and analyze how social innovation in health is being approached and understood in this region. MAIN TEXT To identify the theoretical and methodological developments of social innovation in health between 2013 and 2018, a scoping review with a mixed approach was carried out. Eighty texts in English, Spanish and Portuguese were selected for a process of reflexive analysis of intra and intertextual reading. The approaches identified in the studied initiatives were complementary. The most applied approaches were innovation in health, technological innovation in health and social innovation, each with twelve publications, and social innovation in health and ecohealth with ten and seven publications respectively. The approaches showed a general interest in reaching the goals of the Sustainable Development Goals (SDGs), the Alma Ata Declaration and the Ottawa Letter. CONCLUSIONS The social innovation in health approach in Latin America adopts educational strategies, identifies risk factors, optimizes resources, promotes interculturality, participation, community empowerment, and enhances intersectorality and interdisciplinarity. As an approach, process, program or solution, social innovation in health is a conceptual category under construction. This research provides a baseline for other systematic reviews on the subject.
Collapse
Affiliation(s)
- Diana María Castro-Arroyave
- Centro Internacional de Entrenamiento e Investigaciones Médicas (CIDEIM), Cali, Colombia
- Icesi University, Cali, Colombia
| | | |
Collapse
|
26
|
Affiliation(s)
- Andy Haines
- Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, UK
| | | | - Anita Berlin
- Primary Care Education and Community-Based Medical Education, Barts & The London School of Medicine & Dentistry, Queen Mary University of London, London, UK
| | - David L Heymann
- Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Matthew J Harris
- Department of Primary Care and Public Health, Imperial College London, London W6 8RP, UK.
| |
Collapse
|
27
|
Stassen G, Grieben C, Sauzet O, Frob�se I, Schaller A. Health literacy promotion among young adults: a web-based intervention in German vocational schools. Health Educ Res 2020; 35:87-98. [PMID: 32011701 PMCID: PMC7089709 DOI: 10.1093/her/cyaa001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 01/09/2020] [Indexed: 06/10/2023]
Abstract
Against the background of an ageing population, the target group of young adults holds strong societal relevance as the future workforce. At the same time, young adults find themselves in a critical phase of life regarding the manifestation of a healthy lifestyle. In this context, young adults' health literacy gains importance. Web-based interventions implemented in educational settings offer the potential for promoting health literacy, although longitudinal studies remain scarce. Within a pre-post cluster randomized controlled trial with 6-month follow-up, this study investigated whether an 8-week web-based intervention in vocational schools (with or without an additional initial face-to-face measure) improves individual competencies within a structural model of health literacy ('self-perception', 'proactive approach to health', 'dealing with health information', 'self-control', 'self-regulation' and 'communication and cooperation'). The control condition was regular school lessons following the curriculum only. A multi-level regression analysis was performed using the control group as reference. None of the interventions showed a significant improvement in any of the dimensions. Significant differences between the intervention and control were obtained for some dimensions, albeit showing reductions. Future research must examine how to build impactful health literacy promotion in educational settings. Investigations into linking digital and face-to-face measures should continue.
Collapse
Affiliation(s)
- Gerrit Stassen
- Working Group Physical Activity-Related Prevention Research, Institute of Movement Therapy and Movement-Oriented Prevention and Rehabilitation, German Sport University Cologne, Am Sportpark M�ngersdorf 6, Cologne 50933, Germany
| | - Christopher Grieben
- Department 1: Movement-Oriented Prevention and Rehabilitation Sciences, Institute of Movement Therapy and Movement-Oriented Prevention and Rehabilitation, German Sport University Cologne, Am Sportpark M�ngersdorf 6, Cologne 50933, Germany
| | - Odile Sauzet
- Department of Epidemiology and International Public Health, Bielefeld School of Public Health, Bielefeld University, Universit�tsstra�e 25, Bielefeld 33501, Germany
- Centre for Statistics, Bielefeld University, Universit�tsstra�e 25, Bielefeld 33501, Germany
| | - Ingo Frob�se
- Department 1: Movement-Oriented Prevention and Rehabilitation Sciences, Institute of Movement Therapy and Movement-Oriented Prevention and Rehabilitation, German Sport University Cologne, Am Sportpark M�ngersdorf 6, Cologne 50933, Germany
| | - Andrea Schaller
- Working Group Physical Activity-Related Prevention Research, Institute of Movement Therapy and Movement-Oriented Prevention and Rehabilitation, German Sport University Cologne, Am Sportpark M�ngersdorf 6, Cologne 50933, Germany
| |
Collapse
|
28
|
|
29
|
The Lancet. New health indicators for America: aiming to shift practice. Lancet 2020; 395:312. [PMID: 32007147 DOI: 10.1016/s0140-6736(20)30248-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
|
30
|
Lathrop B. Moving Toward Health Equity by Addressing Social Determinants of Health. Nurs Womens Health 2020; 24:36-44. [PMID: 31911097 DOI: 10.1016/j.nwh.2019.11.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 09/02/2019] [Accepted: 11/01/2019] [Indexed: 06/10/2023]
Abstract
Social determinants of health-the conditions in which people are born, grow, work, live, and age that affect health and quality of life-are strongly associated with disparities in health status and life expectancy. Nurses require a comprehensive understanding of social determinants and their associations with health outcomes to provide patient-centered care. Nurses can be leaders and change agents in advancing health equity by screening for social determinants that affect women and by engaging in cross-sector collaboration to build partnerships outside the health care system to address complex social needs. Nurses can also use their experience and knowledge to advocate for system-level change, which is required to address the upstream factors influencing the health of women.
Collapse
|
31
|
Requejo J, Diaz T, Park L, Chou D, Choudhury A, Guthold R, Jackson D, Moller AB, Monet JP, Moran AC, Say L, Strong KL, Banerjee A. Assessing coverage of interventions for reproductive, maternal, newborn, child, and adolescent health and nutrition. BMJ 2020; 368:l6915. [PMID: 31983681 PMCID: PMC7461908 DOI: 10.1136/bmj.l6915] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Progress has been made in priority interventions, but we need new measurement systems that include the whole life course and give better assessment of equity of coverage, argue Jennifer Requejo and colleagues
Collapse
Affiliation(s)
| | | | - Lois Park
- Johns Hopkins University, Baltimore, USA
- University of Southern California, Los Angeles, USA
| | - Doris Chou
- World Health Organization, Geneva, Switzerland
| | | | | | - Debra Jackson
- Unicef, New York, USA
- University of Western Cape, Cape Town, South Africa
| | | | | | | | - Lale Say
- World Health Organization, Geneva, Switzerland
| | | | - Anshu Banerjee
- World Health Organization, Geneva, Switzerland
- United Nations H6+ Technical Group, New York, USA
| |
Collapse
|
32
|
Dixon J, Banwell C, Strazdins L, Corr L, Burgess J. Flexible employment policies, temporal control and health promoting practices: A qualitative study in two Australian worksites. PLoS One 2019; 14:e0224542. [PMID: 31860638 PMCID: PMC6924681 DOI: 10.1371/journal.pone.0224542] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 10/15/2019] [Indexed: 11/18/2022] Open
Abstract
For four decades, theories of job demand-control have proposed that higher occupational status groups have lower health risks due to the stress accompanying jobs featuring high demands but high control. This research examines whether Flexible Work Arrangements (FWAs) can improve the health prospects of a range of workers by giving greater control over work time arrangements. Our setting is Australia, where FWAs were introduced in 2009. In line with these early studies alongside studies of work-life balance, we expected to observe that workers with access to control over daily work times could better control the activities outside of work that influence chronic disease. Using a practice sociology approach, we compared the accounts of twenty-eight workers in blue and white collar industries with differing degrees of work time flexibility. The findings do not contradict early theories describing occupational differences of job demand-control dynamics and their relationship to health risks. However, this study suggests that a) time demands and strains have increased for a broad sweep of workers since the 1980s, b) the greater control of higher occupational status groups has been eroded by the high performance movement, which has attracted less scrutiny than FWAs, and c) more workers are forced to adapt their daily lives, including their approach to health, to accommodate their job demands. Job insecurity further impedes preventative health practices adoption. What might appear to be worker-controlled flexibility can-under the pressures of job insecurity and performance expectations without time limits-transform into health-eroding unpredictability. The answer however is not greater flexibility in the absence of limits on the well-documented precursors of work stress: long hours, job insecurity and intensity-related exhaustion. While there have been welcome developments in job demand-control-health conceptualizations, they typically ignore the out-of-work temporal demands that workers face and which compound on-the-job demands. Redesign of the temporalities of working life within worksites need to be accompanied by society-level policies which address caring responsibilities, gender equality as well as broad labour market conditions.
Collapse
Affiliation(s)
- Jane Dixon
- Research School of Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Cathy Banwell
- Research School of Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Lyndall Strazdins
- Research School of Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Lara Corr
- School of Arts, Social Sciences and Humanities, Faculty of Health, Arts and Design, Swinburne University of Technology, Melbourne, Victoria, Australia
| | - John Burgess
- School of Management, Royal Melbourne University of Technology University, Melbourne, Victoria, Australia
| |
Collapse
|
33
|
McGough B, Murray E, Brownlee L, Barron E, Smith J, Valabhji J. The Healthier You: NHS Diabetes Prevention Programme: digital modes of delivery engage younger people. Diabet Med 2019; 36:1510-1511. [PMID: 31325370 PMCID: PMC7004145 DOI: 10.1111/dme.14083] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
| | - E Murray
- Research Department of Primary Care and Population Health, University College London, London, UK
| | - L Brownlee
- Economics Consulting, RSM UK Consulting LLP, Belfast, UK
| | - E Barron
- Public Health England, London, UK
| | - J Smith
- Public Health England, London, UK
| | - J Valabhji
- NHS England, London, UK
- Department of Diabetes and Endocrinology, Imperial College Healthcare NHS Trust, London, UK
| |
Collapse
|
34
|
Turco JV, Inal-Veith A, Fuster V. Reprint of: Cardiovascular Health Promotion: An Issue That Can No Longer Wait. J Am Coll Cardiol 2019; 72:2945-2950. [PMID: 30522629 DOI: 10.1016/j.jacc.2018.10.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
|
35
|
Abstract
The digital revolution is disrupting the ways in which health research is conducted, and subsequently, changing healthcare. Direct-to-consumer wellness products and mobile apps, pervasive sensor technologies and access to social network data offer exciting opportunities for researchers to passively observe and/or track patients 'in the wild' and 24/7. The volume of granular personal health data gathered using these technologies is unprecedented, and is increasingly leveraged to inform personalized health promotion and disease treatment interventions. The use of artificial intelligence in the health sector is also increasing. Although rich with potential, the digital health ecosystem presents new ethical challenges for those making decisions about the selection, testing, implementation and evaluation of technologies for use in healthcare. As the 'Wild West' of digital health research unfolds, it is important to recognize who is involved, and identify how each party can and should take responsibility to advance the ethical practices of this work. While not a comprehensive review, we describe the landscape, identify gaps to be addressed, and offer recommendations as to how stakeholders can and should take responsibility to advance socially responsible digital health research.
Collapse
Affiliation(s)
- Camille Nebeker
- Department of Family Medicine and Public Health, School of Medicine, University of California San Diego, La Jolla, CA, 92093, USA.
- Research Center for Optimal Digital Ethics in Health, Qualcomm Institute and School of Medicine, University of California San Diego, La Jolla, CA, 92093, USA.
| | - John Torous
- Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave, Boston, MA, 02215, USA
| | | |
Collapse
|
36
|
Abstract
BACKGROUND The Healthy China 2030 strategy sets ambitious targets for China's policy-makers, including a decrease in the smoking rate from 27.7% in 2015 to 20% by 2030. China has made progress on tobacco control in recent years, but many key measures remain underused. This study explores the potential for full implementation of these measures to achieve the targeted reduction in smoking by 2030. METHODS First, a 'business as usual' scenario for China's cigarette market was developed based only on underlying economic parameters. Second, non-price tobacco control measures were then added assuming they are fully implemented by 2030. Third, excise per pack was raised to a level that would increase the real price of cigarettes by 50% in 2030. FINDINGS Under the business as usual scenario, the rate of smoking falls to around 26.6% in 2030. When non-price measures are included, the rate of smoking falls to 22.0% (20.9%~23.1%). Thus, non-price measures alone are unlikely to achieve the Healthy China target. Under the third scenario, excise per pack was roughly doubled in 2030 in order to increase real cigarette prices by 50%. The rate of smoking then falls to 19.7% (18.2%~21.3%), reflecting 78 million (59~97 million) fewer smokers compared with 2016. In addition, real excise revenue from cigarettes increases by 21% (-3%~47%) compared with 2016. CONCLUSION Significantly higher tobacco taxes will be needed to achieve Healthy China 2030 target for reduced smoking even after the implementation of other tobacco control measures.
Collapse
Affiliation(s)
| | - Rong Zheng
- University of International Business and Economics (UIBE), Beijing, China
| |
Collapse
|
37
|
Klein EG, Quisenberry AJ, Shoben AB, Romer D, Peters E. The Influence of Health Numeracy and Health Warning Label Type on Smoking Myths and Quit-Related Reactions. Nicotine Tob Res 2019; 21:974-978. [PMID: 30285145 PMCID: PMC6588388 DOI: 10.1093/ntr/nty207] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 09/27/2018] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Health numeracy helps individuals understand risk information, but limited data exist concerning numeracy's role in reactions to varying types of health warning labels (HWLs) for cigarettes. METHODS A nationally representative online panel of adult current smokers received two exposures (1 week apart) to nine HWLs with either text-only or pictorial images with identical mandated text. Following the second exposure, participants (n = 594) rated their beliefs in smoking myths (eg, health-promoting behaviors can undo the risks of smoking) and how much the warnings made them want to quit smoking. Generalized estimating equation regression examined the relation of objective health numeracy and its interaction with HWL type to smoking-myth beliefs and quit-related reactions. RESULTS Health numeracy was not significantly associated with smoking-myth beliefs; the interaction with HWL type was also nonsignificant. Adult smokers with lower health numeracy had higher quit-related reactions than those with higher numeracy following exposure to HWLs. The type of HWL significantly modified numeracy's associations with quit-related reactions; no significant association existed between text-only HWLs and quit-related reactions, whereas among those who viewed the pictorial warnings, lower numeracy was associated with greater quit-related reactions (β = -.23; p < .001). CONCLUSIONS Lower as compared to higher health numeracy was significantly associated with higher quit-related reactions to HWLs and especially with pictorial HWLs. Health numeracy and HWL type were not associated with the endorsement of smoking myths. The role of health numeracy in effectively communicating risks to smokers warrants thoughtful consideration in the development of tobacco HWLs. IMPLICATIONS Health numeracy plays an important role in an individual's ability to understand and respond to health risks. Smokers with lower health numeracy had greater quit-related reactions to pictorial health warnings than those who viewed text-only warning labels. Development and testing of health warning labels should consider health numeracy to most effectively communicate risk to US smokers.
Collapse
Affiliation(s)
- Elizabeth G Klein
- Division of Health Behavior & Health Promotion, College of Public Health, Ohio State University, Columbus, OH
| | - Amanda J Quisenberry
- Division of Health Behavior & Health Promotion, College of Public Health, Ohio State University, Columbus, OH
| | - Abigail B Shoben
- Division of Biostatistics, College of Public Health, Ohio State University, Columbus, OH
| | - Dan Romer
- Annenberg Public Policy Center, University of Pennsylvania, Philadelphia, PA
| | - Ellen Peters
- Department of Psychology, Ohio State University, Columbus, OH
| |
Collapse
|
38
|
Faller EK, Jean-Pierre G, Inada M, Acido JM. Pedals and Pedagogy: Cycles of Hope and Health. Hawaii J Med Public Health 2019; 78:61-64. [PMID: 31285972 PMCID: PMC6603889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The Kalihi Valley Instructional Bike Exchange (KVIBE) is an innovative youth bike program housed in Kokua Kalihi Valley Family Comprehensive Services (KKV), a community health center in Honolulu, Hawai'i. KVIBE utilizes a popular education model to raise the social consciousness of its youth participants, who are primarily working class, Indigenous, and native to the Philippines or the Pacific Islands, especially Micronesia. Initially designed as a bike repair program where youth could earn a bicycle through sweat equity, KVIBE has grown into an educational space that teaches bicycle mechanics as well as personal history and identity. The KVIBE curriculum incorporates a social determinants of health approach with the Four Connections Framework, an Indigenous health framework developed by KKV and the Islander Institute. This article shares details of this program, as a pedagogical model for programs to engage underserved and marginalized Asian, Pacific Islander and Native Hawaiian youth who suffer from displacement and historical trauma via colonization. Additionally, this article speaks to the importance of seeing marginalized youth not as an at-risk group but as agents in creating community health.
Collapse
Affiliation(s)
| | | | - Megan Inada
- Kokua Kalihi Valley Comprehensive Family Services, Honolulu, HI
| | - Jt Miguel Acido
- Kokua Kalihi Valley Comprehensive Family Services, Honolulu, HI
| |
Collapse
|
39
|
Provence K. Women's health is community health. J Am Pharm Assoc (2003) 2019; 59:301-302. [PMID: 31101311 DOI: 10.1016/j.japh.2019.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
40
|
Brown J. Beware of the "J" Word. J Emerg Med 2019; 56:462-463. [PMID: 30808535 DOI: 10.1016/j.jemermed.2018.12.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 12/20/2018] [Accepted: 12/24/2018] [Indexed: 06/09/2023]
Affiliation(s)
- Joseph Brown
- Ultrasound Fellow, University of California, San Francisco, San Francisco, California and Residency in Emergency Medicine, University of California, San Diego, San Diego, California
| |
Collapse
|
41
|
Brannan M, Bernardotto M, Clarke N, Varney J. Moving healthcare professionals - a whole system approach to embed physical activity in clinical practice. BMC Med Educ 2019; 19:84. [PMID: 30876426 PMCID: PMC6419815 DOI: 10.1186/s12909-019-1517-y] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 03/11/2019] [Indexed: 05/27/2023]
Abstract
BACKGROUND Healthcare professionals are key informants to support individual behaviour change, and although there has been some progress in empowering clinicians to promote physical activity and health at work, an effective strategy overarching the whole medical educational journey is still lacking. This report provides an overview from the Moving Healthcare Professionals programme (MHPP), a whole-system educational approach to embed prevention and physical activity promotion into clinical practice. METHODS The MHPP model integrates educational resources into three core domains of medical education: undergraduate education, postgraduate education and continuing professional development. The interventions are designed to spiral through existing educational approaches rather than as additional special study modules or bolt-on courses, thus reducing self-selection bias in exposure. Interventions include spiral undergraduate education materials, e-learning, embedded post-graduate resources and face-to-face peer-to-peer education. RESULTS To date the MHPP model has been applied in two key areas, physical activity and health and work. The physical activity programme in a partnership between Public Health England and Sport England has delivered face-to-face training to 17,105 healthcare professionals, embedded materials in almost three quarters of English medical schools and overseen > 95,000 e-learning modules completed over two and half years. Evaluation of the individual elements of the model is ongoing and aims to show improvements in knowledge, skills and practice. Further evaluation is planned to assess patient impact. CONCLUSIONS The MHPP model offers a coherent whole-system approach to embed public health action into existing healthcare education models, and as such provides a framework for rapid change as well as upstream implementation to support the clinicians of today and tomorrow.
Collapse
Affiliation(s)
| | | | | | - Justin Varney
- Public Health, Birmingham City Council, Birmingham, UK
| |
Collapse
|
42
|
Cuenca AE, Kapsner S. Medicare Wellness Visits: Reassessing Their Value to Your Patients and Your Practice. Fam Pract Manag 2019; 26:25-30. [PMID: 30855118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
|
43
|
Asiamah N, Kouveliotis K, Petersen C, Eduafo R, Borkey R. Injuries, dislocations, and poor health perceived by older adults to result from vigorous physical activity: implications for active living, health promotion, and gerontology. Adv Gerontol 2019; 32:652-657. [PMID: 31800196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
This study examines older adults' perceptions about their participation in vigorous physical activity (VPA) and the association between VPA and self-related health. A total of 686 older adults responded to self-reported questionnaires, and Pearson's ꭓ2 test and binary logistic regression were used to present findings. About 74% of older adults reported experiencing dislocations, fractures, or/and other forms of injury in intense physical activities lasting 30 minutes or more a day. After controlling for relevant socio-demographic factors, older adults who participated in VPA for 30 or more minutes a day were less likely (OR=0,129; p=0,000) to report good health compared with those who participated in VPA for less than 30 minutes. It is concluded that VPA in older populations can result in casualties that may compel older adults to underrate their health, which can discourage active living habits in older populations and discredit PA/health promotion programs.
Collapse
Affiliation(s)
- N Asiamah
- Africa Center for Epidemiology, P. O. Box AN 18462, Accra North, Accra, Ghana, e mail:
| | - K Kouveliotis
- International Telematic University UNINETTUNO, Department of Health Management, Corso Vittorio Emanuele II, n.39 - 00186, Rome, Italy
| | - C Petersen
- University of Canterbury, School of Applied Sciences, Private Bag 4800, Christchurch 8140, New Zealand
| | - R Eduafo
- Africa Center for Epidemiology, P. O. Box AN 18462, Accra North, Accra, Ghana, e mail:
| | - R Borkey
- Africa Center for Epidemiology, P. O. Box AN 18462, Accra North, Accra, Ghana, e mail:
| |
Collapse
|
44
|
Gee A. Physicians Worldwide: Educate To End Female Genital Cutting. Mo Med 2019; 116:38. [PMID: 30862982 PMCID: PMC6390799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- Amy Gee
- Amy Gee, MD is a PGY2 Resident Physician in the Department of Obstetrics & Gynecology, Saint Louis University School of Medicine, St. Louis, Missouri
| |
Collapse
|
45
|
Lee M, Lee H, Kim Y, Kim J, Cho M, Jang J, Jang H. Mobile App-Based Health Promotion Programs: A Systematic Review of the Literature. Int J Environ Res Public Health 2018; 15:ijerph15122838. [PMID: 30551555 PMCID: PMC6313530 DOI: 10.3390/ijerph15122838] [Citation(s) in RCA: 98] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 12/04/2018] [Accepted: 12/07/2018] [Indexed: 12/02/2022]
Abstract
This study investigated the features and usefulness of mobile app-based health promotion programs for the general population. A comprehensive bibliographic search of studies on health promotion programs using mobile apps in peer-reviewed journals published in English up to November 2017 was performed using the PubMed, Embase, and CINAHL databases. The inclusion criteria were (1) randomized control trial designs; (2) assessed mobile app-based interventions to promote adult health conditions; 12 studies were ultimately included. The most common topics were diet and physical activity (n = 8) and overall healthy lifestyle improvement (n = 4). The purpose of the apps included providing feedback on one’s health status (n = 9) and monitoring individual health status or behavior change (n = 9). Across all studies, health outcomes were shown to be better for mobile app users compared to non-users. Mobile app-based health interventions may be an effective strategy for improving health promotion behaviors in the general population without diseases. This study suggests that mobile app use is becoming commonplace for a variety of health-promoting behaviors in addition to physical activity and weight control. Future research should address the feasibility and effectiveness of using mobile apps for health promotion in developing countries.
Collapse
Affiliation(s)
- Mikyung Lee
- College of Nursing, Yonsei University, 50-1, Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea.
| | - Hyeonkyeong Lee
- Mo-im Kim Nursing Research Institute, College of Nursing, Yonsei University, 50-1, Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea.
| | - Youlim Kim
- College of Nursing, Yonsei University, 50-1, Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea.
| | - Junghee Kim
- Mo-im Kim Nursing Research Institute, College of Nursing, Yonsei University, 50-1, Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea.
| | - Mikyeong Cho
- College of Nursing, Yonsei University, 50-1, Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea.
| | - Jaeun Jang
- College of Nursing, Yonsei University, 50-1, Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea.
| | - Hyoeun Jang
- College of Nursing, Yonsei University, 50-1, Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea.
| |
Collapse
|
46
|
Affiliation(s)
- R I G Holt
- Editor-in-Chief, Diabetic Medicine, Southampton, UK
- University of Southampton, Southampton, UK
| |
Collapse
|
47
|
Kothe E, Lamb M, Bruce L, McPhie S, Klas A, Hill B, Skouteris H. Student midwives' intention to deliver weight management interventions: A theory of planned behaviour & self-determination theory approach. Nurse Educ Today 2018; 71:10-16. [PMID: 30212705 DOI: 10.1016/j.nedt.2018.09.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 07/23/2018] [Accepted: 09/03/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVES Overweight and obesity during pregnancy is a risk to the health of mother and child. Midwives can modify this key risk factor by providing weight management interventions to women before and during pregnancy. This study investigated social cognitive determinants of pre-clinical student midwives' intention to provide weight management intervention in preconception and antenatal clinical contexts. Social cognitive determinants from the theory of planned behaviour (attitudes, subjective norms, perceived behavioural control) and self-determination theory (autonomous motivation) were used to predict pre-clinical students' intentions once they enter practice. METHOD The sample was 183 female pre-clinical student midwives from 17 Australian universities (age range = 18-54 years). Participants received a cross-sectional questionnaire that measured demographic items, attitudes, subjective norms, perceived behavioural control and autonomous motivation towards providing weight management intervention at two different stages of pregnancy - preconception and antenatal. RESULTS Attitudes, subjective norms, and perceived behavioural control accounted for 56% of intention to provide weight management interventions to women planning pregnancy; however, the addition of autonomous motivation was non-significant. In contrast, attitudes and subjective norms (but not perceived behavioural control) accounted for 39% of intention to provide weight management interventions to women during pregnancy. Furthermore, the addition of autonomous motivation to the model was significant and accounted for an additional 3.1% of variance being explained. IMPLICATIONS AND CONCLUSIONS Curriculum changes that support and increase pre-clinical student midwives' intention should focus on these specific correlates of intention in order to foster long term changes in clinical practice. Changes to the education and training of midwives should be carefully considered to understand their impact on these important determinants of intention to engage in this critical clinical skill.
Collapse
Affiliation(s)
- Emily Kothe
- Deakin University, School of Psychology, Geelong, Australia.
| | - Michelle Lamb
- Deakin University, School of Psychology, Geelong, Australia
| | - Lauren Bruce
- Monash Centre for Health Research & Implementation, Monash University, Australia
| | - Skye McPhie
- Deakin University, School of Psychology, Geelong, Australia
| | - Anna Klas
- Deakin University, School of Psychology, Geelong, Australia
| | - Briony Hill
- Monash Centre for Health Research & Implementation, Monash University, Australia
| | - Helen Skouteris
- Deakin University, School of Psychology, Geelong, Australia; Monash Centre for Health Research & Implementation, Monash University, Australia
| |
Collapse
|
48
|
Cafagna G, Seghieri C, Vainieri M, Nuti S. A turnaround strategy: improving equity in order to achieve quality of care and financial sustainability in Italy. Int J Equity Health 2018; 17:169. [PMID: 30454018 PMCID: PMC6245858 DOI: 10.1186/s12939-018-0878-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 10/21/2018] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Equity, financial sustainability, and quality in healthcare are key goals embraced by universal health systems. However, systematic performance management strategies for achieving equity are still weaker than those aimed at achieving financial sustainability and quality of care. Using a vertical equity perspective, the overarching aim of this paper is to examine how improving equity in quality of care impacts on financial sustainability. We applied a simulation to indicators of the heart failure clinical pathway in Tuscany (central Italy), in order to quantify the equity gaps and financial resources that could be reallocated in the absence of performance inequities. METHODS The analysis included all patients hospitalized for heart failure as a principal diagnosis in 2014. We selected five indicators: hospitalization rate, 30-day readmission, cardiology visits, and the utilization of beta-blockers, and ACE inhibitors and sartans. For each indicator, the simulation followed three steps: 1) stratification by socioeconomic status (SES), using education as a proxy for SES; 2) computation of the vertical equity indicator; and 3) assessment of the financial value of the equity gap. RESULTS All indicators showed performance gaps regarding inequities across SES-groups. For the hospitalization rate and 30-day readmission, resources could have been reallocated, if the performance of patients with a low SES had been equal to the performance of patients with a high SES, which amounted to €2,144,422 and €892,790 respectively. In contrast, limited additional resources would have been required for prescriptions and cardiology visits. CONCLUSIONS Reducing equity gaps by improving the performance of low-SES patients may be a crucial strategy to achieving financial sustainability in universal coverage healthcare systems. Universal healthcare systems, which aim to pursue financial sustainability and quality of care, are thus urged to develop performance management actions to improve equity. This approach should not only include the measurement and public disclosure of equity indicators but be part of a comprehensive evidence-based strategy for the management of chronic conditions along the clinical pathway.
Collapse
Affiliation(s)
- Gianluca Cafagna
- Health and Management Laboratory (MeS Lab), Institute of Management, Sant’Anna School of Advanced Studies, Piazza Martiri della Libertà, 24, Pisa, Italy
| | - Chiara Seghieri
- Health and Management Laboratory (MeS Lab), Institute of Management, Sant’Anna School of Advanced Studies, Piazza Martiri della Libertà, 24, Pisa, Italy
| | - Milena Vainieri
- Health and Management Laboratory (MeS Lab), Institute of Management, Sant’Anna School of Advanced Studies, Piazza Martiri della Libertà, 24, Pisa, Italy
| | - Sabina Nuti
- Health and Management Laboratory (MeS Lab), Institute of Management, Sant’Anna School of Advanced Studies, Piazza Martiri della Libertà, 24, Pisa, Italy
| |
Collapse
|
49
|
Gapstur SM, Drope JM, Jacobs EJ, Teras LR, McCullough ML, Douglas CE, Patel AV, Wender RC, Brawley OW. A blueprint for the primary prevention of cancer: Targeting established, modifiable risk factors. CA Cancer J Clin 2018; 68:446-470. [PMID: 30303518 DOI: 10.3322/caac.21496] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 08/15/2018] [Accepted: 08/15/2018] [Indexed: 01/27/2023] Open
Abstract
In the United States, it is estimated that more than 1.7 million people will be diagnosed with cancer, and more than 600,000 will die of the disease in 2018. The financial costs associated with cancer risk factors and cancer care are enormous. To substantially reduce both the number of individuals diagnosed with and dying from cancer and the costs associated with cancer each year in the United States, government and industry and the public health, medical, and scientific communities must work together to develop, invest in, and implement comprehensive cancer control goals and strategies at the national level and expand ongoing initiatives at the state and local levels. This report is the second in a series of articles in this journal that, together, describe trends in cancer rates and the scientific evidence on cancer prevention, early detection, treatment, and survivorship to inform the identification of priorities for a comprehensive cancer control plan. Herein, we focus on existing evidence about established, modifiable risk factors for cancer, including prevalence estimates and the cancer burden due to each risk factor in the United States, and established primary prevention recommendations and interventions to reduce exposure to each risk factor.
Collapse
Affiliation(s)
- Susan M Gapstur
- Senior Vice President, Behavioral and Epidemiology Research Group, American Cancer Society, Atlanta, GA
| | - Jeffrey M Drope
- Vice President, Economic & Health Policy Research, American Cancer Society, Atlanta, GA
| | - Eric J Jacobs
- Senior Scientific Director, Behavioral and Epidemiology Research Group, American Cancer Society, Atlanta, GA
| | - Lauren R Teras
- Senior Principal Scientist, Behavioral and Epidemiology Research Group, American Cancer Society, Atlanta, GA
| | - Marjorie L McCullough
- Senior Scientific Director, Behavioral and Epidemiology Research Group, American Cancer Society, Atlanta, GA
| | - Clifford E Douglas
- Vice President, Tobacco Control, and Director, Center for Tobacco Control, American Cancer Society, Atlanta, GA
| | - Alpa V Patel
- Senior Scientific Director, Behavioral and Epidemiology Research Group, American Cancer Society, Atlanta, GA
| | - Richard C Wender
- Chief Cancer Control Officer, American Cancer Society, Atlanta, GA
| | - Otis W Brawley
- Chief Medical and Scientific Officer and Executive Vice President of Research, American Cancer Society, Atlanta, GA
| |
Collapse
|
50
|
Jacobs E, Tamayo M, Rosenbauer J, Schulze MB, Kuss O, Rathmann W. Protocol of a cluster randomized trial to investigate the impact of a type 2 diabetes risk prediction model on change in physical activity in primary care. BMC Endocr Disord 2018; 18:72. [PMID: 30326888 PMCID: PMC6192326 DOI: 10.1186/s12902-018-0299-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Accepted: 10/02/2018] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Little evidence exists on the impact of diabetes risk scores, e.g. on physicians and patient's behavior, perceived risk of persons, shared-decision making and particularly on patient's health. The aim of this study is to investigate the impact of a non-invasive type 2 diabetes risk prediction model in the primary health care setting as component of routine health checks on change in physical activity. METHODS Parallel group cluster randomized controlled trial including 30 primary care physicians (PCPs) and 300 participants in the region of Düsseldorf and surrounding urban and rural municipalities, West Germany. On cluster level, PCPs will be randomized into intervention or control group using a biased coin minimization technique. Participants in the control group are going to have a routine health check "Check-up 35" which is recommended biannually for all people ≥35 years of age in Germany. In the intervention group, the routine health check is expanded by usage of a non-invasive diabetes risk prediction model (German Diabetes Risk Score). Primary outcome is change in physical activity after 1 year. Secondary outcomes include aspects of targeted counseling, motivation of participant's to change lifestyle, perceived and objectively measured diabetes risk, acceptance of diabetes risk scores, quality of life, depression and anxiety. Patients will be followed over 12 months. Hierarchical or mixed models will be conducted, including a random intercept to adjust for cluster, the respective baseline value, and covariates to compare the groups. DISCUSSION This pragmatic cluster randomized controlled trial will enhance our knowledge on the clinical impact of diabetes risk scores for the first time in the real-life primary health care setting. TRIAL REGISTRATION ClinicalTrials.gov NCT03234322 , registered on July 28, 2017.
Collapse
Affiliation(s)
- Esther Jacobs
- Institute for Biometrics and Epidemiology, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Auf’m Hennekamp 65, 40225 Düsseldorf, Germany
- German Center for Diabetes Research (DZD), 85764 München-Neuherberg, Germany
| | - Miguel Tamayo
- The Association of Statutory Health Insurance Physicians North Rhine, Tersteegenstraße 9, 40474 Düsseldorf, Germany
| | - Joachim Rosenbauer
- Institute for Biometrics and Epidemiology, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Auf’m Hennekamp 65, 40225 Düsseldorf, Germany
- German Center for Diabetes Research (DZD), 85764 München-Neuherberg, Germany
| | - Matthias B. Schulze
- German Center for Diabetes Research (DZD), 85764 München-Neuherberg, Germany
- German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Arthur-Scheunert-Allee 114-116, 14558 Nuthetal, Germany
| | - Oliver Kuss
- Institute for Biometrics and Epidemiology, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Auf’m Hennekamp 65, 40225 Düsseldorf, Germany
- German Center for Diabetes Research (DZD), 85764 München-Neuherberg, Germany
- Institute of Medical Statistics, Düsseldorf University Hospital and Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Wolfgang Rathmann
- Institute for Biometrics and Epidemiology, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Auf’m Hennekamp 65, 40225 Düsseldorf, Germany
- German Center for Diabetes Research (DZD), 85764 München-Neuherberg, Germany
| |
Collapse
|