Global, regional, and national burden of heart failure associated with atrial fibrillation.

BACKGROUND: Heart failure is a leading cause of mortality and morbidity worldwide, and Atrial fibrillation (AF) is among many modifiable risk factors for heart failure. No estimates are available on the magnitude of the burden of heart failure associated with AF, and this study estimated the global, regional, and national burdens associated with AF. METHODS: We used the comparative risk assessment method to estimate the disease burden in terms of prevalence and years lived with disability (YLD). The population-attributable fraction for heart failure and AF was calculated from prevalence estimates of AF and the recalculated relative risks of heart failure associated with AF from a systematic review summarising the longitudinal association between AF and outcomes. The burden of heart failure was retrieved from the Global Burden of Disease database. RESULTS: Globally, 2.6% (95% uncertainty interval 1.3 to 4.7%) of the burden of heart failure is associated with AF. This was 1.5 (95% UI 0.6 to 3.2) million people in 2019, a 49.8% increase from 1990. The highest prevalence was from South-East Asia, East Asia and Oceania. The highest YLD was estimated for Central Europe, Eastern Europe and Central Asia. High-income countries showed a sharp decline in the age standardised prevalence and YLD rates from 1990 to 2019. CONCLUSION: The burden of heart failure associated with AF has increased substantially over the past two decades despite the advances in AF management. However, falling prevalence and YLD rates of heart failure associated with AF in high-income countries over time indicate that reducing this burden is possible.

Methodology to derive preference for health screening programmes using discrete choice experiments: a scoping review.

BACKGROUND: While involving users in healthcare decision-making has become increasingly common and important, there is a lack of knowledge about how to best design community-based health screening programs. Reviews of methods that incorporate discrete choice experiments (DCEs) are scarce, particularly for non-cancer illnesses like cardiovascular disease, diabetes and liver disease. We provide an overview of currently available applications and methods available by using DCEs in health screening programs, for chronic conditions. METHODS: A scoping review was undertaken, where four electronic databases were searched for key terms to identify eligible DCE studies related to community health screening. We included studies that met a pre-determined criteria, including being published between 2011 and 2021, in English and reported findings on human participants. Data were systematically extracted, tabulated, and summarised in a narrative review. RESULTS: A total of 27 studies that used a DCE to elicit preferences for cancer (n = 26) and cardiovascular disease screening (n = 1) programmes were included in the final analysis. All studies were assessed for quality, against a list of 13 criteria, with the median score being 9/13 (range 5-12). Across the 27 studies, the majority (80%) had the same overall scores. Two-thirds of included studies reported a sample size calculation, approximately half (13/27) administered the survey completely online and over 75% used the general public as the participating population. CONCLUSION: Our review has led to highlighting several areas of current practice that can be improved, particularly greater use of sample size calculations, increased use of qualitative methods, better explanation of the chosen experimental design including how choice sets are generated, and methods for analysis.

Intervention programs designed to promote healthy romantic relationships in youth: A systematic review.

INTRODUCTION AND OBJECTIVES: To conduct a systematic literature review of intervention programs designed to promote healthy romantic relationships in youth (aged 12-25 years). The focus was on universal interventions that have the potential to be effective and widely implemented. METHODS: We systematically searched PubMed, PsycINFO, Social Science Database, and Embase. Articles were included if they were a randomized controlled trial (RCT) or quasi-experimental study and reported on a universal intervention aimed at promoting healthy romantic relationship knowledge, attitudes, and behaviors among youth. RESULTS: The search strategy identified 27 studies (26,212 participants). Interventions were found to be effective for improving healthy romantic relationship knowledge in the target population. However, the findings were mixed for intervention effectiveness in changing relationship attitudes/beliefs, and there was limited evidence to support change across behavioral outcomes. CONCLUSIONS: This review highlights the need for future research, including high quality RCTs with longer follow-up periods in a broad range of cultural and ethnic settings, to improve the generalisability of findings. Interventions for adolescents that improve knowledge and behavioral change relating to healthy romantic relationships have the potential to reduce mental and physical health problems during this phase of development.

Prevalence of traditional bullying and cyberbullying among children and adolescents in Australia: A systematic review and meta-analysis.

BACKGROUND: Despite increased awareness of the adverse impact of bullying on mental health, the prevalence of bullying in Australia is uncertain. The aim of the current study was to conduct a systematic review and meta-analysis to estimate the prevalence of bullying (traditional and cyber) among Australian children and adolescents. This study synthesised bullying prevalence studies on victimisation experiences (being bullied) and perpetration experiences (bullying others). METHOD: A systematic review of electronic databases (A+ Education, EMBASE, ERIC, PubMed, PsycINFO and Scopus up to 27 May 2017) was conducted. In addition, reference lists of included studies, theses recorded at the National Library of Australia, and government websites were surveyed to identify local area data as well as state and nationally representative data. Overall, 898 studies were screened and out of the 126 studies assessed for eligibility, 46 satisfied the pre-determined inclusion criteria. Meta-analyses based on quality-effects models generated pooled prevalence estimates for each of the two types of bullying involvement (victimisation and perpetration), as well as distinct models for traditional bullying and cyberbullying experiences by the type of involvement. RESULTS: Overall, the 12-month prevalence of bullying victimisation was 15.17% (95% confidence interval = [9.17, 22.30]) and perpetration was 5.27% (95% confidence interval = [3.13, 7.92]). The lifetime prevalence for traditional bullying victimisation was 25.13% (95% confidence interval = [18.73, 32.11]) and perpetration was 11.61% (95% confidence interval = [7.41, 16.57]). Cyberbullying victimisation and perpetration were less common with lifetime prevalence of 7.02% (95% confidence interval = [2.41, 13.54]) and 3.45% (95% confidence interval = [1.13, 6.84]), respectively. CONCLUSION: Bullying is common among children and adolescents in Australia. There is a need to improve the measurement of bullying using a standardised instrument and for prevalence estimates to be collected on a regular basis to assess change over time. Wide implementation of anti-bullying programmes in Australian schools is a viable public health approach for the prevention of mental health problems.

Economic Evaluation of an Intervention Designed to Reduce Bullying in Australian Schools.

BACKGROUND: There is a shortage of information on the costs and benefits of anti-bullying programs implemented in Australia. Information on the costs and benefits of anti-bullying programs is vital to assist policy making regarding the adoption of these programs. The aim of this study was to estimate the changes to costs and health benefits of implementing the "Friendly Schools Friendly Families" (FSFF) anti-bullying intervention in Australia. METHODS: A societal perspective cost-effectiveness analysis was undertaken based on randomised controlled trial data for an anti-bullying intervention implemented in primary schools in Western Australia. The modelling strategy addressed changes to costs comprising intervention costs, less cost-savings, and then changes to health benefits measured by avoidable disability-adjusted life years (DALYs). Costs and health benefits were identified, measured, and valued in 2016 Australian dollars. Intermediate events modelled included anxiety disorders, depressive disorders, intentional self-harm, cost-savings accrued by educator time, and reduced productivity losses for carers associated with absenteeism. Uncertainty analysis and scenario analyses were also conducted. RESULTS: The prevalence of bullying victimisation was reduced by 18% by the Friendly Schools Friendly Families anti-bullying intervention. At a national level, this is expected to result in the avoidance of 9114 DALYs (95% CI 8770-9459) and cost-savings of A$120 million per year. The majority of cost-savings were associated with the reduction in mental healthcare. The model results demonstrated that the FSFF anti-bullying intervention is likely to be a cost-effective approach to reduce bullying in Australia, relative to a threshold of A$50,000 per DALY averted, with an ICER of A$1646. CONCLUSIONS: The Friendly Schools Friendly Families anti-bullying intervention represents a good investment compared to usual activities for the management of child and adolescent bullying in Australia. The investment and implementation of evidence-based interventions that reduce bullying victimisation and bullying perpetration in schools could reduce the economic burden associated with common mental health disorders and thereby improve the health of many Australians.

The Cost of Neurodevelopmental Disability: Scoping Review of Economic Evaluation Methods.

The provision of effective care models for children with neurodevelopmental delay or disability can be challenging in resource constrained healthcare systems. Economic evaluations have an important role in informing resource allocation decisions. This review systematically examined the scope and methods of economic models evaluating interventions for supporting neurodevelopment among children with common neurodevelopmental disorders and identified methods of economic models and presented policy implications. This scoping review employed the Arksey and O'Malley framework and aligned with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Four electronic databases were systematically searched to identify eligible model-based economic evaluations of neurodevelopmental care models published since 2000. The Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist was used to assess quality of reporting. Data were systematically extracted, tabulated, and qualitatively synthesised across diagnostic categories. Searches identified 1431 unique articles. Twelve studies used a decision analytic model to evaluate care for neurodevelopmental disorders and were included in the review. Included studies focused on attention-deficit/hyperactivity disorder (ADHD, n=6), autism spectrum disorder (ASD, n=3), cerebral palsy (n=2), and dyslexia (n=1). The most used decision analytic modelling approach was a Markov model (n=6), followed by a decision tree (n=3), and a combination of decision tree and Markov model (n=3). Most studies (n=7) adopted a societal perspective for reporting costs. None of the reviewed studies modelled impact on families and caregivers. Four studies reported cost-savings, three identified greater quality of life, and three identified cost increases.

Economic Evaluation of Long-Term Survivorship Care for Cancer Patients in OECD Countries: A Systematic Review for Decision-Makers.

Long-term cancer survivorship care is a crucial component of an efficient healthcare system. For numerous reasons, there has been an increase in the number of cancer survivors; therefore, healthcare decision-makers are tasked with balancing a finite budget with a strong demand for services. Decision-makers require clear and pragmatic interpretation of results to inform resource allocation decisions. For these reasons, the impact and importance of economic evidence are increasing. The aim of the current study was to conduct a systematic review of economic evaluations of long-term cancer survivorship care in Organization for Economic Co-operation and Development (OECD) member countries and to assess the usefulness of economic evidence for decision-makers. A systematic review of electronic databases, including MEDLINE, PubMed, PsycINFO and others, was conducted. The reporting quality of the included studies was appraised using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist. Each included study's usefulness for decision-makers was assessed using an adapted version of a previously published approach. Overall, 3597 studies were screened, and of the 235 studies assessed for eligibility, 34 satisfied the pre-determined inclusion criteria. We found that the majority of the included studies had limited value for informing healthcare decision-making and conclude that this represents an ongoing issue in the field. We recommend that authors explicitly include a policy statement as part of their presentation of results.

The Economic Cost of Child and Adolescent Bullying in Australia.

OBJECTIVE: To conduct a systematic review and meta-analysis and estimate the economic costs attributable to child and adolescent bullying victimization in Australia. METHOD: The costs of bullying victimization were measured from a societal perspective that accounted for costs associated with health care, education resources, and productivity losses. A prevalence-based approach was used to estimate the annual costs for Australians who experienced bullying victimization in childhood and adolescence. This study updated a previous systematic review summarizing the association between bullying victimization and health and nonhealth outcomes. Costs were estimated by calculating population attributable fractions to determine the effects of bullying victimization on increased risk of adverse health outcomes, such as anxiety disorders, depressive disorders, intentional self-harm, and tobacco use. A top-down approach to cost estimation was taken for all outcomes of interest except for costs incurred by educational institutions and productivity losses of victims' caregivers, for which a bottom-up cost estimation was applied. RESULTS: Annual costs in Australian dollars (AUD) in 2016 on health and nonhealth outcomes attributable to child and adolescent bullying victimization were estimated at AUD $763 million: AUD $750 million for health system costs with AUD $147 million for anxiety disorders, AUD $322 million for depressive disorders, AUD $57 million for intentional self-harm, and AUD $224 million for tobacco use; AUD $7.5 million for productivity losses of victims' caregivers; and AUD $6 million for educational services. CONCLUSION: The findings from this study suggest a substantial annual cost to Australian society as a result of bullying victimization with more than 8% of annual mental health expenditure in Australia estimated to be attributable to bullying victimization.

The contribution of bullying victimisation to the burden of anxiety and depressive disorders in Australia.

AIM: There is now a strong body of literature showing that bullying victimisation during childhood and adolescence precedes the later development of anxiety and depressive disorders. This study aimed to quantify the burden of anxiety and depressive disorders attributable to experiences of bullying victimisation for the Australian population. METHODS: This study updated a previous systematic review summarising the longitudinal association between bullying victimisation and anxiety and depressive disorders. Estimates from eligible studies published from inception until 18 August 2018 were included and meta-analyses were based on quality-effects models. Pooled relative risks were combined with a contemporary prevalence estimate for bullying victimisation for Australia in order to calculate population attributable fractions (PAFs) for the two mental disorder outcomes. PAFs were then applied to estimates of the burden of anxiety and depressive disorders in Australia expressed as disability-adjusted life years (DALYs). RESULTS: The findings from this study suggest 7.8% of the burden of anxiety disorders and 10.8% of the burden of depressive disorders are attributable to bullying victimisation in Australia. An estimated 30 656 DALYs or 0.52% (95% uncertainty interval 0.33-0.72%) of all DALYs in both sexes and all ages in Australia were attributable to experiences of bullying victimisation in childhood or adolescence. CONCLUSION: There is convincing evidence to demonstrate a causal relationship between bullying victimisation and mental disorders. This study showed that bullying victimisation contributes a significant proportion of the burden of anxiety and depressive disorders. The investment and implementation of evidence-based intervention programmes that reduce bullying victimisation in schools could reduce the burden of disease arising from common mental disorders and improve the health of Australians.

The impact of the environment on health in Mongolia: a systematic review.

Mongolia has significant exposure to environmental risk factors because of poor environmental management and behaviors, and children are increasingly vulnerable to these threats. This study aimed to assess levels of exposure and summarize the evidence for associations between exposures to environmental risk factors and adverse health outcomes in Mongolia, with a particular focus on children. A systematic review was conducted using the PubMed, EMBASE, Web of Science, Global Health Library, CINAHL, CABI, Scopus, and mongolmed.mn electronic databases up to April 2014 . A total of 59 studies meeting the predetermined criteria were included. Results indicate that the Mongolian population has significant exposure to outdoor and indoor air pollution, metals, environmental tobacco smoke, and other chemical toxins, and these risk factors have been linked to respiratory and cardiovascular diseases among adults and respiratory diseases and neurodevelopmental disorders among children. Well-designed epidemiological investigations in vulnerable populations especially in pregnant women and children are recommended.