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Rights, preferences, needs and expectations of patients and citizens can only be respected and addressed if they are well understood. As such, a continuous, systematic and formalised dialogue between patients, citizens and policy makers is required to ensure ethical and socially appropriate cancer prevention, diagnostics, treatment and care. Relying on donations and project-based funding is not a sustainable way to ensure patient involvement and representativeness in policy. Patient organizations need long term, structural support to fulfil their role as patient representatives and support network in order to deliver the best possible service and to play their role as a professional representative of their disease-specific community. Inequalities can only be tackled if they are properly identified. This requires the definition of appropriate determinants fit for (inter)national comparison and extension and linkage of good quality data registries for cancer that allow the monitoring these inequalities.
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Children and Adolescents and Young Adults with cancer represent a young population with specific needs, which need to be addressed in a patient- and cancer-driven way. There is an urgent need to support and extend the ongoing initiatives in Belgium. First, multidisciplinary care programmes dedicated to children need to be reviewed, and those for Adolescents and Young Adults need to be developed with close collaboration between paediatric and adult oncology and haematology teams. This needs to be done considering the entire patient journey; from cancer prevention, diagnosis, treatment, rehabilitation, follow-up of late effects, transition pathways between paediatric and adult wards, and palliative care. Second, national haemato/oncology precision programmes adapted to this young population with rare cancers, including infrastructure to manage cancer gene predisposition in CAYAs with cancers and their relatives, needs to be developed. This multi-level plan aims to ensure improved outcome with high quality of care for the young population with cancer in Belgium in line with Europe's Beating Cancer Plan initiatives.
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As electric bikes (e-bikes) rapidly develop in China, their traffic safety issues are becoming increasingly prominent. Accurately detecting risky riding behaviors and conducting mechanism analysis on the multiple risk factors are crucial in formulating and implementing precise management policies. The emergence of shared e-bikes and the advancements in interpretable machine learning present new opportunities for accurately analyzing the determinants of risky riding behaviors. The primary objective of this study is to examine and analyze the risk factors related to speeding behavior to aid urban management agencies in crafting necessary management policies. This study utilizes a large-scale dataset of shared e-bike trajectory data to establish a framework for detecting speeding behavior. Subsequently, the extreme gradient boosting (XGBoost) model is employed to identify the level of speeding risk by leveraging its excellent identification ability. Moreover, based on measuring the degree of interaction among road, traffic, and weather characteristics, the investigation of the complex interactive effects of these risk factors on high-risk speeding is conducted using bivariate partial dependence plots (PDP) by its superior parsing ability. Feature importance analysis results indicate that the top five ranked variables that significantly affect the identified results of speed risk levels are land use density, rainfall, road level, curbside parking density, and bike lane width. The interaction analysis results indicate that higher levels of road and bike lane width correspond to an increased possibility of high-risk speeding among riders. Land use density, curbside parking density, and rainfall display a nonlinear effect on high-risk speeding. Introducing road level, bike lane width, and time interval could change the patterns of nonlinear effects in land use density, curbside parking density, and rainfall. Finally, several policy recommendations are proposed to improve e-bike traffic safety by utilizing the extracted feature values associated with a higher probability of high-risk speeding.
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This scoping review aims to comprehensively explore the landscape of taboos and their impact on sexual and reproductive health. Titled "Forbidden Conversations," it delves into the intricate web of societal, cultural, and religious norms that have contributed to the elusive and often stigmatized nature of sexual and reproductive health topics. The review navigates through the multifaceted dimensions of these taboos, shedding light on their impact on individuals, communities, and public health while advocating for a paradigm shift toward open, inclusive, and informed dialogue. The analysis within this review spans a decade, capturing the most recent and relevant literature to map the landscape of taboos in sexual and reproductive health. It explores the persistent societal apprehensions and subsequent stigmatization surrounding topics such as menstruation, contraception, fertility, sexual orientation, and gender identity. The review contextualizes the multifaceted challenges presented by these prevailing norms by tracing historically rooted taboos and their evolution across different cultures and contexts. The scoping review identifies the profound implications of these taboos on public health, highlighting how they contribute to disparities in access to healthcare, perpetuate misinformation, and infringe upon the fundamental rights of individuals. It addresses the challenges in sexual education, emphasizing how these taboos impede comprehensive understanding and enforcement of sexual and reproductive health rights among adolescents and young adults. The intersectional approach taken in this review situates these taboos within broader systems of inequality, emphasizing the compounded impact they have on marginalized populations. Through this comprehensive exploration, the review aims to provide actionable insights and identify existing research, policy, and practice gaps. It seeks to lay the foundation for future initiatives that advocate for destigmatization, empowerment, and equity in sexual and reproductive health. Ultimately, "Forbidden Conversations" aims to steer the conversation toward openness and inclusivity while advocating for unbiased, comprehensive sexual and reproductive healthcare with dignity for all individuals.
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The availability and linkage of comprehensive data on cancer mortality, incidence, screening and vaccination (HPV/HB) are essential for monitoring the process and impact of all screening and vaccination programmes, and to generate evidence to improve prevention policies. Linkage of data registries will allow better exploitation of real-world data. Simplification of data sharing for epidemiological research is of utmost importance. Human, as well as technical/technological and legal/regulatory barriers need to be tackled in Belgium to aid actors involved in screening, to facilitate organised linkage of data. Rapid advances in technologies for early detection and screening for a broad range of cancer types provide significant opportunities. Such tests are not yet ready for adoption in screening programmes. Emerging evidence should be monitored to ensure that promising innovations can transition to implementation studies in a timely manner. More and sustained research is needed to generate the necessary scientific relevance for new screening techniques in relevant cancer types.
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INTRODUCTION AND FRAMEWORK: Sleep capital contributes to individual and societal wellbeing, productivity, and economic outcomes and involves a novel aspect of brain capital. It encompasses the quality and quantity of sleep as integral components that influence cognitive abilities, mental and brain health, and physical health, affecting workplace productivity, learning, decision-making, and overall economic performance. Here, we bring a framework to understand the complex relationship between sleep quality, health, wellbeing, and economic productivity. Then we outline the multilevel impact of sleep on cognitive abilities, mental/brain health, and economic indicators, providing evidence for the substantial returns on investment in sleep health initiatives. Moreover, sleep capital is a key factor when considering brain health across the lifespan, especially for the aging population. DISCUSSION: We propose specific elements and main variables to develop specific indexes of sleep capital to address its impacts on health, wellbeing and productivity. CONCLUSION: Finally, we suggest policy recommendations, workplace interventions, and individual strategies to promote sleep health and brain capital. Investing in sleep capital is essential for fostering a healthier, happier, fairer and more productive society.
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Given that cities are the major contributors to carbon emissions, studying urban compactness (UC) and its impact on carbon emissions from energy consumption (CEECs) is crucial. This study calculated Hangzhou's township-level urban UC and CEECs using a hybrid subjective-objective weighted regression model on integrated panel datasets. By employing a geographically weighted regression (GWR) model, the spatio-temporal heterogeneity of the UC-CEEC relationship from 2006 to 2019 was uncovered. The results indicated an overall increase in UC, with significant variations across different counties. CEECs were higher in the central region, shifting eastward due to distinct urban development levels and policies. Moreover, the effects of various UC factors exhibited significant spatiotemporal inconsistency, with the impact intensity gradually diminishing. Additionally, the explanatory power of these factors declined and diversified over time. These findings emphasize the need for a comprehensive understanding of the relationship between UC and CEECs within the complex metropolitan environment and the importance of regulating their coordinated development. The research not only offers a more scientific approach to managing the growth of county-level cities and supporting balanced urbanization but also presents policy recommendations.
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A broad understanding of the aims and objectives of the international open science movement was recently adopted with the 2021 UNESCO Recommendation on Open Science, expanding the focus of open science to include scientific knowledge, infrastructures, knowledge systems and the open engagement of societal actors. In response, recent discussions on science policy practice are shifting to the implementation of open science via national policies. While policy instruments to support some aspects of open science are well-studied, guidance on the emerging 'social' aspects of open science has lagged, prompting UNESCO to generate guidance. In this paper, several authors of the UNESCO Open Science Toolkit guidance document on 'Engaging societal actors in Open Science' synthesize the scholarly underpinnings behind its recommendations. This work draws upon a targeted search from academic, policy, and grey literature in the fields of open science and community engagement, with a special focus on citizen science, to derive guidance on how to overcome barriers to the uptake of societal engagement approaches. The results present building blocks of what an enabling environment for the open engagement of societal actors could look like, identifying key considerations and reflecting on opportunities and challenges for progressing and evaluating sound open engagement of societal actors into regional & national (open) science policies.
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OBJECTIVE: This study aims to examine the complex nature of opioid use disorder (OUD) in chronic noncancer pain (CNCP) by exploring its antecedents, attributes, consequences, and interrelated concepts. DESIGN: A systematic literature review was conducted to gather relevant studies published between 2015 and 2022, utilizing the CINAHL, MEDLINE, PsycINFO, and PubMed databases. DATA SOURCES: The selected databases provided a comprehensive range of articles related to OUD in CNCP, ensuring a comprehensive topic analysis. METHODS: Twenty-two articles meeting the inclusion criteria were included in the analysis. These articles were critically reviewed and analyzed to identify key themes and concepts related to OUD in CNCP. RESULTS: The findings of this study shed light on the multifaceted aspects of OUD in CNCP, including its antecedents, such as goals of physical function improvement, prescription of opioids for CNCP, social influences, and mental health dynamics. The attributes of OUD in CNCP were identified as chronic pain, noncancer pain, opioid use, misuse, and abuse. OUD's consequences in CNCP include impaired functioning, increased health risks, psychological distress, social challenges, and economic burden. CONCLUSION: Understanding the complexity of OUD in CNCP is crucial for improving patient outcomes. Collaborative efforts among healthcare systems, regulatory bodies, and professional organizations are needed to develop policies promoting safe and effective pain management while mitigating risks associated with opioid use in CNCP. IMPLICATIONS FOR PRACTICE: Implementing policy recommendations derived from this study enhances care and outcomes for individuals with CNCP. By addressing complex issues of OUD in CNCP and adopting evidence-based practices, healthcare providers can optimize pain management and promote well-being in CNCP patients.
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Analgesics, Opioid , Chronic Pain , Opioid-Related Disorders , Humans , Chronic Pain/drug therapy , Chronic Pain/psychology , Opioid-Related Disorders/psychology , Opioid-Related Disorders/complications , Analgesics, Opioid/therapeutic use , Concept Formation , Pain Management/methods , Pain Management/standardsABSTRACT
Opioid overdose and Opioid Use Disorder (OUD) statistics underscore an urgent need to significantly expand access to evidence-based OUD treatment. Office Based Opioid Treatment (OBOT) has proven effective for treating OUD. However, limited access to these treatments persists. Recognizing the need for significant investment in clinical, behavioral, and translational research, the Indiana State Department of Health and Indiana University embarked on a research initiative supported by the "Responding to the Addictions Crisis" Grand Challenge Program. This brief presents recommendations based on existing research and our own analyses of medical claims data in Indiana, where opioid misuse is high and treatment access is limited. The recommendations cover target providers, intervention focus, priority regions, and delivery methods.
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Buprenorphine , Opioid-Related Disorders , Humans , Analgesics, Opioid/adverse effects , Buprenorphine/therapeutic use , Opiate Substitution Treatment/methods , Opioid-Related Disorders/drug therapy , Ambulatory CareABSTRACT
Reducing transportation-related carbon dioxide (CO2) emissions in China poses significant challenges due to the sector's growth potential and variations among provinces and transportation modes. This study utilizes the bottom-up approach and the Logarithmic Mean Divisia Index (LMDI) decomposition method to calculate transportation CO2 emissions and explores the temporal-spatial differences across Chinese provinces. The results reveal that national transportation CO2 emissions increased by 50.14% from 2010 to 2019, and emissions from private cars present the fastest growth among all transportation modes by 254% over the decade. Spatially, higher emissions are found in eastern provinces, and neighboring provinces notably distinguish from each other in terms of the emission proportion of different modes and the factor analysis from LMDI. Regarding the heterogeneity of the spatial emission characteristics, a cluster-based evaluation method is proposed for the 31 provinces according to the emission structure and the LMDI decomposition. Four clusters are derived, each featuring varied emission distribution and driving factors. Correspondingly, policy recommendations are proposed to address the characteristics of each cluster, such as controlling car ownership, promoting integrated transport modes, improving fuel economy, and electrifying urban transportation services. The cluster-based analysis method can provide more specific suggestions to province targeting its emission characteristics rather than its location, which is one of the major contributions of this study.
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To achieve carbon neutrality, the Chinese government needs to gain a comprehensive understanding of the sources and drivers of greenhouse gas (GHG) emissions, particularly at the county level. Anji County in eastern China is a typical example of an industrial transformation from quarrying to a low-carbon economy. This study analyzed the decoupling types and structural characteristics of GHG emissions and the driving factors of carbon dioxide (CO2) emissions in the Anji from 2006 to 2019, and explored the differences between county-level and provincial-level or city-level results. It was observed that energy-related activities are the main source of GHG emissions in Anji and that economic development is the driving factor behind the increasing CO2 emissions. However, industrial transformation and upgradation coupled with the alternative use of clean energy limit the growth of GHG emissions. This study details the GHG emissions of county during the industrial transformation stage and provides corresponding policy recommendations for county governments.
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Greenhouse Gases , Greenhouse Gases/analysis , Carbon Dioxide/analysis , Greenhouse Effect , China , Economic DevelopmentABSTRACT
OBJECTIVES: Systematic reviews (SRs) are becoming essential evidence in the decision-making process within the field of social sciences. This study aimed to investigate how Campbell SRs were cited and explore their specific application roles. STUDY DESIGN AND SETTING: We included Campbell SRs published between 2016 and 2020 by searching the Wiley online library, and retrieved the articles and documents citing Campbell SRs from the Web of Science and Google Scholar by December 31, 2021. We described the characteristics of the SRs and citations, and formulated a set of application roles by analyzing the sentences or paragraphs where the SRs were cited. RESULTS: Sixty nine Campbell SRs were published between 2016 and 2020; they were cited in 641 articles or documents a total of 1,289 times. The primary types of articles that cited Campbell SRs were cross-sectional studies (n = 226, 35.3%), SRs (n = 112, 17.5%), randomized controlled trials (n = 77, 12.0%), and policy reports (n = 57, 8.8%). Articles utilizing Campbell SRs were predominantly led by authors from the United States (n = 184, 28.7%), the United Kingdom (n = 98, 15.3%), and Australia (n = 51, 8.0%). We formulated a set of 10 application roles for the Campbell SRs, of which the most frequent were: describing the current status in the field of interest (n = 691, 53.6%), corroboration of the results (n = 140, 10.9%), identifying research gaps (n = 130, 10.1%), and providing methodological references (n = 126, 9.8%); the role of supporting policy recommendations or decisions accounted for 6.0% (n = 77) of the citations. Approximately 12% of Campbell SRs were used to support policy recommendations or decisions. CONCLUSION: Campbell SRs are widely applied, particularly in scientific research, to describe the current status in the field of interest. Although the current application of Campbell SRs in supporting policy recommendations and decisions may not be predominant, there is a growing recognition of their value in using Campbell SRs to inform decision-making.
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Publications , Humans , Australia , United Kingdom , United States , BibliometricsABSTRACT
Improving laboratory animal management system is one of the effective ways to promote the legalization and standardization of laboratory animal management. This article systematically reviews the relevant content and requirements of the latest laws, regulations, normative documents, and standards formulated and promulgated by the state since 2019 regarding the management of experimental animals. It also analyzes the current institutional framework in managing experimental animals in Sichuan Province from four aspects: administrative management, quality assurance, biosafety, and local standards. Furthermore, this article summarizes the existing problems and proposes corresponding policy recommendations in a targeted manner, aiming to provide a reference for the formulation of robust experimental animal management policies in Sichuan Province.
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Payment by diagnosis related groups(DRG)is an important research direction in China's current medical insurance payment reform.However,it limits the clinical development and utilization of innovative medicines to a certain extent.Additional payments for innovative medicines have been thoroughly studied in many countries.This paper conducted an analysis and summary of the global experience regarding additional payment for innovative medicines under the DRG payment system.U-sing the United States,France,and Germany as case studies,this paper also examined the current state of medical insurance pay-ment for innovative medicines in China and the influence of DRG payment on the development of such medicine.In addition,it has put forward explicit policy recommendations,including the establishment of inclusion criteria,the selection of appropriate payment modes,the implementation of dynamic adjustment mechanisms,the enhancement of payment methods,etc.This paper aims to provide references to comprehensively promote DRG payment reform while further establishing and enhancing medical in-surance payment mechanisms related to innovative medicines in the context of China's national conditions.
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BACKGROUND: The provision of contraceptive care for incarcerated individuals has been largely inconsistent and has contributed to, at best, inadequate care, and at worst reproductive abuses, violence, and coercion. While previous research has identified strategies to remedy known issues, to date, very few recommendations have been implemented across the carceral system. To address this, we conducted a systematic review of policy and practice recommendations to improve contraceptive care to reproductive-aged, incarcerated individuals in the United States. METHODS: We conducted this systematic review utilizing the Joanna Briggs Institute methodology and framed it within the National Implementation Research Network's (NIRN) Exploration stage. We searched PubMed, PSYCInfo, SCOPUS, ProQuest, Web of Science, MedLine, Social Science Citation Index and reference sections of included materials. Basic study information, explicitly stated policy and practice recommendations, and discussions and conclusions that subtly provide recommendations were extracted in full text. We utilized a thematic analysis approach to analyze the extracted text. RESULTS: A total of 45 materials met the inclusion criteria. Seven overarching themes were identified: 1) policy changes needed to implement care; 2) need for contraceptive care in carceral systems; 3) justice agency barriers regarding contraceptive care provision; 4) policy barriers to contraceptive access; 5) funding strategies to improve care; 6) patient preferences for contraceptive care delivery; and 7) healthcare provider knowledge regarding contraceptive care. The seven themes identified shed light on the need for, gaps, barriers, and facilitators of current contraceptive care provision to incarcerated individuals. CONCLUSION: This systematic review accomplished two goals of NIRN's Exploration stage. First, the compiled evidence identified a clear need for change regarding policies and practices pertaining to contraceptive care provision to incarcerated individuals in the United States. Second, our findings identified several evidence-based solutions supported both by research and professional healthcare organizations to address the identified need for change. This study provides an initial blueprint for correctional agencies to implement the necessary changes for improving contraceptive care provision to incarcerated populations. The correctional system is in a unique position to deliver much-needed care, which would result in many potential benefits to the individuals, correctional system, and community at large.
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The place where we live, work and play may influence our alcohol drinking behaviours. This study aimed to present local policy recommendations on urban determinants for alcohol consumption prevention in a low-income and a high-income area of Madrid (Spain) using a participatory action research method, with photovoice and nominal group techniques. Participants (n = 26) engaged in a photovoice project initiated a process of critical reflection by discussing and analysing their alcohol environment based on photographs they took themselves. At the end of six week group discussion sessions, participants identified 33 themes related to their alcohol environment. They later met to translate the final categories into urban policy recommendations using a logical framework approach. Then, with a nominal group, they prioritized these recommendations based on time, impact, feasibility, and cost. Finally, participants produced a total of 61 policy recommendations for the improvement of the alcohol environment, highlighting the need for researcher-community collaborations when designing public health interventions.
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Health Services Research , Public Health , Humans , Poverty , Policy , Spain , Photography , Community-Based Participatory ResearchABSTRACT
BACKGROUND: Autism is a lifelong complex neurodevelopmental condition that affects brain development and behaviour with significant consequences for everyday life. Despite its personal, familial, and societal impact, Europe-wide harmonised guidelines are still lacking for early detection, diagnosis, and intervention, leading to an overall unsatisfactory autistic person and carer journey. METHODS: The care pathway for autistic children and adolescents was analysed in Italy, Spain and the UK from the perspective of carers (using a survey aimed at caregivers of autistic children 0-18 years old), the autistic community, and professionals in order to identify major barriers (treatment gaps) preventing carers from receiving information, support, and timely screening/diagnosis and intervention. RESULTS: Across all three countries, analysis of the current care pathway showed: long waits from the time carers raised their first concerns about a child's development and/or behaviour until screening and confirmed diagnosis; delayed or no access to intervention once a diagnosis was confirmed; limited information about autism and how to access early detection services; and deficient support for families throughout the journey. CONCLUSIONS: These findings call for policy harmonisation in Europe to shorten long wait times for diagnosis and intervention and therefore, improve autistic people and their families' journey experience and quality of life.
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Autistic Disorder , Child , Adolescent , Humans , Infant, Newborn , Infant , Child, Preschool , Autistic Disorder/diagnosis , Autistic Disorder/therapy , Quality of Life , Critical Pathways , Europe , CaregiversABSTRACT
Microplastics are ubiquitous environmental pollutants with the potential for adverse impacts on ecosystems and human health. These particles originate from the fragmentation of larger plastic items, shedding from synthetic fibers, tire abrasions, and direct release from personal care products and industrial processes. Once released into the environment, microplastics can disrupt ecosystems, accumulate in organisms, cause physical harm, and carry chemical pollutants that pose risks to both wildlife and human health. There is an urgent need to comprehensively explore the multifaceted issue of microplastic pollution and understand microbial degradation to reduce environmental pollution caused by microplastics. This paper presents a comprehensive exploration of microplastics, including their types, composition, advantages, and disadvantages, as well as the journey and evolution of microplastic pollution. The impact of microplastics on the microbiome and microbial communities is elucidated, highlighting the intricate interactions between microplastics and microbial ecosystems. Furthermore, the microbial degradation of microplastics is discussed, including the identification, characterization, and culturing methods of microplastic-degrading microorganisms. Mechanisms of microplastic degradation and the involvement of microbial enzymes are elucidated to shed light on potential biotechnological applications. Strategies for reducing microplastic pollution are presented, encompassing policy recommendations and the importance of enhanced waste management practices. Finally, the paper addresses future challenges and prospects in the field, emphasizing the need for international collaboration, research advancements, and public engagement. Overall, this study underscores the urgent need for concerted efforts to mitigate microplastic pollution and offers valuable insights for researchers, policymakers, and stakeholders involved in environmental preservation.