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1.
Glob Health Res Policy ; 9(1): 19, 2024 Jun 05.
Artículo en Inglés | MEDLINE | ID: mdl-38840125

RESUMEN

In Namibia, the Value Added Tax (VAT) Amendment Act 2022, which reclassified the supply of sanitary pads as zero-rated, has significant implications for adolescent girls' menstrual health and education. The policy change responds to the need to address period poverty by making essential menstrual products more accessible and affordable. Menstruation is a normal biological process, and access to sanitary products is a human right. Taxing menstrual products reinforces gender inequalities and raises concerns about the basic rights and dignity of women and girls. The VAT-free policy creates a system to reduce the financial burden on girls and women, making it easier for them to manage their periods safely and with dignity. It has the potential to reduce absenteeism from school, ultimately improving educational outcomes for adolescent girls. However, VAT exemptions alone are insufficient to address the broader accessibility issues that impact menstrual hygiene. Evidence-based policies that focus on the availability and affordability of a full range of sanitary products, in conjunction with regulatory mechanisms for price and quality control, are necessary to ensure that menstrual products are safe, affordable, and accessible for all.


Asunto(s)
Productos para la Higiene Menstrual , Menstruación , Humanos , Femenino , Adolescente , Productos para la Higiene Menstrual/provisión & distribución , Productos para la Higiene Menstrual/economía , Productos para la Higiene Menstrual/estadística & datos numéricos , Impuestos , Namibia , Política de Salud/legislación & jurisprudencia , Salud del Adolescente
2.
Front Public Health ; 12: 1358730, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38841673

RESUMEN

Introduction: The synergy of green taxation, public health expenditures, and life expectancy emerges as a compelling narrative in the intricate symphony of environmental responsibility and public well-being. Therefore, this study examine the impact of green taxation on life expectancy and the moderating role of public health expenditure on the said nexus, particularly in the context of China, an emerging economy. Methods: Statistical data is collected from the National Bureau of Statistics of China to empirically examine the proposed relationships. The dataset contains provincial data across years. Results: Using fixed-effect and system GMM regression models alongwith control variables, the results found a positive and statistically significant influence of green taxation on life expectancy. Moreover, public health expenditures have a positive and statistically significant partial moderating impact on the direct relationship. Discussion: These findings suggest that the higher cost of pollution encourages individuals and businesses to shift to less environmentally harmful alternatives, subsequently improving public health. Moreover, government investment in the health sector increases the availability and accessibility of health facilities; thus, the positive impact of green taxation on public health gets more pronounced. The findings significantly contribute to the fields of environmental and health economics and provide a new avenue of research for the academic community and policymakers.


Asunto(s)
Gastos en Salud , Esperanza de Vida , Impuestos , China , Humanos , Impuestos/estadística & datos numéricos , Impuestos/economía , Gastos en Salud/estadística & datos numéricos , Salud Pública/economía
3.
Front Public Health ; 12: 1344718, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38841676

RESUMEN

Background: The spread of Covid-19 and resultant infection prevention strategies have disturbed the life routine of Chinese young adults, led to reduced physical activity (PA), prolonged screen time (ST) and inadequate sleep duration (SP), and made immense influence on their mental health (MH) and quality of life (QoL). E-Health literacy (EHL) can enable citizens to use available online information to respond to the highly complex information environment and make appropriate health decisions. Objective: This study aims to examine associations between adhering to 24-h movement (24HM) guidelines and MH and QoL among young adults, as well as to identify any mediating or moderating role of EHL in these associations. Methods: 1742 young adults (20.03 ± 1.54 years old, 68.6% females) from north and south China completed self-report measures of 24HM (PA, ST and SP), health indicators (MH and QoL), EHL and demographic information through an online survey between 4 Apr and 16 Jun 2022. Generalized linear mixed models were applied for data analysis. Results: Results showed that adhering to PA, ST and SP guidelines were all positively connected with QoL while MH was associated with adhering ST or SP guidelines. Adhering to more of 24HM guidelines was linked to better MH and QoL. EHL significantly mediated the association of guideline adherence and QoL and moderate that of guideline adherence and MH. Conclusion: This is the first study to investigate the role of EHL on the associations between 24HM and MH as well as QoL during the Covid-19. The findings may contribute to further empirical research or intervention that aims to promote MH or QoL among young adults more effectively or provide valuable references for developing relevant strategies or policy of health promotion or public health events in China.


Asunto(s)
COVID-19 , Ejercicio Físico , Adhesión a Directriz , Alfabetización en Salud , Salud Mental , Calidad de Vida , Humanos , Femenino , Masculino , Adulto Joven , China , COVID-19/prevención & control , Adhesión a Directriz/estadística & datos numéricos , Encuestas y Cuestionarios , Tiempo de Pantalla , Adulto , Adolescente , Sueño
4.
N Z Med J ; 137(1596): 86-93, 2024 Jun 07.
Artículo en Inglés | MEDLINE | ID: mdl-38843552

RESUMEN

Childhood obesity is a critical issue in New Zealand that we can no longer afford to ignore. Currently, one in three children is overweight or obese, putting the health of an entire generation at risk if we continue to delay taking action. This issue highlights a significant matter of equity. Maori and Pacific children and those from socio-economically deprived backgrounds are disproportionately affected, reminding us of the systemic barriers rooted in historical factors that exist within our society. Efforts focussed on changing individual behaviour have achieved limited success in reducing childhood obesity rates. Therefore, it is necessary to shift our focus upstream and address the root causes of this issue. This viewpoint piece underscores the role of the obesogenic environment as the primary driver of childhood obesity, advocating for an upstream approach to enact broader changes in the food environment. Within this framework, this piece puts forward three policy measures that could be essential in addressing the childhood obesity epidemic: implementing a tax on sugary beverages, restricting unhealthy food marketing and ensuring access to healthy food in schools. These policies are backed by substantial evidence of their efficacy, cost-effectiveness and potential to improve health equity, including contextual evidence from successful international models. However, despite ample evidence and support, New Zealand has fallen behind international standards in adopting these measures, partly due to resistance from the food industry and the need for stronger political leadership. Thus, a "call to action" is needed to overcome these challenges, mobilise against the current policy inertia and make addressing childhood obesity a priority.


Asunto(s)
Obesidad Infantil , Humanos , Nueva Zelanda/epidemiología , Obesidad Infantil/prevención & control , Obesidad Infantil/epidemiología , Niño , Política de Salud , Bebidas Azucaradas , Impuestos , Promoción de la Salud/organización & administración , Promoción de la Salud/métodos
5.
Gastroenterol Nurs ; 47(3): 171-176, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38847426

RESUMEN

Although nurses and other healthcare professionals play a key role in preventing hospital-associated infections, studies show that infection control compliance rates have remained low. The purpose of this quality improvement project was to increase infection control compliance of hand hygiene and procedure room disinfection among endoscopy staff at a large urban medical center in Cincinnati, Ohio. This quality improvement project provided an education session on current evidence-based infection control guidelines to 20 participants, including registered nurses and technicians within the endoscopy department. Direct observational audits were conducted 4 weeks before and 4 weeks after the education session, measuring compliance with hand sanitizer, soap and water, and procedure room disinfection, over a period of 150 days. The project goals were met, as hand sanitizer compliance improved by 12%-83%; overall soap and water compliance improved by 20%-75%; and endoscopy procedure room disinfection compliance improved by 14%-92%.


Asunto(s)
Infección Hospitalaria , Adhesión a Directriz , Hospitales Urbanos , Control de Infecciones , Mejoramiento de la Calidad , Humanos , Adhesión a Directriz/estadística & datos numéricos , Control de Infecciones/normas , Infección Hospitalaria/prevención & control , Ohio , Desinfección/métodos , Desinfección/normas , Endoscopía
6.
Appl Ergon ; 119: 104322, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-38823210

RESUMEN

Floor inclination can alter hand force production, and lower limb kinetics, affecting control operations, and threatening operator safety in various domains, such as aviation, naval, construction industry, or agriculture. This study investigates the effects of different floor inclinations, on handle push or pull force production. Participants performed maximal isometric contraction tasks requiring to exert a maximal voluntary force either by pulling or pushing a handle, at different floor inclinations from -30° to +30° about the transverse and longitudinal axes. Maximal hand force and Ground Reaction Forces about both feet were recorded. The results revealed non-equivalent variations in hand and feet responses as a function of inclination angle. Specifically, there was a significant reduction in handle push-pull force production, up to 70% (p < 0.001) for extreme inclinations, around both axes. This study provides critical data for design engineers, highlighting the challenge of production forces at steep angles.


Asunto(s)
Pisos y Cubiertas de Piso , Contracción Isométrica , Extremidad Superior , Humanos , Masculino , Fenómenos Biomecánicos , Adulto , Contracción Isométrica/fisiología , Extremidad Superior/fisiología , Adulto Joven , Femenino , Ergonomía , Análisis y Desempeño de Tareas , Mano/fisiología , Pie/fisiología , Diseño de Equipo , Fuerza de la Mano/fisiología
7.
J Law Health ; 37(2): 52-104, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38833597

RESUMEN

Over half the states have enacted laws diminishing or curtailing the rights of the executive branch (legislatures or governors) to enact laws to preserve, protect, or safeguard public health in the wake of the COVID-19 emergency. Governor DeSantis, of Florida, for example, effectively banned mask mandates in schools during the high point of the epidemic--based on flawed science and erroneous data--and now wants to make that response permanent. The rules effectuating this Executive Order were enacted under an emergency order finding a threat to public health. Nevertheless, the response promulgated by the Florida Department of Health was to prevent public health measures, favoring individual liberties, parental rights (which have previously been held not to apply in the context of the spread of contagious disease epidemics) at the expense of public health and safety. This article explores alternative means to compel state governments, heretofore vested with the police power to protect public health, to comply with this obligation, using the Florida situation as a case study.


Asunto(s)
COVID-19 , Responsabilidad Legal , Salud Pública , Gobierno Estatal , Humanos , COVID-19/prevención & control , COVID-19/epidemiología , Florida , Salud Pública/legislación & jurisprudencia , Libertad , SARS-CoV-2 , Estados Unidos
8.
Glob Health Action ; 17(1): 2353957, 2024 Dec 31.
Artículo en Inglés | MEDLINE | ID: mdl-38826144

RESUMEN

As the world is facing challenges such as pandemics, climate change, conflicts, and changing political landscapes, the need to secure access to safe and high-quality abortion care is more urgent than ever. On 27th of June 2023, the Swedish government decided to cut funding resources available for developmental research, which has played a fundamental role in the advancement of sexual and reproductive health and rights (SRHR) globally, including abortion care. Withdrawal of this funding not only threatens the fulfilment of the United Nations sustainable development goals (SDGS) - target 3.7 on ensuring universal access to SRHR and target 5 on gender equality - but also jeopardises two decades of research capacity strengthening. In this article, we describe how the partnerships that we have built over the course of two decades have amounted to numerous publications, doctoral graduates, and important advancements within the field of SRHR in East Africa and beyond.


Main findings: The two-decade long collaboration between Sweden and East Africa, funded by the Swedish government, has resulted in important partnerships, research findings, and advancements within sexual and reproductive health and rights in East Africa.Added knowledge: The Swedish government is now cutting funding for development research, which jeopardises the progress made so far.Global health impact for policy and action: Governments need to prioritise women's sexual and reproductive health and rights.


Asunto(s)
Creación de Capacidad , Salud Reproductiva , Salud Sexual , Humanos , Creación de Capacidad/organización & administración , Salud Reproductiva/educación , Salud Sexual/educación , África Oriental , Investigación/organización & administración , Femenino , Desarrollo Sostenible , Aborto Inducido
9.
BMJ Open ; 14(6): e084847, 2024 Jun 03.
Artículo en Inglés | MEDLINE | ID: mdl-38830735

RESUMEN

INTRODUCTION: Tranexamic acid (TXA) is an inexpensive and widely available medication that reduces blood loss and red blood cell (RBC) transfusion in cardiac and orthopaedic surgeries. While the use of TXA in these surgeries is routine, its efficacy and safety in other surgeries, including oncologic surgeries, with comparable rates of transfusion are uncertain. Our primary objective is to evaluate whether a hospital-level policy implementation of routine TXA use in patients undergoing major non-cardiac surgery reduces RBC transfusion without increasing thrombotic risk. METHODS AND ANALYSIS: A pragmatic, registry-based, blinded, cluster-crossover randomised controlled trial at 10 Canadian sites, enrolling patients undergoing non-cardiac surgeries at high risk for RBC transfusion. Sites are randomised in 4-week intervals to a hospital policy of intraoperative TXA or matching placebo. TXA is administered as 1 g at skin incision, followed by an additional 1 g prior to skin closure. Coprimary outcomes are (1) effectiveness, evaluated as the proportion of patients transfused RBCs during hospital admission and (2) safety, evaluated as the proportion of patients diagnosed with venous thromboembolism within 90 days. Secondary outcomes include: (1) transfusion: number of RBC units transfused (both at a hospital and patient level); (2) safety: in-hospital diagnoses of myocardial infarction, stroke, deep vein thrombosis or pulmonary embolism; (3) clinical: hospital length of stay, intensive care unit admission, hospital survival, 90-day survival and the number of days alive and out of hospital to day 30; and (4) compliance: the proportion of enrolled patients who receive a minimum of one dose of the study intervention. ETHICS AND DISSEMINATION: Institutional research ethics board approval has been obtained at all sites. At the completion of the trial, a plain language summary of the results will be posted on the trial website and distributed in the lay press. Our trial results will be published in a peer-reviewed scientific journal. TRIAL REGISTRATION NUMBER: NCT04803747.


Asunto(s)
Antifibrinolíticos , Ácido Tranexámico , Humanos , Ácido Tranexámico/uso terapéutico , Ácido Tranexámico/administración & dosificación , Antifibrinolíticos/uso terapéutico , Antifibrinolíticos/administración & dosificación , Canadá , Pérdida de Sangre Quirúrgica/prevención & control , Estudios Cruzados , Transfusión de Eritrocitos , Política Organizacional
10.
BMC Public Health ; 24(1): 1491, 2024 Jun 04.
Artículo en Inglés | MEDLINE | ID: mdl-38834949

RESUMEN

BACKGROUND: Infection by Legionella bacteria is a risk to elderly individuals in health care facilities and should be managed by preventing bacterial proliferation in internal water systems. Norwegian legislation calls for a mandatory Legionella-specific risk assessment with the subsequent introduction of an adapted water management programme. The present study investigates adherence to legislation and guidelines on Legionella control and prevention in Norwegian nursing homes. METHODS: A cross-sectional survey was distributed to Norwegian municipalities to investigate the status of Legionella specific risk assessments of internal water distribution systems and the introduction of water management programmes in nursing homes. RESULTS: A total of 55.1% (n = 228) of the participating nursing homes had performed Legionella-specific risk assessments, of which 55.3% (n = 126) stated that they had updated the risk assessment within the last year. 96.5% introduced a water management programme following a risk assessment, whereas 59.6% of the ones without a risk assessment did the same. Nursing homes with risk assessments were more likely to monitor Legionella levels than those without (61.2% vs 38.8%), to remove dead legs (44.7% vs 16.5%), and to select biocidal preventive treatment over hot water flushing (35.5% vs 4.6%). CONCLUSIONS: This study presents novel insight into Legionella control in Norway, suggesting that adherence to mandatory risk assessment in nursing homes is moderate-low. Once performed, the risk assessment seems to be advantageous as an introduction to future Legionella prevention in terms of the scope and contents of the water management programme.


Asunto(s)
Adhesión a Directriz , Casas de Salud , Microbiología del Agua , Noruega , Estudios Transversales , Casas de Salud/normas , Casas de Salud/legislación & jurisprudencia , Humanos , Adhesión a Directriz/estadística & datos numéricos , Microbiología del Agua/normas , Legionella , Medición de Riesgo , Legionelosis/prevención & control , Abastecimiento de Agua/normas , Abastecimiento de Agua/legislación & jurisprudencia , Anciano
11.
Praxis (Bern 1994) ; 113(5): 113-118, 2024 May.
Artículo en Alemán | MEDLINE | ID: mdl-38864104

RESUMEN

INTRODUCTION: There is potential for improvement in the care of cardiovascular diseases in Switzerland, particularly when it comes to achieving target values defined in guidelines. Adherence scores such as the SGED score for diabetic care established in Switzerland can help to reduce the evidence-performance gap. The CARE score presented here is an adherence score that validly reflects the quality of care for patients with a cardiovascular risk using process and outcome indicators.


Asunto(s)
Enfermedades Cardiovasculares , Medicina General , Adhesión a Directriz , Humanos , Enfermedades Cardiovasculares/prevención & control , Suiza , Indicadores de Calidad de la Atención de Salud , Garantía de la Calidad de Atención de Salud , Factores de Riesgo de Enfermedad Cardiaca , Anciano , Masculino , Persona de Mediana Edad
12.
Arch Osteoporos ; 19(1): 49, 2024 Jun 12.
Artículo en Inglés | MEDLINE | ID: mdl-38864939

RESUMEN

This study compares osteoporosis management between tertiary East Coast hospitals and a FLS-accredited hospital in Malaysia. It identifies significant barriers and highlights the superior performance of FLS in areas like timely treatment initiation and treatment monitoring. The insights are crucial for improving osteoporosis management strategies. INTRODUCTION: Osteoporosis management poses a substantial healthcare challenge, necessitating effective strategies and Clinical Practice Guidelines (CPG) adherence. METHODS: The study employed a self-administered online questionnaire via Google Forms. Orthopedic clinicians from all study sites were invited to participate via messaging platforms. A total of 135 participants completed the questionnaire and the data was proceeded to statistical analyses. RESULTS: The study identified significant barriers, including inadequate knowledge of current osteoporosis guidelines and medications (p = 0.014), limited choice of anti-osteoporosis medication (p < 0.001), insufficient post-fracture care staff (p < 0.001), patients' financial constraints due to socioeconomic status (p = 0.027), and lack of doctor-patient time (p = 0.042). FLS demonstrated superior performance in CPG adherence in areas such as clinical diagnosis of osteoporosis without BMD assessment (p = 0.046), timely treatment initiation (p < 0.001), treatment monitoring using BMD (p = 0.004), reassessment treatment after 3-5 years of bisphosphonate therapy (p = 0.034) and considering anabolic agents in very high-risk patients (p = 0.018). CONCLUSION: The findings highlight an essential opportunity for improvement and emphasize the necessity for robust strategies and strict adherence to Clinical Practice Guidelines (CPG), especially within tertiary East Coast hospitals. The exemplary efficacy demonstrated by the FLS model strongly advocates for its broader integration across multiple hospitals, promising substantial advancements in osteoporotic patient care outcomes throughout Malaysia.


Asunto(s)
Adhesión a Directriz , Osteoporosis , Humanos , Malasia , Osteoporosis/tratamiento farmacológico , Osteoporosis/terapia , Adhesión a Directriz/estadística & datos numéricos , Femenino , Masculino , Encuestas y Cuestionarios , Centros de Atención Terciaria , Conservadores de la Densidad Ósea/uso terapéutico , Persona de Mediana Edad , Guías de Práctica Clínica como Asunto , Fracturas Osteoporóticas/prevención & control , Fracturas Osteoporóticas/terapia
13.
J Water Health ; 22(5): 896-904, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38822468

RESUMEN

Hand hygiene (HH) is the most effective way to curb the spread of healthcare-associated infections. Nonetheless, healthcare personnel encounter difficulties in adhering to WHO HH recommendations. This study aimed to investigate HH compliance and adherence after the implementation of an action plan in a municipal hospital in Moscow. An initial evaluation of HH compliance among clinical health workers was carried out in June 2022 according to the WHO HH guidelines followed by a 3-month re-audit of HH practices. The results were compared to the baseline to evaluate compliance and adherence to HH among healthcare personnel. From June to September 2022, there were 2,732 moments of contact with patients or their immediate surroundings. The HH total compliance rate significantly (p < 0.05) increased from 52.3% in June 2022 to 83.3% in September 2022 with a 75% overall total compliance rate. The profession-specific total compliance rate was highest among nurses (79.6%) and lowest among ancillary staff (69.7%). Staff were also more adherent to the before-moments compared to the after-moments of the HH guidelines. Monthly re-audits and providing feedback resulted in a significant improvement in compliance and adherence with HH guidelines after implementation of the action plan.


Asunto(s)
Adhesión a Directriz , Higiene de las Manos , Control de Infecciones , Higiene de las Manos/normas , Higiene de las Manos/estadística & datos numéricos , Adhesión a Directriz/estadística & datos numéricos , Humanos , Control de Infecciones/métodos , Control de Infecciones/normas , Infección Hospitalaria/prevención & control , Personal de Salud/psicología
14.
Sensors (Basel) ; 24(11)2024 May 26.
Artículo en Inglés | MEDLINE | ID: mdl-38894211

RESUMEN

This study introduces a novel wearable Inertial Measurement Unit (IMU)-based system for an objective and comprehensive assessment of Work-Related Musculoskeletal Disorders (WMSDs), thus enhancing workplace safety. The system integrates wearable technology with a user-friendly interface, providing magnetometer-free orientation estimation, joint angle measurements, and WMSDs risk evaluation. Tested in a cable manufacturing facility, the system was evaluated with ten female employees. The evaluation involved work cycle identification, inter-subject comparisons, and benchmarking against standard WMSD risk assessments like RULA, REBA, Strain Index, and Rodgers Muscle Fatigue Analysis. The evaluation demonstrated uniform joint patterns across participants (ICC=0.72±0.23) and revealed a higher occurrence of postures warranting further investigation, which is not easily detected by traditional methods such as RULA. The experimental results showed that the proposed system's risk assessments closely aligned with the established methods and enabled detailed and targeted risk assessments, pinpointing specific bodily areas for immediate ergonomic interventions. This approach not only enhances the detection of ergonomic risks but also supports the development of personalized intervention strategies, addressing common workplace issues such as tendinitis, low back pain, and carpal tunnel syndrome. The outcomes highlight the system's sensitivity and specificity in identifying ergonomic hazards. Future efforts should focus on broader validation and exploring the relative influence of various WMSDs risk factors to refine risk assessment and intervention strategies for improved applicability in occupational health.


Asunto(s)
Enfermedades Musculoesqueléticas , Enfermedades Profesionales , Dispositivos Electrónicos Vestibles , Humanos , Enfermedades Musculoesqueléticas/fisiopatología , Femenino , Medición de Riesgo/métodos , Adulto , Enfermedades Profesionales/diagnóstico , Enfermedades Profesionales/prevención & control , Enfermedades Profesionales/fisiopatología , Ergonomía/métodos , Postura/fisiología , Lugar de Trabajo
15.
J Public Health Manag Pract ; 30: S6-S14, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38870354

RESUMEN

CONTEXT: Contributing to the evidence base, by disseminating findings through written products such as journal articles, is a core competency for public health practitioners. Disseminating practice-based evidence that supports improving cardiovascular health is necessary for filling literature gaps, generating health policies and laws, and translating evidence-based strategies into practice. However, a gap exists in the dissemination of practice-based evidence in public health. Public health practitioners face various dissemination barriers (eg, lack of time and resources, staff turnover) which, more recently, were compounded by the COVID-19 pandemic. PROGRAM: The Centers for Disease Control and Prevention's Division for Heart Disease and Stroke Prevention (DHDSP) partnered with the National Network of Public Health Institutes to implement a multimodal approach to build writing capacity among recipients funded by three DHDSP cooperative agreements. This project aimed to enhance public health practitioners' capacity to translate and disseminate their evaluation findings. IMPLEMENTATION: Internal evaluation technical assistance expertise and external subject matter experts helped to implement this project and to develop tailored multimodal capacity-building activities. These activities included online peer-to-peer discussion posts, virtual writing workshops, resource documents, one-to-one writing coaching sessions, an online toolkit, and a supplemental issue in a peer-reviewed journal. EVALUATION: Findings from an informal process evaluation demonstrate positive results. Most participants were engaged and satisfied with the project's activities. Across eight workshops, participants reported increased knowledge (≥94%) and enhanced confidence in writing (≥98%). The majority of participants (83%) reported that disseminating evaluation findings improved program implementation. Notably, 30 abstracts were submitted for a journal supplement and 23 articles were submitted for consideration. DISCUSSION: This multimodal approach serves as a promising model that enhances public health practitioners' capacity to disseminate evaluation findings during times of evolving health needs.


Asunto(s)
COVID-19 , Creación de Capacidad , Difusión de la Información , Salud Pública , Escritura , Humanos , Estados Unidos , Salud Pública/métodos , Escritura/normas , COVID-19/prevención & control , COVID-19/epidemiología , Difusión de la Información/métodos , Creación de Capacidad/métodos , Enfermedades Cardiovasculares/prevención & control , SARS-CoV-2 , Centers for Disease Control and Prevention, U.S./organización & administración
16.
J Public Health Manag Pract ; 30(4): 558-566, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38870373

RESUMEN

OBJECTIVES: Complementing the extensive research literature demonstrating that increased alcohol outlet density is associated with excessive alcohol consumption and related harms, this article synthesizes information on the types of alcohol outlet density restrictions in US state-level laws. DESIGN: Statutes and regulations related to alcohol outlet density in all 50 states and the District of Columbia in effect as of January 1, 2022, were collected using Westlaw. State-level density restrictions were coded according to 4 variables and overlaid with existing research on state-specific local authority to regulate outlet density. Alcohol outlet density laws in Michigan and Massachusetts were analyzed in detail as case studies. SETTING: United States. MAIN OUTCOME MEASURE: US state-level licensing laws restricting alcohol outlet density. RESULTS: Thirty-three states and the District of Columbia have state-level licensing laws that limit alcohol outlet density. Of those, 25 have population-based restrictions, 8 have distance-based restrictions, 7 have quotas, and 6 require the licensing agency to consider density-related factors. Within the same group of 34 jurisdictions, 22 apply restrictions to both on- and off-premises outlets, 5 apply them only to on-premises outlets, and 7 apply them only to off-premises outlets. Among the 32 states where localities lack authority to license alcohol outlets, two-thirds have state-level laws restricting outlet density. State-level density restrictions also exist in approximately two-thirds of the states where localities have licensing authority. Case studies of Michigan and Massachusetts highlight how state-level density restrictions operate in practice. CONCLUSIONS: Two-thirds of jurisdictions have state-level alcohol outlet density restrictions, with population-based restrictions being the most common. In addition, outlet density restrictions may exist regardless of limits on local control and whether localities with authority to enact density restrictions have done so. Policymakers and others can reference this assessment to identify examples and opportunities to strengthen the alcohol policy environment in any given state.


Asunto(s)
Bebidas Alcohólicas , Comercio , Gobierno Estatal , Estados Unidos , Humanos , Bebidas Alcohólicas/legislación & jurisprudencia , Comercio/legislación & jurisprudencia , Comercio/estadística & datos numéricos , Consumo de Bebidas Alcohólicas/legislación & jurisprudencia , Consumo de Bebidas Alcohólicas/epidemiología , Concesión de Licencias/legislación & jurisprudencia
17.
Child Care Health Dev ; 50(4): e13285, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38874376

RESUMEN

BACKGROUND: This study aimed to explore the impact of the COVID-19 pandemic on capacity building for health promotion in primary schools from the perspectives of primary school teachers. METHODS: A cross-sectional observational study was conducted via an anonymous online survey between February and May 2022. Three-quarters (n2460) of all schools in the Republic of Ireland were invited to participate. Demographics such as gender, teaching experience, school type and delivering equality of opportunity in schools (DEIS) designation were collected. Perceived capacity for health promotion was measured on a 10-point Likert scale. Facilitators and barriers related to health promotion and aspects of child health prioritised for health promotion in the 2 years after restrictions eased were explored via closed- and open-ended questions. RESULTS: Of the 595 responses, 493 were eligible for analysis. Participants were based in schools in every county in the Republic of Ireland, with most (85.4%, n421) being female. Almost a third (30.5%, n150) were 11-20 years post-qualification, and a quarter (25.2%, n124) had over 30 years' teaching experience. Mean capacity for school-based health promotion pre-pandemic was moderate, at 6.6 ± 2.2 on a 10-point scale. Mean capacity in spring 2022 decreased significantly (p < 0.001) to 4.1 ± 2.4, indicating poor capacity. Capacity ratings did not significantly differ by school type (p = 0.31), socioeconomic designation (p = 0.27) or years post-qualification (p = 0.08). Capacity decrements were most frequently (49.7%, n245) attributed to organisational factors, while individual and community-level factors were cited by 27.6% (n136) and 21.5% (n106) of respondents, respectively. Healthy eating significantly (p < 0.001) decreased as a priority for health promotion between pre-pandemic times (76.3%, n376) and spring 2022 (23.1%, n114). Mental health significantly (p < 0.01) increased as a priority, being listed by 38.1% (n188) as a priority pre-pandemic and doubling to 72.6% (n358) in spring 2022. CONCLUSIONS: Fostering a holistic approach to health promotion in schools remains a challenge. Further efforts are needed to support schools to implement sustainable and balanced systems of health promotion.


Asunto(s)
COVID-19 , Promoción de la Salud , Servicios de Salud Escolar , Maestros , Humanos , COVID-19/epidemiología , COVID-19/prevención & control , Estudios Transversales , Maestros/psicología , Maestros/estadística & datos numéricos , Niño , Femenino , Masculino , Irlanda/epidemiología , Servicios de Salud Escolar/organización & administración , Promoción de la Salud/organización & administración , Instituciones Académicas/organización & administración , Creación de Capacidad , SARS-CoV-2 , Encuestas y Cuestionarios , Adulto
18.
PLoS One ; 19(6): e0304028, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38870150

RESUMEN

SIGNIFICANCE: For decades, tobacco advertisements and promotions have been common in mass media and public places in China. In 2015, China amended the Advertising Law to prohibit the distribution of tobacco advertising, while also initiating waves of tobacco control media campaigns. This study investigates the associations between exposure to anti- and pro-smoking messages, smoking status, and people's smoking-related beliefs and willingness to support tobacco control policies. METHODS: A secondary data analysis was performed with the 2018 Global Adult Tobacco Survey of 19,376 adults aged ≥15 years in China. Anti- and pro-smoking message exposures were measured as the sum of sources (media or places) where respondents have seen the messages. Multivariable logistic regression analyses were conducted to examine the relationships among smoking status, message exposure, and the outcome variables (health harm beliefs, support for increasing tax on cigarettes, support for using part of the increased tax on tobacco control) controlling for smoking status and demographic differences. RESULTS: Overall, 63.3% of the respondents reported being exposed to anti-smoking messages from at least 1 source, while 18.1% were exposed to pro-smoking messages from at least 1 source. Adults who currently, formerly, and never smoked differed in their beliefs about smoking and willingness to support tobacco control policies. Greater reported exposure to anti-smoking messages was positively associated with belief that smoking is harmful, support for increased cigarette tax, and support for using increased tax revenue for tobacco control measures. Meanwhile, greater reported exposure to pro-smoking messages was negatively related to willingness to support cigarette tax increases. CONCLUSIONS: While national and local tobacco control campaigns in China have reached a large proportion of the adult population, there is still room for improvement. China might consider expanding anti-tobacco campaigns, as reported exposure to these messages is associated with increased public awareness of the health hazards of smoking and support for increasing cigarette taxes.


Asunto(s)
Fumar , Humanos , Adulto , China/epidemiología , Masculino , Femenino , Persona de Mediana Edad , Adolescente , Adulto Joven , Encuestas y Cuestionarios , Fumar/psicología , Fumar/epidemiología , Publicidad , Productos de Tabaco/economía , Productos de Tabaco/legislación & jurisprudencia , Anciano , Medios de Comunicación de Masas , Impuestos , Prevención del Hábito de Fumar/métodos , Cese del Hábito de Fumar/psicología
19.
BMC Cardiovasc Disord ; 24(1): 302, 2024 Jun 14.
Artículo en Inglés | MEDLINE | ID: mdl-38877422

RESUMEN

BACKGROUND: Coronary heart disease (CHD) is the leading cause of deaths and disability worldwide. Cardiac rehabilitation (CR) effectively reduces the risk of future cardiac events and is strongly recommended in international clinical guidelines. However, CR program quality is highly variable with divergent data systems, which, when combined, potentially contribute to persistently low completion rates. The QUality Improvement in Cardiac Rehabilitation (QUICR) trial aims to determine whether a data-driven collaborative quality improvement intervention delivered at the program level over 12 months: (1) increases CR program completion in eligible patients with CHD (primary outcome), (2) reduces hospital admissions, emergency department presentations and deaths, and costs, (3) improves the proportion of patients receiving guideline-indicated CR according to national and international benchmarks, and (4) is feasible and sustainable for CR staff to implement routinely. METHODS: QUICR is a multi-centre, type-2, hybrid effectiveness-implementation cluster-randomized controlled trial (cRCT) with 12-month follow-up. Eligible CR programs (n = 40) and the individual patient data within them (n ~ 2,000) recruited from two Australian states (New South Wales and Victoria) are randomized 1:1 to the intervention (collaborative quality improvement intervention that uses data to identify and manage gaps in care) or control (usual care with data collection only). This sample size is required to achieve 80% power to detect a difference in completion rate of 22%. Outcomes will be assessed using intention-to-treat principles. Mixed-effects linear and logistic regression models accounting for clusters within allocated groupings will be applied to analyse primary and secondary outcomes. DISCUSSION: Addressing poor participation in CR by patients with CHD has been a longstanding challenge that needs innovative strategies to change the status-quo. This trial will harness the collaborative power of CR programs working simultaneously on common problem areas and using local data to drive performance. The use of data linkage for collection of outcomes offers an efficient way to evaluate this intervention and support the improvement of health service delivery. ETHICS: Primary ethical approval was obtained from the Northern Sydney Local Health District Human Research Ethics Committee (2023/ETH01093), along with site-specific governance approvals. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12623001239651 (30/11/2023) ( https://anzctr.org.au/Trial/Registration/TrialReview.aspx?id=386540&isReview=true ).


Asunto(s)
Rehabilitación Cardiaca , Estudios Multicéntricos como Asunto , Mejoramiento de la Calidad , Indicadores de Calidad de la Atención de Salud , Ensayos Clínicos Controlados Aleatorios como Asunto , Humanos , Mejoramiento de la Calidad/normas , Rehabilitación Cardiaca/normas , Resultado del Tratamiento , Factores de Tiempo , Indicadores de Calidad de la Atención de Salud/normas , Nueva Gales del Sur , Conducta Cooperativa , Victoria , Enfermedad Coronaria/rehabilitación , Enfermedad Coronaria/diagnóstico , Adhesión a Directriz/normas , Costos de la Atención en Salud
20.
Pharmazie ; 79(6): 124-128, 2024 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-38877679

RESUMEN

Fragility fractures associated with glucocorticoid-induced osteoporosis (GIO) can markedly impair quality of life. However, only 20% of patients are treated in compliance with the relevant management guidelines, and bone mineral density analysis with dual-energy X-ray absorptiometry (DXA) is only rarely performed. We report the intervention methods suggested by pharmacists and describe their efficacy. Patients who visited the outpatient clinic of the General Medicine Department of Ogaki Municipal Hospital and received steroids were enrolled. The rates of DXA implementation and compliance with GIO pharmacotherapy guidelines before and after pharmacist to physician-suggested interventions were compared. Guideline compliance was defined as prescription of osteoporosis drugs to patients with a score of ≥3. Administered prophylaxes and bone mineral density were subsequently assessed. The before and after intervention DXA rates were 1% (1/100 patients) and 96.0% (96/100 patients; P<0.01), respectively. Overall, 96.9% (93/96) of the patients met the GIO criteria for pharmacotherapy initiation (score ≥3), and the guideline compliance rates before and after the intervention were 39.8% (37/93) and 93.5% (87/93; P<0.01), respectively. Of the 56 patients who did not receive prophylaxis, 52 were recommended treatment, yielding an acceptance rate of 82.7% (43/52). Among the 37 patients receiving prophylaxis, 20 (54.1%) had a DXA-related young adult mean of ≤70%, of whom 11 (55.0%) agreed to drug therapy. The acceptance rate of pharmacotherapy recommendations for patients not receiving prophylaxis was higher than that for those receiving prophylaxis (P=0.03). Pharmacist-initiated interventions for GIO facilitates the administration of appropriate pharmacotherapy.


Asunto(s)
Absorciometría de Fotón , Conservadores de la Densidad Ósea , Densidad Ósea , Glucocorticoides , Adhesión a Directriz , Osteoporosis , Farmacéuticos , Humanos , Densidad Ósea/efectos de los fármacos , Osteoporosis/tratamiento farmacológico , Osteoporosis/prevención & control , Femenino , Masculino , Anciano , Glucocorticoides/administración & dosificación , Glucocorticoides/efectos adversos , Persona de Mediana Edad , Conservadores de la Densidad Ósea/administración & dosificación , Anciano de 80 o más Años , Adulto
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