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1.
Artigo em Inglês | MEDLINE | ID: mdl-31174273

RESUMO

Health Impact Assessments (HIAs) motivate effective measures for safeguarding public health. There is consensus that HIAs in low and middle-income countries (LMICs) are lacking, but no study systematically focuses on those that have been successfully conducted across all regions of the world, nor do they highlight factors that may enable or hinder their implementation. Our objectives are to (1) systematically review, geographically map, and characterize HIA activity in LMICs; and (2) apply a process evaluation method to identify factors which are important to improve HIA implementation in LMICs. A systematic review of peer-reviewed HIAs in 156 LMICs was performed in Scopus, Medline, Web of Science, Sociological abstracts, and LILACs (Latin American and Caribbean Health Sciences) databases. The search used PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and covered HIAs across all type of interventions, topics, and health outcomes. HIAs were included if they reported a clear intervention and health outcome to be assessed. No time restriction was applied, and grey literature was not included. The eligible studies were subjected to six process evaluation criteria. The search yielded 3178 hits and 57 studies were retained. HIAs were conducted in 26 out of 156 countries. There was an unequal distribution of HIAs across regions and within LMICs countries. The leading topics of HIA in LMICs were air pollution, development projects, and urban transport planning. Most of the HIAs reported quantitative approaches (72%), focused on air pollution (46%), appraised policies (60%), and were conducted at the city level (36%). The process evaluation showed important variations in the way HIAs have been conducted and low uniformity in the reporting of six criteria. No study reported the time, money, and staff used to perform HIAs. Only 12% of HIAs were based on participatory approaches; 92% of HIAs considered multiple outcomes; and 61% of HIAs provided recommendations and fostered cross-national collaboration. The limited transparency in process, weak participation, and inconsistent delivery of recommendations were potential limitations to HIA implementation in low and middle-income countries. Scaling and improving HIA implementation in low and middle-income countries in the upcoming years will depend on expanding geographically by increasing HIA governance, adapting models and tools in quantitative methods, and adopting better reporting practices.


Assuntos
Países em Desenvolvimento/estatística & dados numéricos , Avaliação do Impacto na Saúde/estatística & dados numéricos , Poluição do Ar/análise , Planejamento de Cidades , Avaliação do Impacto na Saúde/métodos , Humanos , Pobreza , Saúde Pública
2.
J. dev. econ. (Print) ; 138: 1-16, May 2019.
Artigo em Inglês | ODS | ID: biblio-1026122

RESUMO

We investigate the impacts of a widely used sanitation intervention, Community-Led Total Sanitation, which was implemented at scale across rural areas of Indonesia with a randomized controlled trial to evaluate its effectiveness. The program resulted in modest increases in toilet construction, decreased community tolerance of open defecation and reduced roundworm infestations in children. However, there was no impact on anemia, height or weight. We find important heterogeneity along three dimensions: (1) poverty­poorer households are limited in their ability to improve sanitation; (2) implementer identity­scale up involves local governments taking over implementation from World Bank contractors yet no sanitation and health benefits accrue in villages with local government implementation; and (3) initial levels of social capital­villages with high initial social capital built toilets whereas the community-led approach was counterproductive in low social capital villages with fewer toilets being built.


Assuntos
Humanos , Planejamento Sanitário/políticas , Avaliação do Impacto na Saúde/estatística & dados numéricos , Capital Social , Indonésia
3.
Arthritis Rheumatol ; 71(8): 1276-1284, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-30891933

RESUMO

OBJECTIVE: To analyze disease burden in osteoarthritis (OA) according to Multidimensional Health Assessment Questionnaire (MDHAQ)/Routine Assessment of Patient Index Data 3 (RAPID3) scores at the initial visit and the 6-month follow-up visit, compared with rheumatoid arthritis (RA) as a benchmark for high disease burden. METHODS: All patients with all diagnoses at the Rush University Medical Center Division of Rheumatology complete a paper MDHAQ at all visits, saved as a PDF in the electronic health record. MDHAQ 0-10 scores for physical function, pain, and patient global assessment (compiled into RAPID3 0-30 scores) and additional scales at the initial and 6-month follow-up visits, for new OA and RA patients seen from 2011 to 2017, were compared. OA and RA patients were classified as self-referred or physician-referred, and RA patients were classified as disease-modifying antirheumatic drug (DMARD)-naive or having prior-DMARD treatment. Patient groups were compared using t-tests and analysis of variance, adjusted for age, disease duration, body mass index (BMI), education, and ethnicity. RESULTS: Compared with RA patients, OA patients had higher age, BMI, and disease duration. At initial visit, the mean RAPID3 did not differ significantly in OA versus DMARD-naive RA patients, whether self- or physician-referred (range 14.8-16.4 [P = 0.38]), or in all OA patients versus DMARD-naive RA patients versus prior-DMARD RA patients (15.0, 15.7, and 15.8, respectively [P = 0.49]). After 6 months, RAPID3 was improved to 13.3, 10.3, and 10.8, respectively, which represented substantially greater improvement in RA patients than OA patients (P < 0.001). Similar results were seen for most self-reported measures and in adjusted analyses. CONCLUSION: MDHAQ/RAPID3 scores are similar in OA and RA patients at the initial visit, but higher in OA patients than in RA patients 6 months later, reflecting superior RA treatments. The same MDHAQ/RAPID3 allows comparisons of disease burdens in different diseases.


Assuntos
Artrite Reumatoide , Efeitos Psicossociais da Doença , Avaliação do Impacto na Saúde/estatística & dados numéricos , Osteoartrite , Índice de Gravidade de Doença , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Fatores de Tempo
4.
Int J Public Health ; 64(1): 15-26, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29911285

RESUMO

OBJECTIVES: As global environmental change drives inequitable health outcomes, novel health equity assessment methodologies are increasingly required. We review literatures on equity-focused HIA to clarify how equity is informing HIA practice, and to surface innovations for assessing health equity in relation to a range of exposures across geographic and temporal scales. METHODS: A narrative review of the health equity and HIA literatures analysed English articles published between 2003 and 2017 across PubMed, PubMed Central, Biomed Central and Ovid Medline. Title and abstract reviews of 849 search results yielded 89 articles receiving full text review. RESULTS: Considerations of equity in HIA increased over the last 5 years, but equity continues to be conflated with health disparities rather than their root causes (i.e. inequities). Lessons from six literatures to inform future HIA practice are described: HIA for healthy cities, climate change vulnerability assessment, cumulative health risk assessment, intersectionality-based policy analysis, corporate health impact assessment and global health impact assessment. CONCLUSIONS: Academic reporting on incorporating equity in HIA practice has been limited. Nonetheless, significant methodological advancements are being made to examine the health equity implications of multiple environmental exposures.


Assuntos
Saúde Global , Equidade em Saúde , Avaliação do Impacto na Saúde/estatística & dados numéricos , Exposição Ambiental/estatística & dados numéricos , Política de Saúde , Humanos , Formulação de Políticas
5.
Eval Program Plann ; 73: 10-23, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30453183

RESUMO

Despite the growing expectation that researchers report the impact of their research using a case study approach, systematic reviews of research impact have focused on frameworks, indicators, methods of data collection and assessment rather than impact case studies. Our aim is to provide an overview of the characteristics of published research impact case studies, including translation activities, and their reporting quality. We searched for peer-reviewed impact studies published between 2000 and 2018 using a case study approach and selected 25 suitable papers. We applied descriptive statistics to study characteristics, conducted thematic analysis of research translation activities and assessed reporting quality using the 10-point ISRIA statement. 24 papers reported intermediate impacts, such as advocacy, or the development of statements, tools, or technology. 4 reported on longer-term societal impacts, such as health outcomes and economic return on investment. 7 reported on translation activities. Papers scored well against the ISRIA statement on 5 domains of reporting quality. Weakest scores centred around identification of stakeholder needs and stakeholder involvement, and ethics and conflict of interest. We identified the need for more consistency in reporting through a case study approach, more systematic reporting of translation pathways and greater transparency concerning estimated costs and benefits of the research and its translation and impact assessment.


Assuntos
Avaliação do Impacto na Saúde/estatística & dados numéricos , Avaliação do Impacto na Saúde/normas , Projetos de Pesquisa/normas , Pesquisa/normas , Confiabilidade dos Dados , Coleta de Dados/normas , Ética em Pesquisa , Humanos , Pesquisa Médica Translacional/normas
6.
Gac Sanit ; 32(6): 579-581, 2018.
Artigo em Espanhol | MEDLINE | ID: mdl-29759304

RESUMO

It is essential to develop a comprehensive approach to institutionally promoted interventions to assess their impact on health from the perspective of the social determinants of health and equity. Simple, adapted tools must be developed to carry out these assessments. The aim of this paper is to present two tools to assess the impact of programmes and community-based interventions on the social determinants of health. The first tool is intended to assess health programmes through interviews and analysis of information provided by the assessment team. The second tool, by means of online assessments of community-based interventions, also enables a report on inequality issues that includes recommendations for improvement. In addition to reducing health-related social inequities, the implementation of these tools can also help to improve the efficiency of public health interventions.


Assuntos
Participação da Comunidade , Avaliação do Impacto na Saúde/métodos , Promoção da Saúde , Saúde Pública , Fatores Socioeconômicos , Avaliação do Impacto na Saúde/estatística & dados numéricos , Humanos , Política Pública , Determinantes Sociais da Saúde , Espanha
7.
Environ Sci Pollut Res Int ; 25(4): 3120-3126, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-28752303

RESUMO

Daily fish intake is a key parameter of water quality criteria for protecting human health. Daily fish intake values should be representative of consumption patterns and must be practical for regulatory purposes. Thus, values must be scientifically verified and regularly updated for inclusion in water quality criteria. In Korea, four different fish intake values have been identified from food balance sheets (KREI 2000), the Korea National Health and Nutrition Examination Survey (KNHANES) II (Ministry of Health and Welfare 2002), Korean Exposure Factors Handbook (MOE 2007a), and KNHANES IV-V (CDC 2008; 2009; 2010), which have been applied to water quality standards and related national projects and regulations. This paper reviews the estimation methodologies of previous daily fish intake values from multiple sources and improvements in these values between 2000 and 2012. Finally, limitations associated with each value were examined to assist future research and regulatory management. This review provides information on changes in the daily fish intake values and their application in water quality standards in Korea.


Assuntos
Exposição Dietética/normas , Produtos Pesqueiros/normas , Avaliação do Impacto na Saúde/métodos , Avaliação do Impacto na Saúde/normas , Gestão de Riscos/normas , Qualidade da Água/normas , Animais , Inquéritos sobre Dietas/estatística & dados numéricos , Avaliação do Impacto na Saúde/estatística & dados numéricos , Humanos , República da Coreia , Gestão de Riscos/legislação & jurisprudência
8.
Environ Sci Pollut Res Int ; 25(4): 3211-3232, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29230653

RESUMO

Cadmium (Cd) is a heavy metal belonging to the group of the main chemical pollutants of the natural and occupational environment in economically developed countries. The forecasts indicate that contamination of the environment with this toxic metal, and thus the exposure of the general population, will increase. Food (particularly plant products) is the main source of the general population exposure to this element. Moreover, an important, and often the main, source of intoxication with Cd is habitual tobacco smoking. Recent epidemiological studies have provided numerous evidence that even low-level environmental exposure to this toxic metal, nowadays occurring in numerous economically developed countries, creates a risk for health of the general population. The low-level lifetime exposure to this metal may lead to the damage to the kidneys, liver, skeletal system, and cardiovascular system, as well as to the deterioration of the sight and hearing. Moreover, it has been suggested that environmental exposure to this xenobiotic may contribute to the development of cancer of the lung, breast, prostate, pancreas, urinary bladder, and nasopharynx. Taking the above into account, the aim of this review article is to draw more attention to Cd as an environmental risk factor for the health of the general population and the need to undertake preventive actions allowing to reduce the risk of health damage due to a lifetime exposure to this toxic metal.


Assuntos
Cádmio/toxicidade , Países Desenvolvidos/estatística & dados numéricos , Exposição Ambiental/prevenção & controle , Exposição Ambiental/estatística & dados numéricos , Poluentes Ambientais/toxicidade , Avaliação do Impacto na Saúde/estatística & dados numéricos , Cádmio/análise , Poluentes Ambientais/análise , Avaliação do Impacto na Saúde/tendências , Intoxicação por Metais Pesados/epidemiologia , Intoxicação por Metais Pesados/etiologia , Intoxicação por Metais Pesados/prevenção & controle , Humanos , Risco , Fatores de Risco
9.
Braz. J. Pharm. Sci. (Online) ; 54(2): e00221, 2018. tab, graf
Artigo em Inglês | LILACS | ID: biblio-951931

RESUMO

ABSTRACT Cancer has high morbidity and mortality rates related to medication use and produce a costly impact in health care. Thus, patients require constant monitoring and proper coordination of care between different professionals. This study aimed to evaluate the impact generated by a Medication Therapy Management service (MTM) offered to patients with breast cancer in use of polypharmacy. Observational, exploratory, descriptive and retrospective study of a MTM service that included 93 patients. Sociodemographic and clinical data related to pharmacotherapy and the processes associated with the systematization of the service were collected and analyzed. Patients were followed-up by the MTM service on average for 18 months (±4.31) and 185 drug-related problems (DRP) were identified, an average of two DRP per patient. Of these DRP, 48.11% were resolved and 49.73% were in the resolution process. The most common DRP were in the categories of Indication (37.84%), followed by Safety (23.78%). The safety category showed the highest resolution rate (59.09%). The study revealed an increased risk of DRP for patients with three or more comorbidities and using 5 or more medications. The process of systematization of a MTM service in oncology was associated with positive outcomes.


Assuntos
Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Assistência Farmacêutica/classificação , Neoplasias da Mama/diagnóstico , Gerenciamento Clínico , Avaliação do Impacto na Saúde/estatística & dados numéricos , Estudo Observacional , Oncologia/classificação
10.
J Math Biol ; 75(6-7): 1591-1617, 2017 12.
Artigo em Inglês | MEDLINE | ID: mdl-28417166

RESUMO

A general model of an imperfect vaccine for a childhood disease is presented and the effects of different types of vaccine failure on transmission were investigated using models that consider both homogeneous and age-specific mixing. The models are extensions of the standard SEIR equations with an additional vaccinated component that allows for five different vaccine parameters: three types of vaccine failure in decreasing susceptibility to infection via failure in degree ("leakiness"), take ("all-or-nothingness") and duration (waning of vaccine-derived immunity); one parameter reflecting the relative reduction in infectiousness of vaccinated individuals who get infected; and one parameter that reflects the relative reduction in reporting probability of vaccinated individuals due to a possible reduction in severity of symptoms. Only the first four parameters affect disease transmission (as measured by the basic reproduction number). The reduction in transmission due to vaccination is different for age-structured models than for homogeneous models. Notably, if the vaccine exhibits waning protection this could be larger for an age-structured model with high contact rates between young children who are still protected by the vaccine and lower contact rates between adults for whom protection might have already waned. Analytic expressions for age-specific "vaccine impacts" were also derived. The overall vaccine impact is bounded between the age-specific impact for the oldest age class and that of the youngest age class.


Assuntos
Modelos Biológicos , Vacinas/uso terapêutico , Adulto , Fatores Etários , Número Básico de Reprodução , Criança , Doenças Transmissíveis/imunologia , Doenças Transmissíveis/transmissão , Suscetibilidade a Doenças , Transmissão de Doença Infecciosa/prevenção & controle , Transmissão de Doença Infecciosa/estatística & dados numéricos , Avaliação do Impacto na Saúde/estatística & dados numéricos , Humanos , Conceitos Matemáticos , Falha de Tratamento , Vacinação/efeitos adversos , Vacinação/estatística & dados numéricos , Vacinas/efeitos adversos , Vacinas/imunologia
11.
J Hand Surg Am ; 42(4): 296.e1-296.e10, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-28372641

RESUMO

PURPOSE: Over 50,000 power saw-related injuries occur annually in the United States. Numerous safety measures have been implemented to protect the users of these tools. This study was designed to determine which interventions, if any, have had a positive impact on the safety of the consumer or laborer. METHODS: We queried the National Electronic Injury Surveillance System database for hand and upper-extremity injuries attributed to power saws from 1997 to 2014. Demographic information including age, sex, date of injury, device, location, body part involved, diagnosis, and disposition was recorded. We performed statistical analysis using interrupted time series analysis to evaluate the incidence of injury with respect to specific safety guidelines as well as temporal trends including patients' age. RESULTS: An 18% increase in power saw-related injuries was noted from 1997 (44,877) to 2005 (75,037). From 2006 to 2015 an annual decrease of 5.8% was observed. This was correlated with regulations for power saw use by the Consumer Safety Product Commission (CPSC) and Underwriters Laboratories. Mean age of injured patients increased from 48.8 to 52.9 years whereas the proportion of subjects aged less than 50 years decreased from 52.8% to 41.9%. These trends were most pronounced after the 2006 CPSC regulations. CONCLUSIONS: The incidence of power saw injuries increased from 1997 to 2005, with a subsequent decrease from 2006 to 2015. The guidelines for safer operation and improvements in equipment, mandated by the CPSC and Underwriters Laboratories, appeared to have been successful in precipitating a decrease in the incidence of power saw injuries to the upper extremity, particularly in the younger population. CLINICAL RELEVANCE: The publication of safety regulations has been noted to have an association with a decreased incidence in power saw injuries. Based on this, clinicians should take an active role in their practice as well as in their professional societies to educate and counsel patients to prevent further injury.


Assuntos
Traumatismos do Braço/epidemiologia , Qualidade de Produtos para o Consumidor/legislação & jurisprudência , Traumatismos da Mão/epidemiologia , Indústrias/instrumentação , Segurança/legislação & jurisprudência , Fatores Etários , Traumatismos do Braço/etiologia , Traumatismos do Braço/prevenção & controle , Feminino , Regulamentação Governamental , Traumatismos da Mão/etiologia , Traumatismos da Mão/prevenção & controle , Avaliação do Impacto na Saúde/legislação & jurisprudência , Avaliação do Impacto na Saúde/estatística & dados numéricos , Avaliação do Impacto na Saúde/tendências , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Saúde do Trabalhador/legislação & jurisprudência , Saúde do Trabalhador/estatística & dados numéricos , Saúde do Trabalhador/tendências , Vigilância da População , Segurança/estatística & dados numéricos , Estados Unidos/epidemiologia , United States Occupational Safety and Health Administration/legislação & jurisprudência , United States Occupational Safety and Health Administration/estatística & dados numéricos
12.
Public Health ; 145: 83-92, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-28359397

RESUMO

OBJECTIVES: Health impact assessment (HIA) is a systematic process that can be used by public health professionals to examine the potential health effects of a policy, plan, program, or project that originates outside of the health sector. This article presents a case study of how an interdisciplinary team utilized an HIA to analyze the potential health impact of full-day kindergarten (FDK) on communities in Nevada. STUDY DESIGN: Case study. METHODS: With stakeholder and community engagement, we conducted a multistage HIA that included qualitative and quantitative data collection and analysis, a review of existing literature, and projections. The team considered several pathways through which FDK could impact health in Nevada: (1) school performance; (2) physical development (physical activity and nutrition education); and (3) access to school-based meals and health screenings. RESULTS: Findings indicated that access to FDK could enhance opportunities for Nevada's children to harness school-based services, increase physical activity, and promote nutrition education. In addition, based on existing research that suggests relationships between (1) FDK attendance and 3rd and 5th grade math and reading standardized test scores and (2) 3rd and 5th grade test scores and high school graduation, as well as available state and national data, we estimated that access to FDK could increase high school graduation in Nevada by 499-820 students per year. CONCLUSIONS: This HIA demonstrated that access to FDK could impact both student and adult health in Nevada. Our engagement of public health professionals along with stakeholders and the community in the HIA process demonstrated that HIAs can be an important tool for public health professionals to examine the effects on community health of policies, programs, plans or projects that arise outside of the health sector.


Assuntos
Planejamento em Saúde Comunitária/métodos , Avaliação do Impacto na Saúde/métodos , Saúde Pública , Instituições Acadêmicas , Criança , Comportamento Cooperativo , Avaliação do Impacto na Saúde/estatística & dados numéricos , Humanos , Entrevistas como Assunto , Estudos de Casos Organizacionais , Políticas , Formulação de Políticas , Características de Residência , Serviços de Saúde Escolar , Inquéritos e Questionários
13.
Risk Anal ; 37(12): 2420-2434, 2017 12.
Artigo em Inglês | MEDLINE | ID: mdl-28244115

RESUMO

To quantify the on-road PM2.5 -related premature mortality at a national scale, previous approaches to estimate concentrations at a 12-km × 12-km or larger grid cell resolution may not fully characterize concentration hotspots that occur near roadways and thus the areas of highest risk. Spatially resolved concentration estimates from on-road emissions to capture these hotspots may improve characterization of the associated risk, but are rarely used for estimating premature mortality. In this study, we compared the on-road PM2.5 -related premature mortality in central North Carolina with two different concentration estimation approaches-(i) using the Community Multiscale Air Quality (CMAQ) model to model concentration at a coarser resolution of a 36-km × 36-km grid resolution, and (ii) using a hybrid of a Gaussian dispersion model, CMAQ, and a space-time interpolation technique to provide annual average PM2.5 concentrations at a Census-block level (∼105,000 Census blocks). The hybrid modeling approach estimated 24% more on-road PM2.5 -related premature mortality than CMAQ. The major difference is from the primary on-road PM2.5 where the hybrid approach estimated 2.5 times more primary on-road PM2.5 -related premature mortality than CMAQ due to predicted exposure hotspots near roadways that coincide with high population areas. The results show that 72% of primary on-road PM2.5 premature mortality occurs within 1,000 m from roadways where 50% of the total population resides, highlighting the importance to characterize near-road primary PM2.5 and suggesting that previous studies may have underestimated premature mortality due to PM2.5 from traffic-related emissions.


Assuntos
Mortalidade Prematura , Material Particulado/toxicidade , Emissões de Veículos/toxicidade , Adulto , Idoso , Idoso de 80 Anos ou mais , Poluição do Ar/efeitos adversos , Poluição do Ar/análise , Feminino , Avaliação do Impacto na Saúde/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Modelos Estatísticos , North Carolina/epidemiologia , Material Particulado/análise , Medição de Risco/estatística & dados numéricos , Emissões de Veículos/análise
14.
Health Res Policy Syst ; 15(1): 22, 2017 Mar 21.
Artigo em Inglês | MEDLINE | ID: mdl-28327199

RESUMO

BACKGROUND: Realising the economic potential of research institutions, including medical research institutes, represents a policy imperative for many Organisation for Economic Co-operation and Development nations. The assessment of research impact has consequently drawn increasing attention. Research impact assessment frameworks (RIAFs) provide a structure to assess research translation, but minimal research has examined whether alternative RIAFs realise the intended policy outcomes. This paper examines the objectives presented for RIAFs in light of economic imperatives to justify ongoing support for health and medical research investment, leverage productivity via commercialisation and outcome-efficiency gains in health systems, and ensure that translation and impact considerations are embedded into the research process. This paper sought to list the stated objectives for RIAFs, to identify existing frameworks and to evaluate whether the identified frameworks possessed the capabilities necessary to address the specified objectives. METHODS: A scoping review of the literature to identify objectives specified for RIAFs, inform upon descriptive criteria for each objective and identify existing RIAFs. Criteria were derived for each objective. The capability for the existing RIAFs to realise the alternative objectives was evaluated based upon these criteria. RESULTS: The collated objectives for RIAFs included accountability (top-down), transparency/accountability (bottom-up), advocacy, steering, value for money, management/learning and feedback/allocation, prospective orientation, and speed of translation. Of the 25 RIAFs identified, most satisfied objectives such as accountability and advocacy, which are largely sufficient for the first economic imperative to justify research investment. The frameworks primarily designed to optimise the speed of translation or enable the prospective orientation of research possessed qualities most likely to optimise the productive outcomes from research. However, the results show that few frameworks met the criteria for these objectives. CONCLUSION: It is imperative that the objective(s) for an assessment framework are explicit and that RIAFs are designed to realise these objectives. If the objectives include the capability to pro-actively drive productive research impacts, the potential for prospective orientation and a focus upon the speed of translation merits prioritisation. Frameworks designed to optimise research translation and impact, rather than simply assess impact, offer greater promise to contribute to the economic imperatives compelling their implementation.


Assuntos
Academias e Institutos/estatística & dados numéricos , Pesquisa Biomédica/estatística & dados numéricos , Academias e Institutos/economia , Austrália , Pesquisa Biomédica/economia , Custos e Análise de Custo , Eficiência , Avaliação do Impacto na Saúde/economia , Avaliação do Impacto na Saúde/estatística & dados numéricos , Política de Saúde , Objetivos Organizacionais , Pesquisa Médica Translacional/economia , Pesquisa Médica Translacional/estatística & dados numéricos
15.
Health Promot Int ; 32(1): 149-156, 2017 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-28180268

RESUMO

Summary: The purpose of this article is to review the status of Health Impact Assessment (HIA) in Switzerland and assess whether HIA can be used to implement Health in All Policies (HiAP) in this highly decentralized country. The methods include expert opinion and an extensive literature review, as well as targeted interviews with key informers in the cantons of Geneva, Jura and Ticino. HIA has been implemented successfully since the early 2000s in Switzerland. However, integration has been heterogeneous with only a few cantons taking the lead. Integration of HIA at the federal level was attempted in 2012 but failed due to resistance from a pro-business lobby. HIA in Switzerland has the potential to contribute to HiAP, but success depends on a wider dissemination of HIA and on some form of integration at the national level. In this respect, a 'bottom-up' approach based on inter-cantonal collaborations appears more promising than the 'top-down' federal level approach.


Assuntos
Avaliação do Impacto na Saúde/estatística & dados numéricos , Política de Saúde , Avaliação do Impacto na Saúde/legislação & jurisprudência , Implementação de Plano de Saúde/organização & administração , Humanos , Colaboração Intersetorial , Administração em Saúde Pública , Suíça
16.
Proc Natl Acad Sci U S A ; 114(7): 1524-1529, 2017 02 14.
Artigo em Inglês | MEDLINE | ID: mdl-28154145

RESUMO

When a new vaccine is introduced, it is critical to monitor trends in disease rates to ensure that the vaccine is effective and to quantify its impact. However, estimates from observational studies can be confounded by unrelated changes in healthcare utilization, changes in the underlying health of the population, or changes in reporting. Other diseases are often used to detect and adjust for these changes, but choosing an appropriate control disease a priori is a major challenge. The "synthetic controls" (causal impact) method, which was originally developed for website analytics and social sciences, provides an appealing solution. With this approach, potential comparison time series are combined into a composite and are used to generate a counterfactual estimate, which can be compared with the time series of interest after the intervention. We sought to estimate changes in hospitalizations for all-cause pneumonia associated with the introduction of pneumococcal conjugate vaccines (PCVs) in five countries in the Americas. Using synthetic controls, we found a substantial decline in hospitalizations for all-cause pneumonia in infants in all five countries (average of 20%), whereas estimates for young and middle-aged adults varied by country and were potentially influenced by the 2009 influenza pandemic. In contrast to previous reports, we did not detect a decline in all-cause pneumonia in older adults in any country. Synthetic controls promise to increase the accuracy of studies of vaccine impact and to increase comparability of results between populations compared with alternative approaches.


Assuntos
Grupos Controle , Avaliação do Impacto na Saúde/estatística & dados numéricos , Hospitalização/estatística & dados numéricos , Vacinas Pneumocócicas , Pneumonia/prevenção & controle , Vacinação , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Viés , Criança , Pré-Escolar , Feminino , Avaliação do Impacto na Saúde/métodos , Humanos , Lactente , América Latina/epidemiologia , Masculino , Pessoa de Meia-Idade , Infecções Pneumocócicas/epidemiologia , Infecções Pneumocócicas/prevenção & controle , Pneumonia/epidemiologia , Pneumonia/etiologia , Estados Unidos/epidemiologia , Vacinação/estatística & dados numéricos , Vacinas Conjugadas , Adulto Jovem
17.
Prev Med ; 95S: S92-S94, 2017 02.
Artigo em Inglês | MEDLINE | ID: mdl-27509869

RESUMO

Health Impact Assessments are an important tool to help policymakers perceive the potential positive and negative contributions of decisions to public health. While they have been increasingly used in the United States, studies have not examined intermediate effects. Using key stakeholder interviews, this manuscript examines policy outcomes and other related effects of the HIA 21months after completing a Health Impact Assessment Report around connectivity policy. Further, it reflects on the measurement of these effects as part of the monitoring and evaluation stage of the Health Impact Assessment process.


Assuntos
Planejamento de Cidades/normas , Avaliação do Impacto na Saúde/estatística & dados numéricos , Política de Saúde , Saúde Pública/normas , Transportes/normas , Planejamento de Cidades/métodos , Avaliação do Impacto na Saúde/métodos , Humanos , Entrevistas como Assunto , Formulação de Políticas , Avaliação de Programas e Projetos de Saúde , Saúde Pública/estatística & dados numéricos , Transportes/métodos , West Virginia
18.
Artigo em Inglês | MEDLINE | ID: mdl-29642303

RESUMO

This research aimed at exploring the development of the capacitybuilding process in environmental and health impact assessment, including the consideration of subsequent, capacity-building achievements. Data were gathered through questionnaires, participatory observations, in-depth interviews, focus group discussions, and capacity building checklist forms. These data were analyzed using content analysis, descriptive statistics, and inferential statistics. Our study used the components of the final draft for capacity-building processes consisting of ten steps that were formulated by synthesis from each respective process. Additionally, the evaluation of capacity building levels was performed using 10-item evaluation criteria for nine communities. The results indicated that the communities performed well under these criteria. Finally, exploration of the factors influencing capacity building in environmental and health impact assessment indicated that the learning of community members by knowledge exchange via activities and study visits were the most influential factors of the capacity building processes in environmental and health impact assessment. The final revised version of capacitybuilding process in environmental and health impact assessment could serve as a basis for the consideration of interventions in similar areas, so that they increased capacity in environmental and health impact assessments.


Assuntos
Fortalecimento Institucional/estatística & dados numéricos , Meio Ambiente , Avaliação do Impacto na Saúde/estatística & dados numéricos , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Tailândia , Adulto Jovem
19.
Epidemiol Prev ; 40(2): 131-7, 2016.
Artigo em Italiano | MEDLINE | ID: mdl-27290891

RESUMO

The Health Impact Assessment (HIA) has already been tested in dozens of nations, including Italy, and the reflection is now mature enough to allow a first evaluation of its effective capacity to offer an inclusive tool for prevention. The analysis focuses in particular on the HIA ability to address, through a participatory approach, one of its founding values: the democratic nature of decisions with an impact on public health. In most cases, the experiments carried out so far seem to be disappointing: the participation is often absent or performed in a rhetorical form. Sometimes the HIA has even been used in an instrumental way to justify decisions already taken, with the only result to further erode the credibility of experts and institutions. In this work, however, the author will try to show how, on the contrary, a greater involvement in the evaluation and decision-making processes could improve the effectiveness of HIA in terms of prevention, while at the same time promoting a relationship of trust between experts, institutions, and citizens on which to establish an ecologically and socially sustainable development.


Assuntos
Tomada de Decisões Gerenciais , Avaliação do Impacto na Saúde , Avaliação de Programas e Projetos de Saúde , Avaliação do Impacto na Saúde/normas , Avaliação do Impacto na Saúde/estatística & dados numéricos , Pesquisa sobre Serviços de Saúde/normas , Humanos , Itália/epidemiologia , Formulação de Políticas , Avaliação de Programas e Projetos de Saúde/normas , Saúde Pública
20.
PLoS One ; 11(5): e0154052, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27167124

RESUMO

BACKGROUND: The Antwerp ring road has a traffic density of 300,000 vehicles per day and borders the city center. The 'Ringland project' aims to change the current 'open air ring road' into a 'filtered tunneled ring road', putting the entire urban ring road into a tunnel and thus filtering air pollution. We conducted a health impact assessment (HIA) to quantify the possible benefit of a 'filtered tunneled ring road', as compared to the 'open air ring road' scenario, on air quality and its long-term health effects. MATERIALS AND METHODS: We modeled the change in annual ambient PM2.5 and NO2 concentrations by covering 15 kilometers of the Antwerp ring road in high resolution grids using the RIO-IFDM street canyon model. The exposure-response coefficients used were derived from a literature review: all-cause mortality, life expectancy, cardiopulmonary diseases and childhood Forced Vital Capacity development (FVC). RESULTS: Our model predicts changes between -1.5 and +2 µg/m³ in PM2.5 within a 1,500 meter radius around the ring road, for the 'filtered tunneled ring road' scenario as compared to an 'open air ring road'. These estimated annual changes were plotted against the population exposed to these differences. The calculated change of PM2.5 is associated with an expected annual decrease of 21 deaths (95% CI 7 to 41). This corresponds with 11.5 deaths avoided per 100,000 inhabitants (95% CI 3.9-23) in the first 500 meters around the ring road every year. Of 356 schools in a 1,500 meter perimeter around the ring road changes between -10 NO2 and + 0.17 µg/m³ were found, corresponding to FVC improvement of between 3 and 64ml among school-age children. The predicted decline in lung cancer mortality and incidence of acute myocardial infarction were both only 0.1 per 100,000 inhabitants or less. CONCLUSION: The expected change in PM2,5 and NO2 by covering the entire urban ring road in Antwerp is associated with considerable health gains for the approximate 352,000 inhabitants living in a 1,500 meter perimeter around the current open air ring road.


Assuntos
Poluentes Atmosféricos/análise , Avaliação do Impacto na Saúde/estatística & dados numéricos , Modelos Estatísticos , Material Particulado/análise , Emissões de Veículos/prevenção & controle , Idoso , Poluentes Atmosféricos/toxicidade , Poluição do Ar/prevenção & controle , Bélgica , Criança , Cidades , Monitoramento Ambiental , Feminino , Humanos , Expectativa de Vida/tendências , Masculino , Material Particulado/toxicidade , Transportes , Emissões de Veículos/análise , Capacidade Vital/fisiologia
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