A public health framework to translate risk factors related to political violence and war into multi-level preventive interventions

2010 ◽  
Vol 70 (1) ◽  
pp. 71-79 ◽  
Author(s):  
Joop T.V.M. De Jong
Author(s):  
Nina van der Vliet ◽  
Anita W.M. Suijkerbuijk ◽  
Adriana T. de Blaeij ◽  
G. Ardine de Wit ◽  
Paul F. van Gils ◽  
...  

It is widely acknowledged that in order to promote public health and prevent diseases, a wide range of scientific disciplines and sectors beyond the health sector need to be involved. Evidence-based interventions, beyond preventive health interventions targeting disease risk factors and interventions from other sectors, should be developed and implemented. Investing in these preventive health policies is challenging as budgets have to compete with other governmental expenditures. The current study aimed to identify, compare and rank cost-effective preventive interventions targeting metabolic, environmental, occupational and behavioral risk factors. To identify these interventions, a literature search was performed including original full economic evaluations of Western country interventions that had not yet been implemented in the Netherlands. Several workshops were held with experts from different disciplines. In total, 51 different interventions (including 13 cost saving interventions) were identified and ranked based on their incremental cost-effectiveness ratio (ICER) and potential averted disability-adjusted life years (DALYs), resulting in two rankings of the most cost-effective interventions and one ranking of the 13 cost saving interventions. This approach, resulting in an intersectoral ranking, can assist policy makers in implementing cost-effective preventive action that considers not only the health sector, but also other sectors.


Crisis ◽  
1999 ◽  
Vol 20 (1) ◽  
pp. 28-35 ◽  
Author(s):  
Annie Mino ◽  
Arnaud Bousquet ◽  
Barbara Broers

The high mortality rate among drug users, which is partly due to the HIV epidemic and partly due to drug-related accidental deaths and suicides, presents a major public health problem. Knowing more about prevalence, incidence, and risk factors is important for the development of rational preventive and therapeutic programs. This article attempts to give an overview of studies of the relations between substance abuse, suicidal ideation, suicide, and drug-related death. Research in this field is hampered by the absence of clear definitions, and results of studies are rarely comparable. There is, however, consensus about suicidal ideation being a risk factor for suicide attempts and suicide. Suicidal ideation is also a predictor of suicide, especially among drug users. It is correlated with an absence of family support, with the severity of the psychosocial dysfunctioning, and with multi-drug abuse, but also with requests for treatment. Every clinical examination of a drug user, not only of those who are depressed, should address the possible presence of suicidal ideation, as well as its intensity and duration.


2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Le Chang ◽  
Wangheng Hou ◽  
Lei Zhao ◽  
Yali Zhang ◽  
Yanbin Wang ◽  
...  

AbstractIn this study, we investigate the seroprevalence of SARS-CoV-2 antibodies among blood donors in the cities of Wuhan, Shenzhen, and Shijiazhuang in China. From January to April 2020, 38,144 healthy blood donors in the three cities were tested for total antibody against SARS-CoV-2 followed by pseudotype SARS-CoV-2 neutralization tests, IgG, and IgM antibody testing. Finally, a total of 398 donors were confirmed positive. The age- and sex-standardized SARS-CoV-2 seroprevalence among 18–60 year-old adults (18–65 year-old in Shenzhen) was 2.66% (95% CI: 2.24%–3.07%) in Wuhan, 0.033% (95% CI: 0.0029%–0.267%) in Shenzhen, and 0.0028% (95% CI: 0.0001%–0.158%) in Shijiazhuang, respectively. Female sex and older-age were identified to be independent risk factors for SARS-CoV-2 seropositivity among blood donors in Wuhan. As most of the population of China remained uninfected during the early wave of the COVID-19 pandemic, effective public health measures are still certainly required to block viral spread before a vaccine is widely available.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
◽  

Abstract Autism is a set of heterogeneous neurodevelopmental conditions, characterised by early-onset difficulties in social communication and restricted, repetitive behaviour and interests. The worldwide population prevalence is about 1% with an increasing incidence and prevalence rates. Autism affects more male than female individuals, and comorbidity is common (>70% have concurrent conditions). Determinants of these changes in incidence and prevalence rates may also be related to exposure to environmental factors and to modifications in diagnostic concepts and criteria. In spite of the uncertainty in determinants of incidence of autisms, there is evidence that environmental characteristics play a significant role both as autism risk factors and as potential obstacles that influence the capabilities of autonomously and fully “using” everyday spaces. The workshop aims to provide a framework on risk factors of autism and explore the relationship with the built environment, focusing on the quality of the everyday spaces and projecting the effects that it could have in the long term on achieving a desirable level of quality of life. The 11th Sustainable Development Goals of United Nations “Make cities inclusive, safe, resilient and sustainable” underlines the necessity of designing policies and projects acting to enhance and promote healthy cities and communities by addressing the needs of the most vulnerable groups of inhabitants. Herewith we bring together the discipline of Public Health and Urban Design to promote an interdisciplinary debate on a little explored topic investigating how the approaches adopted during childhood to promote the wellbeing of people with ASD can be related or strengthen by focusing also on built environment design intervention to pursue and reach the same objectives even during adulthood. The workshop will consist of four presentations. The first focuses on giving an overview on current knowledge of intervention for people with autism, presenting also criteria for evidence-based interventions. The second explores the relationship between autism and built environment by providing an exhaustive framework of the available research literature in order to identify a first set of spatial requirements for autism friendly cities. The third examines the impact of built environment on ASD users with the aim of developing a specific evaluation tool for healthcare spaces and best practices formulation according to the specific sensorial hypo- or hyper-activation of people with autism. Finally, the fourth reports the results of a two years Research & Development project called “GAP REDUCE” finalized at developing an Assistive Technology tool to support people with ASD, adult and high-functioning, to plan urban itineraries towards daily destinations. Key messages World's incidence of autism is about 1% with an increasing incidence whose determining rates may also be related to environmental factors and to modifications in diagnostic concepts and criteria. Environmental characteristics play a significant role also as potential obstacles that influence the capabilities of people with autism of autonomously and fully “using” everyday spaces.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Poggio Rosana ◽  
Goodarz Danaei ◽  
Laura Gutierrez ◽  
Ana Cavallo ◽  
María Victoria Lopez ◽  
...  

Abstract Background The effective management of cardiovascular (CVD) prevention among the population with exclusive public health coverage in Argentina is low since less than 30% of the individuals with predicted 10-year CVD risk ≥10% attend a clinical visit for CVD risk factors control in the primary care clinics (PCCs). Methods We conducted a non-controlled feasibility study using a mixed methods approach to evaluate acceptability, adoption and fidelity of a multi-component intervention implemented in the public healthcare system. The eligibility criteria were having exclusive public health coverage, age ≥ 40 years, residence in the PCC’s catchment area and 10-year CVD risk ≥10%. The multi-component intervention addressed (1) system barriers through task shifting among the PCC’s staff, protected medical appointments slots and a new CVD form and (2) Provider barriers through training for primary care physicians and CHW and individual barriers through a home-based intervention delivered by community health workers (CHWs). Results A total of 185 participants were included in the study. Of the total number of eligible participants, 82.2% attended at least one clinical visit for risk factor control. Physicians intensified drug treatment in 77% of participants with BP ≥140/90 mmHg and 79.5% of participants with diabetes, increased the proportion of participants treated according to GCP from 21 to 32.6% in hypertensive participants, 7.4 to 33.3% in high CVD risk and 1.4 to 8.7% in very high CVD risk groups. Mean systolic and diastolic blood pressure were lower at the end of follow up (156.9 to 145.4 mmHg and 92.9 to 88.9 mmHg, respectively) and control of hypertension (BP < 140/90 mmHg) increased from 20.3 to 35.5%. Conclusion The proposed CHWs-led intervention was feasible and well accepted to improve the detection and treatment of risk factors in the poor population with exclusive public health coverage and with moderate or high CVD risk at the primary care setting in Argentina. Task sharing activities with CHWs did not only stimulate teamwork among PCC staff, but it also improved quality of care. This study showed that community health workers could have a more active role in the detection and clinical management of CVD risk factors in low-income communities.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
V Bellisario ◽  
R Bono ◽  
G Squillacioti ◽  
M Caputo ◽  
I Gintoli ◽  
...  

Abstract Background Childhood obesity is an important public health issue worldwide and includes different risk factors, such as environmental pollutants exposure or physical activity. Neighborhood composition and green spaces availability could contrast obesogenic lifestyles and promote healthy habits, whereas, urbanization and traffic volume exposure are inversely associated with physical activity and worsen effects on childhood health. Methods This project analyzed students involved in the HBSC survey from the Piedmont Region. Data were collected in 2018, following the protocol. All the subjects were georeferenced within buffers around schools. Green-spaces availability was measured by Normalised Difference Vegetation Index (NDVI-satellite images) while urbanization was calculated by population density, traffic intensity (satellite measurements) and air pollution concentration (sampling stations). Results Overall, the sample included 3022 subjects, with amount 50% male/female and 30% for each age group (11-13-15 years old). Concerning weight status, above 14% of the all sample is obese or overweight, with, respectively, 20% among boys and 11% among girls. Preliminary analyses showed an association between weight status and population density (rural vs urbanized areas). Currently, we are analyzing the association with greenness and the other measures of urbanization. Conclusions Our preliminary findings suggest that high urbanization levels impact health implementing weight in children. We are testing the hypothesis that greenness positively influences weight status and reduce negative effects of urbanization and air pollution. The managing of these risk factors must be deepened and corroborated by active preventive Public Health strategies for improving children health. Key messages Urbanization and greenness may influence weight status in children. Public Health strategies must be improved for children health.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
M. Flook ◽  
C. Jackson ◽  
E. Vasileiou ◽  
C. R. Simpson ◽  
M. D. Muckian ◽  
...  

Abstract Background Severe Acute Respiratory Syndrome coronavirus-2 (SARS-CoV-2) has challenged public health agencies globally. In order to effectively target government responses, it is critical to identify the individuals most at risk of coronavirus disease-19 (COVID-19), developing severe clinical signs, and mortality. We undertook a systematic review of the literature to present the current status of scientific knowledge in these areas and describe the need for unified global approaches, moving forwards, as well as lessons learnt for future pandemics. Methods Medline, Embase and Global Health were searched to the end of April 2020, as well as the Web of Science. Search terms were specific to the SARS-CoV-2 virus and COVID-19. Comparative studies of risk factors from any setting, population group and in any language were included. Titles, abstracts and full texts were screened by two reviewers and extracted in duplicate into a standardised form. Data were extracted on risk factors for COVID-19 disease, severe disease, or death and were narratively and descriptively synthesised. Results One thousand two hundred and thirty-eight papers were identified post-deduplication. Thirty-three met our inclusion criteria, of which 26 were from China. Six assessed the risk of contracting the disease, 20 the risk of having severe disease and ten the risk of dying. Age, gender and co-morbidities were commonly assessed as risk factors. The weight of evidence showed increasing age to be associated with severe disease and mortality, and general comorbidities with mortality. Only seven studies presented multivariable analyses and power was generally limited. A wide range of definitions were used for disease severity. Conclusions The volume of literature generated in the short time since the appearance of SARS-CoV-2 has been considerable. Many studies have sought to document the risk factors for COVID-19 disease, disease severity and mortality; age was the only risk factor based on robust studies and with a consistent body of evidence. Mechanistic studies are required to understand why age is such an important risk factor. At the start of pandemics, large, standardised, studies that use multivariable analyses are urgently needed so that the populations most at risk can be rapidly protected. Registration This review was registered on PROSPERO as CRD42020177714.


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