Priorities for improving chemicals management in the WHO European Region—stakeholders’ views

Abstract Background Prevention of the impact of chemicals on human health and the environment is an increasing focus of public health polices and policy makers. The World Health Organization European Centre for Environment and Health wanted to know what were stakeholders’ priorities for improving chemicals management and prevention. Methods Semi-structured interviews were undertaken with 18 diverse stakeholders to answer this question. The interview questionnaire was developed using current WHO chemical meeting reports, the Evidence Implementation Model for Public Health Systems and categories of the theory of diffusion. Stakeholder views were attained on three main questions within the questionnaire. (i) What priority actions should be undertaken to minimize the negative impact of chemicals? (ii) Who needs to be more involved and what roles should they have? (iii) How can science and knowledge on chemicals and health be translated into policies more effectively and what are the greatest barriers to overcome? Results Cross cutting issues, such as legislation strengthening and enforcement, further collection of information, capacity building, education and awareness raising were considered priorities. The responders had the same vision on roles and responsibilities of different stakeholders. The greatest barrier to adoption, implementation and enforcement of evidence-based policies reported was leadership and political commitment to chemical safety. Conclusions Priorities raised differed depending on knowledge, professional background and type of stakeholder. Factors influencing priority identification at the national level include international and global context, availability of information, knowledge of the current situation and evidence-based good practice, and risks and priorities identified through national assessments.

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Modernisation of Higher Education – Willful Action or Wishful Thinking? The Case of Bulgaria

Педагогически форум ◽

10.15547/pf.2020.018 ◽

2020 ◽

Vol 8 (3) ◽

pp. 3-17

Author(s):

Elena Blagoeva

Keyword(s):

Higher Education ◽

Economic Crisis ◽

Negative Impact ◽

National Level ◽

Sustainable Growth ◽

Research Approach ◽

Case Study Methodology ◽

The Impact ◽

The Eu

The impact of the last global economic crisis (2008) on the European economy put a strain on higher education (HE), yet it also pushed the sector towards intensive reforms and improvements. This paper focuses on the “Strategy for the Development of Higher Education in the Republic of Bulgaria 2014-2020”. With a case study methodology, we explore the strategic endeavours of the Bulgarian government to comply with the European directions and to secure sustainable growth for the HE sector. Our research question is ‘How capable is the Bulgarian HE Strategy to overcome the economic and systemic restraints of Bulgarian higher education?’. Because the development of strategies for HE within the EU is highly contextual, a single qualitative case study was chosen as the research approach. HE institutions are not ivory towers, but subjects to a variety of external and internal forces. Within the EU, this is obviated by the fact that Universities obtain their funds from institutions such as governments, students and their families, donors, as well as EU-level programmes. Therefore, to explore how these pressures interact to affect strategic action on national level, the case method is well suited as it enabled us to study the phenomena thoroughly and deeply. The paper suggests the actions proposed within the Strategy have the potential to overcome the delay, the regional isolation and the negative impact of the economic crisis on the country. Nevertheless, the key elements on which the success or failure of this Strategy hinges are the control mechanisms and the approach to implementation. Shortcomings in these two aspects of strategic actions in HE seem to mark the difference between gaining long-term benefits and merely saving face in front of international institutions.

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Defining Preterm Birth and Stillbirth in the Western Pacific: A Systematic Review

Asia Pacific Journal of Public Health ◽

10.1177/10105395211026099 ◽

2021 ◽

pp. 101053952110260

Author(s):

Mairead Connolly ◽

Laura Phung ◽

Elise Farrington ◽

Michelle J. L. Scoullar ◽

Alyce N. Wilson ◽

...

Keyword(s):

Preterm Birth ◽

National Level ◽

Health Indicators ◽

Western Pacific ◽

World Health ◽

Middle Income ◽

Middle Income Countries ◽

Definition Of ◽

Health Organization ◽

The Impact

Preterm birth and stillbirth are important global perinatal health indicators. Definitions of these indicators can differ between countries, affecting comparability of preterm birth and stillbirth rates across countries. This study aimed to document national-level adherence to World Health Organization (WHO) definitions of preterm birth and stillbirth in the WHO Western Pacific region. A systematic search of government health websites and 4 electronic databases was conducted. Any official report or published study describing the national definition of preterm birth or stillbirth published between 2000 and 2020 was eligible for inclusion. A total of 58 data sources from 21 countries were identified. There was considerable variation in how preterm birth and stillbirth was defined across the region. The most frequently used lower gestational age threshold for viability of preterm birth was 28 weeks gestation (range 20-28 weeks), and stillbirth was most frequently classified from 20 weeks gestation (range 12-28 weeks). High-income countries more frequently used earlier gestational ages for preterm birth and stillbirth compared with low- to middle-income countries. The findings highlight the importance of clear, standardized, internationally comparable definitions for perinatal indicators. Further research is needed to determine the impact on regional preterm birth and stillbirth rates.

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The impact of COVID-19 on the care of people living with noncommunicable diseases in low- and middle-income countries: an online survey of physicians and pharmacists in nine countries

Primary Health Care Research & Development ◽

10.1017/s146342362100030x ◽

2021 ◽

Vol 22 ◽

Author(s):

Chris Bullen ◽

Jessica McCormack ◽

Amanda Calder ◽

Varsha Parag ◽

Kannan Subramaniam ◽

...

Keyword(s):

Public Health ◽

Healthcare Workers ◽

Online Survey ◽

World Health ◽

Noncommunicable Diseases ◽

Middle Income ◽

Middle Income Countries ◽

Health Measures ◽

The Impact ◽

Low And Middle Income

Abstract Background: The global COVID-19 pandemic has disrupted healthcare worldwide. In low- and middle-income countries (LMICs), where people may have limited access to affordable quality care, the COVID-19 pandemic has the potential to have a particularly adverse impact on the health and healthcare of individuals with noncommunicable diseases (NCDs). A World Health Organization survey found that disruption of delivery of healthcare for NCDs was more significant in LMICs than in high-income countries. However, the study did not elicit insights into the day-to-day impacts of COVID-19 on healthcare by front-line healthcare workers (FLHCWs). Aim: To gain insights directly from FLHCWs working in countries with a high NCD burden, and thereby identify opportunities to improve the provision of healthcare during the current pandemic and in future healthcare emergencies. Methods: We recruited selected frontline healthcare workers (general practitioners, pharmacists, and other medical specialists) from nine countries to complete an online survey (n = 1347). Survey questions focused on the impact of COVID-19 pandemic on clinical practice and NCDs; barriers to clinical care during the pandemic; and innovative responses to the many challenges presented by the pandemic. Findings: The majority of FLHCWs responding to our survey reported that their care of patients had been impacted both adversely and positively by the public health measures imposed. Most FLHCs (95%) reported a deterioration in the mental health of their patients. Conclusions: Continuity of care for NCDs as part of pandemic preparedness is needed so that chronic conditions are not exacerbated by public health measures and the direct impacts of the pandemic.

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Analyzing the Renewable Energy and CO2 Emission Levels Nexus at an EU Level: A Panel Data Regression Approach

Processes ◽

10.3390/pr9010130 ◽

2021 ◽

Vol 9 (1) ◽

pp. 130

Author(s):

Mihail Busu ◽

Alexandra Catalina Nedelcu

Keyword(s):

Renewable Energy ◽

Panel Data ◽

Co2 Emissions ◽

Co2 Emission ◽

Negative Impact ◽

National Level ◽

Renewable Energy Consumption ◽

Urbanization Level ◽

Carbon Dioxide Co2 ◽

The Impact

In the past decades, carbon dioxide (CO2) emissions have become an important issue for many researchers and policy makers. The focus of scientists and experts in the area is mainly on lowering the CO2 emission levels. In this article, panel data is analyzed with an econometric model, to estimate the impact of renewable energy, biofuels, bioenergy efficiency, population, and urbanization level on CO2 emissions in European Union (EU) countries. Our results underline the fact that urbanization level has a negative impact on increasing CO2 emissions, while biofuels, bioenergy production, and renewable energy consumption have positive and direct impacts on reducing CO2 emissions. Moreover, population growth and urbanization level are negatively correlated with CO2 emission levels. The authors’ findings suggest that the public policies at the national level must encourage the consumption of renewable energy and biofuels in the EU, while population and urbanization level should come along with more restrictions on CO2 emissions.

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Gender Differences in Association between Air Pollution and Daily Mortality in the Capital of the Green Lungs of Poland–Population-Based Study with 2,953,000 Person-Years of Follow-Up

Journal of Clinical Medicine ◽

10.3390/jcm9082351 ◽

2020 ◽

Vol 9 (8) ◽

pp. 2351

Author(s):

Łukasz Kuźma ◽

Krzysztof Struniawski ◽

Szymon Pogorzelski ◽

Hanna Bachórzewska-Gajewska ◽

Sławomir Dobrzycki

Keyword(s):

Public Health ◽

Gender Differences ◽

Air Pollution ◽

Air Quality ◽

Air Pollutant ◽

World Health ◽

The European Union ◽

Daily Mortality ◽

Male Population ◽

The Impact

(1) Introduction: air pollution is considered to be one of the main risk factors for public health. According to the European Environment Agency (EEA), air pollution contributes to the premature deaths of approximately 500,000 citizens of the European Union (EU), including almost 5000 inhabitants of Poland every year. (2) Purpose: to assess the gender differences in the impact of air pollution on the mortality in the population of the city of Bialystok—the capital of the Green Lungs of Poland. (3) Materials and Methods: based on the data from the Central Statistical Office, the number—and causes of death—of Białystok residents in the period 2008–2017 were analyzed. The study utilized the data recorded by the Provincial Inspectorate for Environmental Protection station and the Institute of Meteorology and Water Management during the analysis period. Time series regression with Poisson distribution was used in statistical analysis. (4) Results: A total of 34,005 deaths had been recorded, in which women accounted for 47.5%. The proportion of cardiovascular-related deaths was 48% (n = 16,370). An increase of SO2 concentration by 1-µg/m3 (relative risk (RR) 1.07, 95% confidence interval (CI) 1.02–1.12; p = 0.005) and a 10 °C decrease of temperature (RR 1.03, 95% CI 1.01–1.05; p = 0.005) were related to an increase in the number of daily deaths. No gender differences in the impact of air pollution on mortality were observed. In the analysis of the subgroup of cardiovascular deaths, the main pollutant that was found to have an effect on daily mortality was particulate matter with a diameter of 2.5 μm or less (PM2.5); the RR for 10-µg/m3 increase of PM2.5 was 1.07 (95% CI 1.02–1.12; p = 0.01), and this effect was noted only in the male population. (5) Conclusions: air quality and atmospheric conditions had an impact on the mortality of Bialystok residents. The main air pollutant that influenced the mortality rate was SO2, and there were no gender differences in the impact of this pollutant. In the male population, an increased exposure to PM2.5 concentration was associated with significantly higher cardiovascular mortality. These findings suggest that improving air quality, in particular, even with lower SO2 levels than currently allowed by the World Health Organization (WHO) guidelines, may benefit public health. Further studies on this topic are needed, but our results bring questions whether the recommendations concerning acceptable concentrations of air pollutants should be stricter, or is there a safe concentration of SO2 in the air at all.

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Whose Health in Whose City? A Systems Thinking Approach to Support and Evaluate Plans, Policies, and Strategies for Lasting Urban Health

Sustainability ◽

10.3390/su132112225 ◽

2021 ◽

Vol 13 (21) ◽

pp. 12225

Author(s):

Silvio Cristiano ◽

Samuele Zilio

Keyword(s):

Public Health ◽

Urban Planning ◽

Systems Thinking ◽

Urban Health ◽

Urban Governance ◽

Well Being ◽

World Health ◽

Urban Systems ◽

Health Issues ◽

The Impact

An increasing interest has been present in scientific literature and policy making for the links between urban environments and health, as also learnt from the COVID-19 pandemic. Collaboration between urban planning and public health is therefore critical for enhancing the capabilities of a city to promote the well-being of its people. However, what leverage potential for urban health can be found in existing plans, policies, and strategies that address urban health? Starting from the relationship between urban systems and health issues, the purpose of this contribution is to broaden the systemic knowledge of urban systems and health so as to try to figure out the impact potential of local urban governance on public health. Considering the systemic nature of health issues, as defined by the World Health Organisation, this is done through a systems thinking epistemological approach. Urban health proposals are studied and assessed in four European cities (Copenhagen, London, Berlin, and Vienna). Current criticalities are found, starting from the guiding goal of such proposals, yet a systemic approach is suggested aimed at supporting and evaluating lasting and healthy urban planning and management strategies.

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The challenge of bringing evidence in decision-making for public health emergencies: can preparedness reach out to HTA?

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.942 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

C E Chronaki ◽

A Miglietta

Keyword(s):

Public Health ◽

Decision Making ◽

Policy Development ◽

Digital Health ◽

Resource Planning ◽

Public Health Emergency ◽

Evidence Based ◽

Public Health Emergencies ◽

The Impact ◽

Evidence Based Decision Making

Abstract Evidence-based decision-making is central to public health. Implementing evidence-informed actions is most challenging during a public health emergency as in an epidemic, when time is limited, scientific uncertainties and political pressures tend to be high, and reliable data is typically lacking. The process of including data for preparedness and training for evidence-based decision making in public health emergencies is not systematic and is complicated by many barriers as the absence of common digital tools and approaches for resource planning and update of response plans. Health Technology Assessment (HTA) is used with the aim to improve the quality and efficiency of public health interventions and to make healthcare systems more sustainable. Many of today's public health crises are also cross-border, and countries need to collaborate in a systematic and standardized way in order to enhance interoperability to share data and to plan coordinated response. Digital health tools have an important role to play in this setting, facilitating use of knowledge about the population that can potentially affected by the crisis within and across regional and national borders. To strengthen the impact of scientific evidence on decision-making for public health emergency preparedness and response, it is necessary to better define and align mechanisms through which interdisciplinary evidence feeds into decision-making processes during public health emergencies and the context in which these mechanisms operate. Activities and policy development in the HTA network could inform this process. The objective of this presentation is to identify barriers for evidence-based decision making during public health emergencies and discuss how standardization in digital health and HTA processes may help overcome these barriers leading to more effective coordinated and evidence-based public health emergency response.

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The Impact of the COVID-19 Pandemic on Antibiotic Prescribing Trends in Outpatient Care: A Nationwide, Quasi-Experimental Approach

Antibiotics ◽

10.3390/antibiotics10091040 ◽

2021 ◽

Vol 10 (9) ◽

pp. 1040

Author(s):

Tânia Magalhães Silva ◽

Marta Estrela ◽

Eva Rebelo Gomes ◽

Maria Piñeiro-Lamas ◽

Adolfo Figueiras ◽

...

Keyword(s):

Public Health ◽

Outpatient Care ◽

Experimental Approach ◽

National Level ◽

Series Data ◽

Antibiotic Prescribing ◽

Prescribing Trends ◽

Quasi Experimental ◽

The Impact

Coronavirus disease 2019 (COVID-19) has spread globally and is currently having a damaging impact on nearly all countries in the world. The implementation of stringent measures to stop COVID-19 dissemination had an influence on healthcare services and associated procedures, possibly causing antibiotic consumption fluctuations. This paper aims to evaluate the immediate and long-term impact of the COVID-19 pandemic on antibiotic prescribing trends in outpatient care of the Portuguese public health sector, including in primary healthcare centers and hospitals, as well as on specific antibiotic groups known to be closely associated with increased resistance. Segmented regression analysis with interrupted time series data was used to analyze whether the COVID-19 pandemic had an impact in antibiotic prescribing tendencies at a national level. The outcomes from this quasi-experimental approach demonstrate that, at the beginning of the pandemic, a significant, immediate decrease in the overall antibiotic prescribing trends was noticed in the context of outpatient care in Portugal, followed by a statistically non-significant fall over the long term. The data also showed a significant reduction in the prescription of particular antibiotic classes (antibiotics from the Watch group, 3rd-generation cephalosporins, fluoroquinolones, and clarithromycin) upon COVID-19 emergence. These findings revealed an important disruption in antibiotics prescribing caused by the current public health emergency.

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ANALISIS HUBUNGAN SALURAN TEGANGAN TINGGI LISTRIK TERHADAP JARINGAN SELULAR DI DAERAH GRAHA INDAH TAMBAKBOYO LAMONGAN

JOUTICA ◽

10.30736/jti.v4i2.338 ◽

2019 ◽

Vol 4 (2) ◽

pp. 255

Author(s):

Kemal Farouq Mauladi ◽

Nurul Fuad

Keyword(s):

Public Health ◽

Magnetic Fields ◽

Electric Field ◽

Cellular Networks ◽

Electromagnetic Fields ◽

Electricity Generation ◽

Negative Impact ◽

Electrical Energy ◽

Electric And Magnetic Fields ◽

The Impact

Telecommunications technology is developing very rapidly, ranging from users or engineers. The development of smartphone smartphones is also increasingly in demand, so that the use of electricity needs is also increasing. The need for electricity usage has resulted in more standing voltage in some settlements. The establishment of sutet will have a negative impact on public health. In addition, the influence of electrical energy on humans occurs because the electrical energy generated by electricity generation or electricity that is channeled gives rise to electromagnetic fields. The higher the voltage required by an equipment, the greater the electric field that is distributed. Besides that, it can also find ways to reduce the negative impact of the electric and magnetic fields produced by SUTET which impacts the process of the occurrence of electric and magnetic fields on SUTET. From the problems above, the author intends to determine the effect or correlation between the impact of SUTET on cellphone network transmissions or channels. This research can later determine the negative impact caused by SUTET for the surrounding community, and the impact of SUTET radiation on cellular networks.

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Evaluation of whole genome sequencing for the identification and typing of Vibrio cholerae

10.1101/327973 ◽

2018 ◽

Author(s):

David R. Greig ◽

Ulf Schafer ◽

Sophie Octavia ◽

Ebony Hunter ◽

Marie A. Chattaway ◽

...

Keyword(s):

Public Health ◽

Whole Genome Sequencing ◽

Vibrio Cholerae ◽

Species Identification ◽

Genome Sequencing ◽

National Level ◽

Whole Genome ◽

Surveillance Programs ◽

El Tor ◽

The Impact

AbstractEpidemiological and microbiological data on Vibrio cholerae isolated between 2004 and 2017 (n=836) and held in the Public Health England culture archive were reviewed. The traditional biochemical species identification and serological typing results were compared with the genome derived species identification and serotype for a sub-set of isolates (n=152). Of the 836 isolates, 750 (89.7%) were from faecal specimens, 206 (24.6%) belonged to serogroup O1 and seven (0.8%) were serogroup O139, and 792 (94.7%) isolates from patients reporting recent travel abroad, most commonly to India (n=209) and Pakistan (n=104). Of the 152 isolates of V. cholerae speciated by kmer identification, 149 (98.1%) were concordant with the traditional biochemical approach. Traditional serotyping results were 100% concordant with the whole genome sequencing (WGS) analysis for identification of serogroups O1 and O139 and Classical and El Tor biotypes. ctxA was detected in all isolates of V. cholerae O1 El Tor and O139 belonging to sequence type (ST) 69, and in V. cholerae O1 Classical variants belonging to ST73. A phylogeny of isolates belonging to ST69 from UK travellers clustered geographically, with isolates from India and Pakistan located on separate branches. Moving forward, WGS data from UK travellers will contribute to global surveillance programs, and the monitoring of emerging threats to public health and the global dissemination of pathogenic lineages. At the national level, these WGS data will inform the timely reinforcement of direct public health messaging to travellers and mitigate the impact of imported infections and the associated risks to public health.

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